title: Factors associated with asthma among under-fives in Mulago hospital, Kampala Uganda: a cross sectional study.
abstract: BACKGROUND
  Asthma is the most common chronic childhood illness, with rapidly increasing prevalence in low-income countries. Among young children, asthma is often under-diagnosed.We investigated the factors associated with asthma among under-fives presenting with acute respiratory symptoms at Mulago hospital, Uganda.
  
  
  METHODS
  A hospital-based cross sectional study of 614 children with cough and/or difficult breathing, and fast breathing, was conducted between August 2011 and June 2012. A questionnaire focusing on clinical history of the child was administered to the caretakers. A physical examination and, laboratory and radiological investigations were done. Asthma was defined according to GINA (Global Initiative for Asthma) guidelines which were modified by excluding the symptom of "chest tightness", spirometry/peak expiratory flow measurements and by adding chest x-ray findings to distinguish asthma from pneumonia. A panel of three paediatricians reviewed the participants' case reports and, guided by the study definitions, made a diagnosis of asthma or other. Multivariable logistic regression analysis was done to determine factors independently associated with asthma.
  
  
  RESULTS
  Of the 614 children, 128 (20.8%) had asthma, 125 (20.4%) bronchiolitis, 167 (27.2%) bacterial pneumonia only, 163 (26.5%) viral pneumonia while 31 (5.1%) had other diagnoses including pulmonary tuberculosis. The majority (71.1%) of children with asthma were aged ≥ 12 months. Factors associated with asthma included maternal asthma (AOR 2.4, 95% CI 1.2, 4.6), a history of allergy in the patient (AOR 2.6, 95% CI 1.2, 5.4,), use of gas for cooking (AOR 3.8, 95% CI 1.2, 13.3), prematurity (AOR 9.3, 95% CI 1.2, 83.3) and high level of education of caretaker (AOR 9.1, 95% CI 1.1, 72.8).
  
  
  CONCLUSIONS
  Maternal asthma, a history of allergy in the patient, use of gas for cooking, prematurity and high level of education of caretaker were significantly associated with asthma. There is need for studies to explore the role of the above factors in development and exacerbation of childhood asthma to provide information that can be used to design strategies for asthma prevention and control.
authors.affiliation: Child Health and Development Centre, Makerere University College of Health Sciences, Kampala, Uganda. rnantanda@gmail.com.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Nantanda
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Ostergaard
authors.forename: Grace
authors.initials: G
authors.lastname: Ndeezi
authors.forename: James K
authors.initials: JK
authors.lastname: Tumwine
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D001988:Bronchiolitis / Q000175:diagnosis*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D011014:Pneumonia / Q000175:diagnosis*; D015995:Prevalence; D011859:Radiography; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology
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