Prevalence of asthma, rhinitis and eczema among schoolchildren in Kelantan, Malaysia

ARIA Care Pathways 2019: Next-Generation Allergic Rhinitis Care and Allergen Immunotherapy in Malaysia

An increase in the prevalence of allergic rhinitis (AR) worldwide presents a significant burden to the health care system. An initiative was started in Europe designated as Allergic Rhinitis and Its Impact on Asthma (ARIA) to develop internationally applicable guidelines by utilising an evidence-based approach to address this crucial issue. The efforts are directed at empowerment of patients for self-management, the use of digital mobile technology to complement and personalise treatment, and establishment of real-life integrated care pathways (ICPs). This guideline includes aspects of patients' and health care providers' management and covers the main areas of treatment for AR. The model provides better real-life health care than the previous traditional models. This review summarises the ARIA next-generation guideline in the context of the Malaysian health care system.

The effect of mobile applications in enhancing asthma knowledge among school children with asthma in Malaysia

PURPOSE

This study set out to evaluate the impact of health education provided on mobile applications (app) to urban-living school children with asthma in Malaysia to improve their asthma-related knowledge.

DESIGN AND METHODS

This was a quasi-experimental study with pre-and post-intervention involving 214 respondents from six schools were selected randomly and assigned to the experimental and control groups. The intervention, i.e. the health education via mobile apps was given to the experimental group while the control group received the routine face-to-face education.

RESULTS

The mean knowledge score increased post-intervention in the experimental group from 15.5 ± 8.77 to 24.6 ± 6.69. Children with a moderate level of knowledge accounted for the biggest proportion in both group control and experimental groups in the pre-intervention stage. In contrast, the proportion of children with a high level of knowledge was the highest in the experimental group post-intervention. Therefore, health education delivered via mobile apps led to a statistically significant improvement in the asthma knowledge of the children (F [1, 288] = 22.940, p ≤0.01).

CONCLUSION

Compared to the conventional face-to-face education methods of lectures or handbooks, mobile technology is more effective in delivering health education and improving the knowledge of school children with asthma. Therefore, educational modules aimed at improving knowledge should be modified to incorporate mobile apps.

PRACTICE IMPLICATIONS

Health education via mobile applications is considered a great innovation in school children with asthma education, or as a supplement to conventional learning methods. It is necessary to place health education via mobile applications as a prominent learning strategy for school children with asthma.

Prevalence of asthma-like symptoms and assessment of lung function in schoolchildren born with low birth weight

INTRODUCTION

This study aimed to determine the prevalence of asthma-like symptoms among schoolchildren with low birth weight (LBW), and to compare the lung function of these children with that of children with normal birth weight.

METHODS

This was a comparative cross-sectional study. We recruited children aged 8-11 years from eight primary schools in Kota Bharu, Kelantan, Malaysia. The children were divided into two groups: those with LBW (< 2,500 g) and those with normal birth weight (≥ 2,500 g). Parents of the enrolled children were asked to complete a translated version of the International Study of Asthma and Allergies in Childhood questionnaire. Lung function tests, done using a MicroLoop Spirometer, were performed for the children in both groups by a single investigator who was blinded to the children's birth weight.

RESULTS

The prevalence of 'ever wheezed' among the children with LBW was 12.9%. This value was significantly higher than that of the children with normal birth weight (7.8%). Forced vital capacity (FVC), forced expiratory volume in one second, and forced expiratory flow when 50% and 75% of the FVC had been exhaled were significantly lower among the children with LBW as compared to the children with normal birth weight.

CONCLUSION

LBW is associated with an increased prevalence of asthma-like symptoms and impaired lung function indices later in life. Children born with LBW may need additional follow-up so that future respiratory problems can be detected early.

Clinical Features of Allergic Rhinitis and Skin Prick Test Analysis Based on the ARIA Classification: A Preliminary Study in Malaysia

Introduction: Allergic rhinitis (AR) is a prevalent disease worldwide but is still underdiagnosed in many parts of Asia. We studied the clinical profiles of AR patients in our community based on the new ARIA classification and investigated the aetiological allergens using a skin prick test. Materials and Methods: In 2008, 142 newly diagnosed patients with AR were seen and underwent skin prick testing with 90 patients completing the study. Results: Intermittent mild and moderate/severe AR were evident in 10% and 21.1% of the patients, while persistent mild and moderate/severe were seen in 20% and 48.9%, respectively. Rhinitis and asthma co-morbidity occurred in 28.8% with asthma incidence significantly higher in persistent AR (P = 0.002). There was no significant association between AR severity, city living and asthma co-morbidity. Nasal itchiness and sneezing were the main presenting complaints and were more common in intermittent AR (P <0.05). Sleep disturbance was associated with moderate-severe AR (P <0.05). Polypoidal mucosa was associated with asthma co-morbidity (P <0.05). Mono sensitivity reaction occurred in 12.2% of patients and was associated with fungi sensitivity (P<0.05). Majority of patients were oligosensitive (52.8%) and polysensitive (34.4%) and were significantly associated with moderate-severe persistent AR (P <0.01). The highest positive skin prick reaction and the largest average wheal diameter were for the house dust mites and cat allergen (P <0.05). Conclusion: Our results reflected the AR profiles in our country, which was comparable with typical profiles of the neighbouring country and other Mediterranean countries with a similar temperate climate. Key words: Allergic rhinitis, ARIA classification, Malaysia, Skin prick test

Atopy: pediatric ENT manifestations in children

OBJECTIVE

The aim of the present study is to discuss the basics of atopy in children in relationship to the principal ENT allergic disorders such as allergic rhinitis, rhinosinusitis and their impact on lower airways, allergic otitis media, and oral cavity focusing on their natural history.

