STS recurrent attacks of breathlessness and wheeze, that

STS PROPOSAL 2018

REFERENCE ID: 2018-05625 

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TITLE: Knowledge and awareness about bronchial asthma among adolescents in Tamil Nadu.

INTRODUCTION:

Asthma is a common, chronic inflammatory disease of the lower respiratory tract which is characterised by the recurrent attacks of breathlessness and wheeze, that may be aggravated upon exertion and has diurnal variation. 14 Asthma tends to affect people of all age groups thereby hindering their day-to-day lives and that of their families. 1

Globally, the prevalence of asthma is estimated to range from 3% to 38% in children and from 2% to 12% in adults hence making it the one of the commonest disorders among children. 1,2 According to a study conducted by the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis (INSEARCH) with 85,105 men and 84,470 women from 12 urban and 11 rural locations in India in the year 2012, the overall prevalence of asthma was 2.05% (adults aged ?15 years). 3

Pediatric asthma differs from that of adults by having multiple phenotypes and a variable natural course of disease. 12 Even though asthma can potentially occur at any age, the prevalence of pediatric asthma is far greater. It is usually diagnosed by 5 years of age and up to 50% of the cases are symptomatic by 2 years of age. In the United States, it is estimated that about 15 million of asthma patients are under the age of 18 years. 13

Though some cases of pediatric asthma, seem to recover, 30–80% of cases tend to relapse in adulthood, that is, not all cases of pediatric asthma are out growable. 4 Some cases of pediatric asthma are likely to recur, especially in early adulthood, i.e., during the phase adolescence. 15,16 Studies conducted on unbiased populations, indicate that almost one third of asthmatics despite being symptomatic, are often underdiagnosed and are hence forced to lead a life of compromised quality. 5,6,7,8,9,10

Adolescence is the transitional phase from childhood to adulthood. Therefore, adolescent asthma happens to be a distinguished category with varied treatment requirements when compared to both children and adults. Hence better knowledge and awareness about asthma among adolescents may help to improve the chances of early diagnosis. 11

However, trends in knowledge of asthma amongst adolescents is still rarely studied, in comparison with other age groups. Therefore, I establish the need for this study with the goal to fill this lacunae by assessing the knowledge and awareness of asthma amongst adolescents.

 

 

OBJECTIVES:

Current study is to be conducted to assess the level of knowledge, awareness and source of information of asthma among intermediate and late adolescents who are studying in government and private schools in rural, urban and semi-urban areas of Chennai, Thiruvallur and Kanchipuram districts of Tamil Nadu.

METHODOLOGY:

Study design and setting:

·         A prospective, cross sectional study to be conducted among adolescents in Chennai, Thiruvallur and Kanchipuram districts of Tamil Nadu.

·         The study is to be conducted among adolescents studying in various schools, from both government and private sectors situated in rural, urban and semi-urban areas in order to minimise sample bias.

·         Sampling is to be done using convenience sampling method.

·         A content and face validated questionnaire is to be used to collect the data from the participants.

Study method: Questionnaire based study.

Duration of study: 2 months

Plan of analysis /statistical tools:

The collected data would be reviewed and statistically analysed by using SPSS. Mann Whitney and Kruskal-Wallis tests will be applied to relate the study variables.

Sample size: 1000

Inclusion criteria:

·         Middle adolescents (Ages 13-16 years)

·         Late adolescents (Ages 17-19 years)

Exclusion criteria:

·         Early adolescents- since they may/may not be able to understand and answer the questions put forth effectively (Ages 10-12years)

·         Medical/ Paramedical students- to avoid sample bias

·         Currently known cases of asthma

 

Data collection procedure:

A self?administered questionnaire will be used as a tool to collect the data from the subjects. 
The questionnaire containing relevant questions to the topic of study will be distributed to subjects.
The questionnaire would include demographic details such as 1) Name 2) Age 3) Sex 4) Education.
The subjects will be asked to tick only one of the options in the column for each question. After prior briefing about the study, sufficient time will be given to complete the questionnaire.

