Identification of the risk factors and management of asthma among children in naivasha, Kenya

Abstract

Background: In Kenya, asthma affects 10% of the population. Major factors contributing to asthma morbidity and mortality are environmental exposures to risk factors, under diagnosis and under treatment. Most asthma exacerbations can be prevented if management is comprehensive. Poorly managed asthma leads to emergency treatment and hospitalization, which are much more costly for patients than effectively managed treatment. Study objective: The study’s objective was to evaluate the risk factors and management of asthma among children aged 5-12 years in Naivasha District. Study Design: The study was ahospital-based cross-sectional study. Study Population: The study population was composed of 150 Children aged 5-12years diagnosed with asthma in Naivasha District. Methodology: Purposeful sampling of children diagnosed with asthma, aged 5-12yrs old attending Naivasha District Hospital, Karagita Dispensary and Finlay Hospitals was done to enroll 150 children into the study. Questionnaires were administered to caregivers of children diagnosed with asthma. In addition, the prescriptions were examined to check for clinician’s drug prescribing patterns. Data was analyzed using stata version 12 and the results summarized in tables. Inferential and descriptive statistics was derived by using P values and confidence intervals. Results: Factors that were found to be significantly associated with asthma control were; duration of stay in or near a flower farm, presence of a smoker in the family and presence of household pet. Conditional logistic regression models were fitted to estimate odds ratio and 95% confidence intervals (CI). Uncontrolled asthma was associated with presence of a smoker in the household(OR= 0.46; 95% CI, 0.095-22.629), presence of household pets( OR= 4.36; 95% CI, 1.182-16.057) and duration of stay near a pesticide treated farm(OR=0.72; 95% CI, 0.05380.975).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. In addition, asthma management was not in line with the national guidelines resulting in suboptimal therapy. Conclusion: Inconclusion, environmental pollutants are risk factors to asthma control.The factors that had a strong association to asthma control were environmental tobacco smoke (p=0.008),duration of stay near a pesticide treated flower farm (p=0.022) and presence of household pets (P=0.009).Under utilization of the national asthma guidelines also contributed to poor asthma treatment outcomes. Recommendations: This study was a cross sectional. We therefore recommend that a case control study be carried out using these study findings as a baseline to determine the strength of association between the risk factors and asthma control.