METHODS

An updated and exhaustive review of principal literature on these topics is performed, underlining the constant but growing interest evoked by these disorders most of all the possible sequelae or complications. Considering the different districts which can be selectively or simultaneously affected by the allergic sensitisation, diagnosis can be a really hard task; in this paper, we tried to draw an integrated diagnostic approach to atopic children and some guidelines for a correct therapeutic approach.

CONCLUSIONS

Atopic disorders could expose young patients to years of chronic diseases that interferes with their development and with many important aspects of their lives. For these reasons, and considering the high social and medical costs of this disease, it is extremely important to adequately treat allergic pathologies from the early phases of its natural history. Moreover, we cannot forget that an appropriate therapy of allergic pathologies should not be only able to decrease symptoms but, it should also be able to improve patients health related quality of life.

Prevalence of asthma, eczema and allergic rhinitis: two surveys, 6 years apart, in Kota Bharu, Malaysia

OBJECTIVE

This study was undertaken to determine the prevalence of asthma, eczema, and allergic rhinitis in school children in Kota Bharu, Malaysia, and in so doing to determine the differences in symptom prevalence rates of asthma, and atopic diseases in Kota Bharu school children between 1995 and 2001.

METHODOLOGY

In two studies (1995 and 2001), year one primary school (PS) pupils (6-7 years old) and secondary school (SS) year two pupils (13-14 years old) were randomly selected from the district of Kota Bharu, Kelantan, Malaysia. In 1995, 3939 PS children and 3116 SS children participated, and in 2001 3157 PS children and 3004 SS children participated. The Phase I International Study of Asthma and Allergies in Childhood prevalence written questionnaire and video questionnaire (only shown to SS children) were used in both studies.

RESULTS

The written questionnaire showed no significant changes in the prevalence (1995, 2001) of ever wheeze (8.3%, 6.9%P = 0.06), current wheeze (5.4%, 4.3%P = 0.08), exercise-induced wheeze (EIW; 3.9%, 3.7%P = 0.63), and rhinoconjunctivitis (4.6%, 5%P = 0.42) among PS children. The prevalence of flexural itchy rash increased from 14% to 17.6% (P = 0.004) and night cough decreased from 20.4% to 17.5% (P = 0.005). There were also no significant changes in these symptoms among SS children (1995, 2001): ever wheeze (10.7%, 12%P = 0.37), current wheeze (6.8%, 5.7%P = 0.20), EIW (9.9%, 11.6%P = 0.28), night cough (21.6%, 24%P = 0.39), rhinoconjunctivitis (11%, 15%P = 0.11), and flexural itchy rash (12%, 13%P = 0.11). The video questionnaire showed no significant changes in the prevalence of symptoms in the previous 12 months (1995 vs 2001) for wheeze at rest (3.8%, 2.8%P = 0.12), EIW (6.9%, 8.8%P = 0.32), waking with wheeze (1.7%, 1.7%P = 1.0), and severe wheeze (2.1%, 3%P = 0.12). Night cough in the previous 12 months increased significantly from 5.1% to 8.3% (P = 0.007).

CONCLUSION

Although asthma and atopic disorders are common in this country, the results revealed no major changes in the prevalence rates of these diseases over a period of 6 years.

Prevalence of bronchial asthma and allergic rhinitis in Istanbul school children

The aim of this study was to determine the prevalence of asthma, allergic rhinitis and their related symptoms in Istanbul and to investigate the effect of socioeconomic status on the prevalence of asthma and allergic rhinitis and whether there are differences between the prevalence of childhood asthma in the same and different regions as found in previous studies and our own. The study period was the 1996-1997 school year in three primary schools in Istanbul. For proportional representation of high, middle, and low socioeconomic levels, the schools were selected from three different regions of Istanbul. A translated version of the International Study of Asthma and Allergies in Childhood (ISAAC) was used. The questionnaire was distributed to the parents of 2600 students aged 6-15 years. All of the 2276 children whose parents responded were included in the survey. The overall cumulative and current prevalences of wheezing were 13.7 and 7.2% respectively and the overall cumulative prevalence of allergic rhinitis was 17.6%. There was no statistically significant difference between asthmatics and non-asthmatics by sex, socioeconomic status and passive smoking. Family history of atopy was found to be significantly higher in asthmatics. Although there are differences in the results of studies concerning the prevalence of asthma and allergic rhinitis not only between different countries but also between different regions of the same city, by using a standardized international method, the actual values may be obtained.