Childhood bronchial asthma:Effects of passive smoking and breastfeeding on age at onset and severity
Abstract
Bronchial asthma is a disease characterized by hyper-reactivity of
respiratory airways to gaseous and particulate matter in the air.
cigarette smoke is an important source of indoor air pollution and
an increased rate of bronchitis and pneumonia in children of
smokers is well documented. The association between bronchial
asthma and passive smoking is not well defined. Although breast
milk is known to protect against respiratory infections, the
association between breast-feeding and asthma is not well
described. It was with these unanswered questions in mind that
this study was carried out.
objectives
The obj ecti ves of the study were to determine the effects of
passi ve smoking and breast-feeding upon the age of onset and
severity of bronchial asthma in children.
Materials and methods
A case control study was carried out at Kenyatta National Hospital,
Nairobi, between December 31st 1992 and April 27th 1993 on 450
children aged between 1 and 120 months. Children with bronchial
asthma were matched by age to two different groups of controls in t
a 1:1 ratio. Cases and controls were subjected to a standardized
questionnaire to gather information on age at onset of wheezing,
frequency of asthmatic attacks; duration of breast-feeding and
history of cigarette smoking in the family.
Results
There was a significant association between passive smoking and
onset of bronchial asthma in the first year of life, OR=3.5
(95% C.I. ~.4, 8.7), P=O.004. There also appeared to be a
significant association between passive smoking and asthma
severity. No association was found between breast-feeding and age
at onset of asthma, but exclusive breast-feeding significantly
reduced chances of developing severe forms of bronchial asthma,
O.R.=0.37 (95% C.I. 0.14, 0.98, x2=4.62, p=0.05.
Conclusions and recommendations
Passive smoking predisposes not only to early onset of bronchial /
asthma, but possibly also to more severe forms of the disease. This
study has found that breast-feeding appears to be protective
against severe forms of asthma.
It is strongly recommended that young children should not be
exposed to cigarette smoke. A prospective study is recommended for
further evaluation of the association between breast-feeding and
severity of bronchial asthma in childhood .
Citation
Degree of Master of Medicine in Paediatrics at the University of NairobiPublisher
University of Nairobi Department of Paediatrics and child Health
Description
A dissertation presented as part of the fulfillment for the Degree
of Master of Medicine in Paediatrics at the University of Nairobi