Quality control and confidentiality:

The confidentiality will be duly maintained. The names of the subjects will not be revealed, and the records of this study will be kept private under all circumstances. The results thus obtained will be used for research purposes only. The questions in the questionnaire can be answered without any external influence.

Ethical consideration:

Study will be conducted after obtaining prior approval from Institutional Ethical Committee. Prior consent will be obtained from all the selected subjects before the study is carried out. No subject will be forced to participate in the study. An informed consent form will be handed to every participant and confidentiality will be maintained. The results will be used for research purposes only.

IMPLICATIONS:

·         This study highlights the overall knowledge, awareness and understanding of adolescents about asthma and its symptoms. Thereby enabling them to identify the occurrence of the disease, if so and seek appropriate treatment measures at the earliest.

·         Administration of such necessary treatment at an early stage, can control the progression of the disease and greatly improve the disease prognosis.

REFERENCES:

1.      Koul PA, Patel D. Indian guidelines for asthma: Adherence is the key. Lung India: Official Organ of Indian Chest Society. 2015;32(Suppl 1): S1-S2. doi:10.4103/0970-2113.154511.

2.      O. Cavkaytar, B.E. Sekerel, Baseline management of asthma control, Hacettepe University, Faculty of Medicine, Pediatric Allergy and Asthma Unit, Ankara, Turkey, October 2012.

3.      Jindal SK, Aggarwal AN, Gupta D, Agarwal R, Kumar R, Kaur T, et al. Indian study on epidemiology of asthma, respiratory symptoms and chronic bronchitis in adults (INSEARCH) Int J Tuberc Lung Dis. 2012;16:1270–7.

4.      T.J. Warke, P.S. Fitch, V. Brown, R. Taylor, J.D.M. Lyons, M. Ennis, M.D. Shields, Outgrown asthma does not mean no airways inflammation, European Respiratory Journal 2002 19: 284-287; DOI: 10.1183/09031936.02.00882002

5.      Bousquet J, Bullinger M, Fayol C, et al. Assessment of quality of life in patients with perennial allergic rhinitis with the French version of the SF-36 Health Status Questionnaire. J Allergy Clin Immunol 1994;94:182–8.

6.      Siersted HC, Boldsen J, Hansen HS, et al. Population based study of risk factors for underdiagnosis of asthma in adolescence: Odense schoolchild study. Br Med J 1998; 316:651–5.

7.      Bousquet J, Knani J, Henry C, et al. Undertreatment in a nonselected population of adult patients with asthma. J Allergy Clin Immunol 1996;98:514–21.

8.      Nish WA, Schwietz LA. Underdiagnosis of asthma in young adults presenting for USAF basic training. Ann Allergy 1992; 69:239–42.

9.      Nathell L, Larsson K, Jensen I. Determinants of undiagnosed asthma. Allergy 2002;57:687–93.

10.  Larsson L, Boethius G, Uddenfeldt M. Differences in utilization of asthma drugs between two neighbouring Swedish provinces: relation to prevalence of obstructive airway disease. Thorax 1994;49:41–9.

11.  Price JF Issues in adolescent asthma: what are the needs? Thorax 1996;51:S13-S17.

12.  Indian J Med Res 145, May 2017, pp 581-583 DOI: 10.4103/ijmr.IJMR_420_17

13.  Anwar  H,  Jaffer  NH, Al-Sadri  E. Asthma  Knowledge  among  asthmatic  school students.  Oman medical journal 2008;23(2):90.

14.  Godfrey S. What is asthma?.  Arch Dis Child. 1985;60(11):997.

15.  Bronnimann S, Burrows B. A prospective study of the natural history of asthma. Remission and relapse rates. Chest 1986;90:480–484.

16.  Radford PJ, Hopp RJ, Biven RE, Degan JA, Bewtra AK, Townley RG. Longitudinal changes in bronchial hyperresponsiveness in asthmatic and previously asthmatic children. Chest 1992;101:624–629.

 

 

 

 

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