title: Geographical variations of asthma and asthma symptoms among schoolchildren aged 5 to 8 years and 12 to 15 years in Palestine: the International Study of Asthma and Allergies in Childhood (ISAAC).
abstract: BACKGROUND
  Many studies demonstrated the existence of geographic differences, within and between countries, in the prevalence of asthma, rhinitis, and eczema. However, in Palestine, there are no comprehensive Palestinian data to compare with those from other regional and international centers.
  
  
  OBJECTIVE
  To describe the prevalence of asthma and asthma symptoms in schoolchildren in two districts (Ramallah and North Gaza) in Palestine.
  
  
  METHODS
  After a two-stage stratified systematic sampling, approximately 14,500 schoolchildren, from the first and second grades of elementary school (ages 5 to 8 years) and eighth and ninth school grades (ages 12 to 15 years), were invited to participate in a survey using International Study of Asthma and Allergies in Childhood phase III questionnaires and protocols.
  
  
  RESULTS
  In general, younger children were reported to have a higher 12-month wheezing prevalence rate than older children (9.6 and 7.2%, respectively), and more physician-diagnosed asthma (8.4 and 5.9%, respectively). However, nocturnal cough and exercise-related wheezing were higher in the older age group compared with younger children. Younger children living in North Gaza district showed slightly higher prevalence rates for asthma and asthma symptoms, but older children had higher rates in Ramallah district. After adjustment using logistic regression analysis, male sex, living in inland areas, and younger age were shown to predict 12-month wheezing and physician-diagnosed asthma.
  
  
  CONCLUSIONS
  Palestinian children have asthma symptoms rates that are similar to several countries in the Mediterranean region such as Spain and Turkey, but still lower than other Middle East countries such as Saudi Arabia and Israel.
authors.affiliation: Laboratorium voor Pneumologie (Eenheid voor Longtoxicologie), KU Leuven, Belgium. nuha.shareef@med.kuleuven.ac.be
authors.forename: Nuha A
authors.initials: NA
authors.lastname: El-Sharif
authors.forename: Benoit
authors.initials: B
authors.lastname: Nemery
authors.forename: Fikry
authors.initials: F
authors.lastname: Barghuthy
authors.forename: Shaban
authors.initials: S
authors.lastname: Mortaja
authors.forename: Radwan
authors.initials: R
authors.lastname: Qasrawi
authors.forename: Ziad
authors.initials: Z
authors.lastname: Abdeen
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008877:Middle East / Q000453:epidemiology; D015999:Multivariate Analysis; D015995:Prevalence; D012135:Respiratory Sounds; D012307:Risk Factors; D012572:School Health Services; D012737:Sex Factors