Study and Monitoring the Prevalence of Asthma among School Children in Gaborone, Botswana

Background: Asthma prevalence is high (> 10%) in developed countries, and though data for most of Africa is still missing, rates are rising in developing countries as they grow more westernised. Asthma is the 14th most important chronic disease in the world in terms of the prevalence, extent, and duration of disability, affecting 334 million individuals of all ages. The prevalence in Africa has been reported ranging from 18% in Kenya to 20% in South Africa. We investigated the prevalence of asthma in school children in Gaborone, Botswana.

Methods: This was a descriptive cross-sectional research. The ISAAC approach was employed. A proportionate size random sample of two age groups of children (13-14 year olds and 6-7 year olds) was enrolled in ten schools in a systematic manner. A table of random numbers was used to choose the schools. A minimum sample of 924 individuals (462 from each group) was sufficient to achieve a precision of 3% around our estimated prevalence of asthma of 10% with 95% confidence, assuming a 20% non-response rate. The International study of Asthma and Allergies in Children (ISAAC) questionnaire was used to collect information. In accordance with the ISAAC criteria, Asthma was defined as wheezing in the previous 12 months. Data was captured in microsoft excel and analysed using SPSS version 23.

Results: Asthma (wheezing in the previous 12 months) was present in 16.5% (194/1175). The prevalence of asthma (wheezing in the previous 12 months) was 15.9% among 6-7 year olds and 16.8% among 13-14 year olds. The prevalence of school type in private schools was 22.3% versus 14.5% in public schools. More severe asthma was associated with older children, 13 -14 years. The older children reported more limited speech due to wheezing (OR= 2.0, 95% CI =1.034, 3.9, p-value=0.043), ever had asthma (OR= 1.5, 95% CI=1.031, 2.3, p-value=0.034) and wheezing during exercise (OR=3.4, 95% CI= 2.5, 4.9, p-value= <0.001) compared to the younger children 6-7 years. Private school students had more wheezing symptoms.. They were more likely to have ever wheezed (OR=2.2, .95% CI=1.7,2.9, p-value < 0.0001), wheezed in the previous twelve months (have asthma) (OR=1.7,95%CI=1.2,2.4, p-value = 0.001), ever had asthma (OR=2.4, 95% CI=1.7,3.5, p-value<0.0001), and wheezed during exercise (OR=1.8, 95% CI=1.4,2.4, p-value < 0.0001).

Conclusion: Asthma is very common among school children in Gaborone, Botswana, with older children having more severe asthma symptoms. When compared to public schools, private schools had a higher prevalence of asthma. In Botswana, more research is needed to examine the prevalence of asthma in rural and urban areas.