Abstract
Objective
To investigate the prevalence, associated factors, and control level of asthma in Jordanian high school students.
Methods
A descriptive, comparative, cross sectional design was used and a cluster sample of 2691 students (mean age = 14.5 years, 51.0% girls), drawn from eight randomly selected public high schools in Northern Jordan, participated in the study. Each student had the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire completed in the classroom between February and May, 2015.
Results
The prevalence of recent wheezing in the last 12 months was 11.7% whereas the prevalence of diagnosed asthma was 6.2%. About 49% of students experienced cough all the time, and 33.5% experienced waking up at night due to wheezing some of the time. About 30.9% of students reported moderate to big exercise-induced asthma. The mean total Asthma Control Test (ACT) score was 5.85 (SD = 3.56) with all of students reporting uncontrolled asthma during the last month. Higher rates of asthma symptoms were reported by females, 10th graders, and students with negative family history. Importantly, students with diagnosed asthma or recent wheezing reported higher rates of ever smoking tobacco vs. non-asthmatics (p < 0.000); dual (18.6% vs. 9.8%), cigarettes only (11.2% vs. 7.3%), and waterpipe only (18.0% vs. 14.7%).
Conclusion
Overall, students with asthma or wheezing had increased rates of tobacco smoking. Policies need to be set and enforced to provide a better environment for these youth, especially making all schools smoke-free zones. A multifaceted, comprehensive awareness and management program is required in schools to control and manage asthma symptoms.
Acknowledgments
The authors would like to thank the students, parents, teachers, and school principals for participating in the study.
Declaration of interest: The authors declare no conflicts of interest. The authors alone are responsible for the content and writing of the paper. The current manuscript was supported by Deanship of Scientific Research at Jordan University of Science and Technology with fund no. NA-MA/90/2015.
References
[1] Sears M, Greene J, Willan A, Wiecek E, Taylor D, Flannery E, et al. A longitudinal, population-based, cohort study of childhood asthma followed to adulthood. N Engl J Med. 2003;349(15):1414–22.10.1056/NEJMoa022363Suche in Google Scholar
[2] Al-Motlaq M. Prevalence and factors affecting childhood asthma in the Middle East: a literature review. Middle East J Nurs [P]. 2009;3(1):11–6.Suche in Google Scholar
[3] Asher M, Montefort S, Björkstén B, Lai C, Strachan D, Weiland S, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet (London, England). 2006;368(9537):733–43.10.1016/S0140-6736(06)69283-0Suche in Google Scholar
[4] Pearce N, Aït‐Khaled N, Beasley R, Mallol J, Keil U, Mitchell E, et al. Worldwide trends in the prevalence of asthma symptoms: phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax. 2007;62(9):758–66.10.1136/thx.2006.070169Suche in Google Scholar
[5] Mallol J, Solé D, Asher I, Clayton T, Stein R, Soto-Quiroz M. Prevalence of asthma symptoms in Latin America: the International Study of Asthma and Allergies in Childhood (ISAAC). Pediatr Pulmonol. 2000;30(6):439–44.10.1002/1099-0496(200012)30:6<439::AID-PPUL1>3.0.CO;2-ESuche in Google Scholar
[6] Lai C, Beasley R, Crane J, Foliaki S, Shah J, Weiland S. Global variation in the prevalence and severity of asthma symptoms: phase three of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax. 2009;64(6):476–83.10.1136/thx.2008.106609Suche in Google Scholar
[7] Wennergren G. The prevalence of asthma has reached a plateau. Acta Paediatr. 2011;100(7):938–9.10.1111/j.1651-2227.2011.02307.xSuche in Google Scholar
[8] Demir A, Celikel S, Karakaya G, Kalyoncu A. Asthma and allergic diseases in school children from 1992 to 2007 with incidence data. J Asthma. 2010;47(10):1128–35.10.3109/02770903.2010.517336Suche in Google Scholar
[9] Control CfD, Prevention. Vital signs: asthma prevalence, disease characteristics, and self-management education: United States, 2001–2009. MMWR Morb Mortal Wkly Rep. 2011;60(17):547–52.Suche in Google Scholar
[10] Wong G, Leung T, Ko F, Lee K, Lam P, Hui D, et al. Declining asthma prevalence in Hong Kong Chinese schoolchildren. Clin Exp Allergy. 2004;34(10):1550–5.10.1111/j.1365-2222.2004.02064.xSuche in Google Scholar
