Factors that influence adequacy of asthma control in children residing in Naivasha, a flower growing area in Kenya

Abstract

Background: In Kenya, asthma affects 10% of the population. One of the modifiable risk factors contributing to asthma morbidity and mortality is environmental exposure. Naivasha flower farms introduce pesticides persistently into the environment and these may drift onto residential property or other areas where children play. Proximity of households to the pesticide treated farms may also increase exposure of children to the pesticides. Pesticide exposure has been shown to exacerbate already existing asthma, a relationship that has not been studied in Kenya.

Objectives: To identify risk factors that exacerbate asthma and influence adequacy of Asthma control in children residing in a flower growing area in Kenya.

Methodology: The design was a cross-sectional study that involved 150 asthmatic children aged 5-12 years residing a flower growing area. The study was conducted between May and July, 2014 in Naivasha, which is home to Kenya’s largest horticultural flower farms. Participants were interviewed using a structured questionnaire while asthma control was measured using a validated Asthma control tool. Logistic regression was done to identify variables that affected asthma control.

Results: Majority of the asthmatic children were males (56.7%) while females were 43.33%. Risk factors that were found to be significantly associated with asthma control were; duration of stay in or near a flower farm (OR = 0.723, 95%CI (0.538-0.975), presence of a smoker in the family (OR = 0.463, 95%CI (0.094-22.629) and presence of household pet (OR = 4.358, 95%CI (1.182-16.057). There was no significant relationship between the child’s asthma control and age of child, sex of child, distance of school from flower, guardian’s level of education, guardian’s income, and guardian’s occupation as a flower farm worker, child’s age of diagnosis and use of indoor pesticides.

Conclusion: The use of Integrated Pest Management (IPM) should be promoted as it keeps environmental exposure pesticides to a minimum.