title: Burden of asthma among children in a developing megacity: childhood asthma study, Pakistan.
abstract: OBJECTIVE
  Global burden of childhood asthma has increased in the past few decades, particularly in low-income countries. In Pakistan, there is a lack of community-based epidemiological studies estimating the burden of asthma among children. This study determined the prevalence and predictors of asthma among children 3-17 years of age in Karachi, Pakistan.
  
  
  METHODS
  A two-stage community-based representative cross-sectional survey was conducted in Karachi from March 2012 to April 2013 comprising 1046 children aged 3-17 years. Of 7500 clusters, 80 were randomly selected, and of these, 15 children per cluster were enrolled randomly. A translated and pre-tested version of International Study of Asthma and Allergies in Children questionnaire was administered.
  
  
  RESULTS
  The overall prevalence of asthma among study participants was 10.2% (95% CI: 8.4-12.0). Asthma was more likely to occur among boys (adj. OR: 2.5, 95% CI: 1.6-4.0), children in the younger age group (3-7 years) (adj. OR: 2.9, 95% CI: 1.7-4.8), those living in households with ill-ventilated kitchens (adj. OR: 1.8, 95% CI: 1.1-3.1), having family history of asthma (adj. OR: 2.3, 95% CI: 1.3-3.9) and those of the Sindhi ethnicity (adj. OR: 2.2, 95% CI: 1.1-4.4).
  
  
  CONCLUSIONS
  This study is the first robust evidence regarding asthma among children in Pakistan, reporting a high burden in this group. Family history, male gender, Sindhi ethnicity and ill-ventilated kitchen were identified as important predictors of asthma. Targeted preventive measures and intervention studies are required to better understand and reduce the burden of asthma among children in Pakistan.
authors.affiliation: Department of Community Health Sciences, Aga Khan University , Karachi , Pakistan and.
authors.forename: Adeel Ahmed
authors.initials: AA
authors.lastname: Khan
authors.forename: Sana
authors.initials: S
authors.lastname: Tanzil
authors.forename: Tanzil
authors.initials: T
authors.lastname: Jamali
authors.forename: Afshan
authors.initials: A
authors.lastname: Shahid
authors.forename: Shahla
authors.initials: S
authors.lastname: Naeem
authors.forename: Ambreen
authors.initials: A
authors.lastname: Sahito
authors.forename: Fraz Anwar
authors.initials: FA
authors.lastname: Siddiqui
authors.forename: Asaad Ahmed
authors.initials: AA
authors.lastname: Nafees
authors.forename: Zafar
authors.initials: Z
authors.lastname: Fatmi
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014028:Tobacco Smoke Pollution; D014691:Ventilation
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Asthma; ISAAC (International Study of Asthma and Allergies in Children) questionnaire; Pakistan; children; prevalence and predictors