Study and Monitoring the Prevalence of Asthma among School Children in Gaborone, Botswana

Background: Asthma prevalence is high (> 10%) in developed countries, and while data for most of Africa is still lacking, rates in developing countries are rising as they become more westernized. Asthma is the world’s 14th most important chronic disease in terms of prevalence, extent, and duration of disability, affecting 334 million people of all ages. The prevalence in Africa has been reported to range from 18% in Kenya to 20% in South Africa. In Gaborone, Botswana, we investigated the prevalence of asthma in schoolchildren. Methods: This was a cross-sectional descriptive study. The ISAAC method was used. A proportionate size random sample of two age groups of children (13-14 year olds and 6-7 year olds) was systematically enrolled in ten schools. The schools were chosen using a table of random numbers. A sample size of 924 people (462 from each group) was sufficient to achieve a precision of 3% around our estimated prevalence of asthma of 10% with 95% confidence, assuming a 20% non-response rate. The International Study of Childhood Asthma and Allergies (ISAAC) A questionnaire was used to collect data. Asthma was defined by the ISAAC criteria as wheezing in the previous 12 months. The data was entered into Microsoft Excel and then analyzed with SPSS version 23. Results: Asthma (wheezing in the previous 12 months) was present in 16.5 percent (194/1175) of the participants. Asthma (wheezing in the previous 12 months) was found in 15.9 percent of 6-7 year olds and 16.8 percent of 13-14 year olds. The prevalence of school type was 22.3 percent in private schools and 14.5 percent in public schools. Asthma severity was associated with older children, 13-14 years old. When compared to the younger children 6-7 years, the older children reported more limited speech due to wheezing (OR=2.0, 95 percent CI =1.034, 3.9, pvalue=0.043), ever had asthma (OR=1.5, 95 percent CI=1.031, 2.3, p-value=0.034), and wheezing during exercise (OR=3.4, 95 percent CI=2.5, 4.9, p-value=0.001). Students in private schools had more wheezing symptoms. They were more likely to have ever wheezed (OR=2.2, 95 percent CI=1.7,2.9, p-value 0.0001), wheezed in the previous twelve months (have asthma) (OR=1.7, 95 percent CI=1.2,2.4, p-value = 0.001), ever had asthma (OR=2.4, 95 percent CI=1.7,3.5, p-value 0.0001), and wheezed during exercise (OR=1.8, 95 percent CI=1.4,

Conclusion: Asthma is very common among Gaborone, Botswana, schoolchildren, with older children experiencing more severe asthma symptoms. Private schools had a higher prevalence of asthma than public schools. More research is needed in Botswana to investigate the prevalence of asthma in rural and urban areas.

Author(s) Details

Andrew Kiboneka
Department of Paediatrics & Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.

Michael Levin
Allergy Division, Department of Paediatrics & Child Health, University of Cape Town and Red Cross Memorial Children’s Hospital, South Africa.

Thembisile Mo salakatane
Department of Paediatrics & Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.

Ishmael Makone
Department of Paediatrics & Adolescent Health, Princess Marina Hospital, Gaborone, Botswana.

Eric Wobudeya
Directorate of Paediatrics & Child Health, Mulago National Referral Hospital, Kampala, Uganda.

Boikanyo Makubate
Department of Mathematics & Computational Sciences, Botswana International University of Science & Technology Palapye, Botswana.

Russell Hopp
Division of Allergy/Immunology, Creighton University Medical Centre, Omaha, Nebraska, USA.

Loeto Mazhani
Department of Paediatrics & Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.

Shiang-Ju Kung
Division of Allergy & Immunology, Children’s Hospital of Philadelphia, Pennsylvania, USA.

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