Wheeze and urban variation in South Asia.
Typically, urban South Asia is characterised by narrow streets, heavy traffic, visible haze, unplanned city architecture and the use of kerosene or wood-burning stoves at home. However, some urban areas in South Asia are clean and modern, with concrete housing, vehicle emission regulations and use of smoke-free household fuel. The purpose of this study was to compare wheeze prevalence in 13-14-year-olds between two South Asian cities (Galle, Chandigarh), representing each of the above two archetypes. The validated one-page International Study on Asthma and Allergies in Childhood (ISAAC) questionnaire for 13-14-year-olds was used for the study. Of 1814 distributed questionnaires, 1737 (95.8%) were completed correctly and returned (Galle: n=1162; Chandigarh: n=575). Crude prevalence rates, and prevalence odds ratios (with 95% two-sided confidence intervals (CI) for comparison of prevalence rates), were calculated. The prevalence rate for wheezing in Galle (28.7%) was higher than in Chandigarh (12.5%). The prevalence odds ratios (Galle versus Chandigarh) for lifetime wheezing (2.3; 1.8-2.9), wheezing in the previous year (2.1; 1.6-2.7), exercise-related wheeze (4.8; 3.5-6.7) and physician-diagnosed wheeze (1.7; 1.2-2.3) demonstrated significant differences in wheeze prevalence between the two cities ( P<0.05). The numbers of 13-14-year-olds experiencing less than 12 wheezing episodes per year or sleep disturbance due to wheeze of less than 1 night per week were also significantly higher for Galle than Chandigarh. There is a higher prevalence of wheeze in 13-14-year-old children living in an old-fashioned, congested city than in a clean and modern city in South Asia.
Mistry
Rikki
R
Tayside Institute of Child Health, Ninewells Hospital and Medical School, DD1 9SY, Dundee, Scotland, UK.
Wickramasingha
Nandanee
N
Ogston
Simon
S
Singh
Meenu
M
Devasiri
Vasantha
V
Mukhopadhyay
Somnath
S
D000293:Adolescent; D000397:Air Pollution / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012130:Respiratory Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D012135:Respiratory Sounds; D013188:Sri Lanka / Q000453:epidemiology; D014505:Urban Population