[11] Abuekteish F, Alwash R, Hassan M, Daoud A. Prevalence of asthma and wheeze in primary school children in northern Jordan. Ann Trop Paediatr. 1996;16(3):227–31.10.1080/02724936.1996.11747831Suche in Google Scholar
[12] Abu-Ekteish F, Otoom S, Shehabi I. Prevalence of asthma among Bedouins and urban school children in Jordan using Isaac phase III protocol. Arch Dis Child. 2008;93(Suppl 2):pw163.Suche in Google Scholar
[13] Abu-Ekteish F, Otoom S, Shehabi I, editors. Prevalence of asthma in Jordan: comparison between Bedouins and urban schoolchildren using the International Study of Asthma and Allergies in Childhood phase III protocol. Allergy Asthma Proc. 2009;30(2):181–5.10.2500/aap.2009.30.3208Suche in Google Scholar
[14] Al-sheyab N, Gallagher R, Crisp J, Shah S. Peer-led education for adolescents with asthma in Jordan: a cluster-randomized controlled trial. Pediatrics. 2012;129(1):e106–12.10.1542/peds.2011-0346Suche in Google Scholar PubMed
[15] Al-Akour N, Khader Y. Quality of life in Jordanian children with asthma. Int J Nurs Pract. 2008;14(6):418–26.10.1111/j.1440-172X.2008.00715.xSuche in Google Scholar PubMed
[16] Braman S. The global burden of asthma. Chest. 2006;130(1 Suppl):4S–12S.10.1378/chest.130.1_suppl.4SSuche in Google Scholar PubMed
[17] Akinbami L, Schoendorf K. Trends in childhood asthma: prevalence, health care utilization, and mortality. Pediatrics. 2002;110(2 Pt 1):315–22.10.1542/peds.110.2.315Suche in Google Scholar PubMed
[18] Woodgate R. Health professionals caring for chronically ill adolescents: adolescents’ perspectives. J Soc Pediatr Nurs. 1998;3(2):57–68.10.1111/j.1744-6155.1998.tb00029.xSuche in Google Scholar PubMed
[19] Wieringa M, Weyler J, Nelen V, Van Hoof K, Van Bastelaer F, Van Sprundel M, et al. Prevalence of respiratory symptoms: marked differences within a small geographical area. Int J Epidemiol. 1998;27(4):630–5.10.1093/ije/27.4.630Suche in Google Scholar PubMed
[20] Sears M. Trends in the prevalence of asthma. Chest. 2014;145(2):219–25.10.1378/chest.13-2059Suche in Google Scholar PubMed
[21] Ellwood P, Asher M, García-Marcos L, Williams H, Keil U, Robertson C, et al. Do fast foods cause asthma, rhinoconjunctivitis and eczema? Global findings from the International Study of Asthma and Allergies in Childhood (ISAAC) phase three. Thorax. 2013;68(4):351–60.10.1136/thoraxjnl-2012-202285Suche in Google Scholar PubMed
[22] Masoli M, Fabian D, Holt S, Beasley R, Program GIfA. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy. 2004;59(5):469–78.10.1111/j.1398-9995.2004.00526.xSuche in Google Scholar PubMed
[23] Al-Sheyab N, Gallagher R, Roydhouse J, Crisp J, Shah S. Feasibility of a peer-led, school-based asthma education programme for adolescents in Jordan. East Mediterr Health J. 2012;18(5):468–73.10.26719/2012.18.5.468Suche in Google Scholar PubMed
[24] Agency CI. The World Factbook 2014–15: Government Printing Office; 2015.Suche in Google Scholar
[25] Asher M, Keil U, Anderson H, Beasley R, Crane J, Martinez F, et al. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995;8(3):483–91.10.1183/09031936.95.08030483Suche in Google Scholar PubMed
[26] Lai C, Chan J, Chan A, Wong G, Ho A, Choy D, et al. Comparison of the ISAAC video questionnaire (AVQ3.0) with the ISAAC written questionnaire for estimating asthma associated with bronchial hyperreactivity. Clin Exp Allergy. 1997;27(5):540–5.10.1111/j.1365-2222.1997.tb00742.xSuche in Google Scholar
[27] Shaw R, Woodman K, Ayson M, Dibdin S, Winkelmann R, Crane J, et al. Measuring the prevalence of bronchial hyper-responsiveness in children. Int J Epidemiol. 1995;24(3):597–602.10.1093/ije/24.3.597Suche in Google Scholar PubMed
[28] Miller M, Lee J, Miller D, Wenzel S, Group TS. Recent asthma exacerbations: a key predictor of future exacerbations. Respir Med. 2007;101(3):481–9.10.1016/j.rmed.2006.07.005Suche in Google Scholar PubMed
[29] Schatz M, Sorkness C, Li J, Marcus P, Murray J, Nathan R, et al. Asthma Control Test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists. J Allergy Clin Immunol. 2006;117(3):549–56.10.1016/j.jaci.2006.01.011Suche in Google Scholar PubMed
[30] Prabhakaran L, Arul E, Abisheganaden J, Chee J. Difference in Asthma Control Test–(ACT) scores in three different clinical practice settings. Ann Acad Med Singapore. 2010;39(10):783–9.10.47102/annals-acadmedsg.V39N10p783Suche in Google Scholar
[31] Boulet L-P, FitzGerald JM, Reddel HK. The revised 2014 GINA strategy report: opportunities for change. Curr Opin Pulm Med. 2015;21(1):1–7.10.1097/MCP.0000000000000125Suche in Google Scholar PubMed
[32] Reddel HK, Bateman ED, Becker A, Boulet L-P, Cruz AA, Drazen JM, et al. A summary of the new GINA strategy: a roadmap to asthma control. Eur Respir J. 2015;46(3):622–39.10.1183/13993003.00853-2015Suche in Google Scholar PubMed PubMed Central
[33] Wieringa M, Vermeire P, Brunekreef B, Weyler J. Increased occurrence of asthma and allergy: critical appraisal of studies using allergic sensitization, bronchial hyper-responsiveness and lung function measurements. Clin Exp Allergy. 2001;31(10):1553–63.10.1046/j.1365-2222.2001.01188.xSuche in Google Scholar PubMed
[34] von Hertzen L, Haahtela T. Signs of reversing trends in prevalence of asthma. Allergy. 2005;60(3):283–92.10.1111/j.1398-9995.2005.00769.xSuche in Google Scholar PubMed
[35] Alzyoud S, Weglicki LS, Kheirallah KA, Haddad L, Alhawamdeh KA. Waterpipe smoking among middle and high school Jordanian students: patterns and predictors. Int J Environ Res Public Health. 2013;10(12):7068–82.10.3390/ijerph10127068Suche in Google Scholar PubMed PubMed Central
[36] Pietinalho A, Pelkonen A, Rytilä P. Linkage between smoking and asthma. Allergy. 2009;64(12):1722–7.10.1111/j.1398-9995.2009.02208.xSuche in Google Scholar
[37] Ronchetti R, Villa M, Barreto M, Rota R, Pagani J, Martella S, et al. Is the increase in childhood asthma coming to an end? Findings from three surveys of schoolchildren in Rome, Italy. Eur Respir J. 2001;17(5):881–6.10.1183/09031936.01.17508810Suche in Google Scholar
[38] Alomari MA, Al-Sheyab NA. Cigarette smoking lowers blood pressure in adolescents: the Irbid-TRY. Inhal Toxicol. 2016;28(3):140–4.10.3109/08958378.2016.1145769Suche in Google Scholar
[39] Musaiger AO, Al-Mannai M, Tayyem R, Al-Lalla O, Ali EY, Kalam F, et al. Perceived barriers to healthy eating and physical activity among adolescents in seven Arab countries: a cross-cultural study. Scientific World J. 2013;2013:232164.10.1155/2013/232164Suche in Google Scholar
[40] Musaiger A, Al-Mannai M, Al-Lalla O, Saghir S, Halahleh I, Benhamed M, et al. Obesity among adolescents in five Arab countries; relative to gender and age. Nutr Hosp. 2013;28(6):1922–5.10.1155/2013/232164Suche in Google Scholar
[41] AlAl-Motlaq M, Sellick K, Barnett T. EvaluatingEvaluating the asthma friendly schools program in primary schools in Gippsland Victoria. Churchill, Monash University, School of Nursing and Midwifery, Gippsland Campus. 2010.Suche in Google Scholar
[42] Al-Sheyab N, Gallagher R, Gallagher P, Shah S. Cigarette smoking in adolescents with asthma in Jordan: impact of peer-led education in high schools. J Nurs Educ Pract. 2013;3(9):13.10.5430/jnep.v3n9p13Suche in Google Scholar
[43] Thomson NC, Chaudhuri R. Asthma in smokers: challenges and opportunities. Curr Opin Pulm Med. 2009;15(1):39–45.10.1097/MCP.0b013e32831da894Suche in Google Scholar
[44] Gelb AF, Schein A, Nussbaum E, Shinar CM, Aelony Y, Aharonian H, et al. Risk factors for near-fatal asthma. CHEST J. 2004;126(4):1138–46.10.1016/S0012-3692(15)31289-7Suche in Google Scholar
[45] Boulet L, FitzGerald J, McIvor R, Zimmerman S, Chapman K. Influence of current or former smoking on asthma management and control. Can Respir J. 2008;15(5):275–9.10.1155/2008/725074Suche in Google Scholar PubMed PubMed Central
©2018 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Review Article
- Alexithymia, fibromyalgia, and psychological distress among adolescents: literature review
- Original Articles
- Perceptions of sexual abstinence among Muslim adolescent girls in southern Thailand
- Human adenovirus-36 seropositivity and obesity among Midwestern US adolescents
- Influence of waist circumference on blood pressure status in non-obese adolescents
- Self perceived psychosocial impact of dental aesthetics among young adults: a cross sectional questionnaire study
- Experience of violence amongst female medical and nursing students and their perception regarding violence against women in Delhi, India
- Adaptation and validation of the disruptive behaviour disorders teacher rating scale as a screening tool for early detection of disruptive behaviour disorders in schools in a lower-middle income setting
- Post-traumatic stress and growth among CPR survivors in the southeast of Iran
- Effect of communication skills based group counseling on mothers’ sex dialogue with their adolescent daughters
- Prevalence of obesity among youths in Mississippi: United States, 1999–2015
- Factors related to job burnout among nurses in the Razi Psychiatric Hospital, Iran
- Health-promoting behaviors in nursing students: is it related to self-efficacy for health practices and academic achievement?
- HEEADSSS up: pediatric residents’ confidence and practice in adolescent health care before and after mandatory adolescent medicine rotations in Thailand
- Mainstreaming youth-friendly health services into existing primary health care facilities: experiences from South-South Nigeria
- Determinants of HIV testing and receipt of test results among adolescent girls in Nigeria: the role of assets and decision-making
- Yoga versus physical exercise for cardio-respiratory fitness in adolescent school children: a randomized controlled trial
- Prevalence, associated factors, and control level of asthma symptoms among adolescents in Northern Jordan
- Facilitating factors of self-care among HIV-positive young women in Iran: a qualitative study
- The relationship between spiritual intelligence and aggression in medical science students in the southeast of Iran
- Better informed is better decided: Addressing the risks of delaying childbearing for female higher educational students
- Case Report
- First break psychosis in a young military veteran with cannabis use disorder: an educational case report
Artikel in diesem Heft
- Review Article
- Alexithymia, fibromyalgia, and psychological distress among adolescents: literature review
- Original Articles
- Perceptions of sexual abstinence among Muslim adolescent girls in southern Thailand
- Human adenovirus-36 seropositivity and obesity among Midwestern US adolescents
- Influence of waist circumference on blood pressure status in non-obese adolescents
- Self perceived psychosocial impact of dental aesthetics among young adults: a cross sectional questionnaire study
- Experience of violence amongst female medical and nursing students and their perception regarding violence against women in Delhi, India
- Adaptation and validation of the disruptive behaviour disorders teacher rating scale as a screening tool for early detection of disruptive behaviour disorders in schools in a lower-middle income setting
- Post-traumatic stress and growth among CPR survivors in the southeast of Iran
- Effect of communication skills based group counseling on mothers’ sex dialogue with their adolescent daughters
- Prevalence of obesity among youths in Mississippi: United States, 1999–2015
- Factors related to job burnout among nurses in the Razi Psychiatric Hospital, Iran
- Health-promoting behaviors in nursing students: is it related to self-efficacy for health practices and academic achievement?
- HEEADSSS up: pediatric residents’ confidence and practice in adolescent health care before and after mandatory adolescent medicine rotations in Thailand
- Mainstreaming youth-friendly health services into existing primary health care facilities: experiences from South-South Nigeria
- Determinants of HIV testing and receipt of test results among adolescent girls in Nigeria: the role of assets and decision-making
- Yoga versus physical exercise for cardio-respiratory fitness in adolescent school children: a randomized controlled trial
- Prevalence, associated factors, and control level of asthma symptoms among adolescents in Northern Jordan
- Facilitating factors of self-care among HIV-positive young women in Iran: a qualitative study
- The relationship between spiritual intelligence and aggression in medical science students in the southeast of Iran
- Better informed is better decided: Addressing the risks of delaying childbearing for female higher educational students
- Case Report
- First break psychosis in a young military veteran with cannabis use disorder: an educational case report