Prevalence of Coexistent Allergic Rhinitis in Schoolchildren with Bronchial Asthma and Its Association with Asthma Control

Introduction: Bronchial asthma (BA) is a common chronic respiratory disease in children with a wide variation in global prevalence due to differences in environmental and genetic factors as well as differences in diagnostic criteria. Allergic rhinitis (AR) is one of the major risk factors associated with childhood asthma, with coexistent AR reported in 60%–70% of children with asthma in India. According to the one airway hypothesis, with evidence from epidemiological and clinical studies, the upper and lower airways share the same pathophysiological changes. This similarity results in inflammatory changes in either airway to have an effect on each other. Very few Indian studies have reported on increasing prevalence of childhood BA. Hence, it is essential to diagnose and treat concomitant AR in patients with BA to achieve good asthma control. Aim: To study the prevalence of coexistent AR in schoolchildren with BA and its association with asthma control. Materials and Methods: This prospective cross-sectional study was done during 3 months period from June to August 2018 in five randomly selected schools from a semi-urban area. A total of 1417 students of both genders belonging to 8–14 years of age were included. Demographic details were noted and spirometry was done. BA was diagnosed and control of asthma was assessed based on the Global Initiative for Asthma guidelines. Children diagnosed with BA were administered AR and its Impact on Asthma (ARIA) questionnaire to determine the prevalence and severity of AR. Data were analyzed using SPSS Version-20 and the severity of ARIA was correlated with asthma control using Pearson's correlation test. Results: The prevalence of BA among 1417 schoolchildren was 5.86% and majority of the asthmatic children were not well controlled (95%). 97.5% of children with BA had coexistent AR. There was a significant ( P < 0.001) correlation between the severity of AR with asthma control. Conclusions: Our study showed a high prevalence of coexistent AR in children with BA. Children with greater severity of AR were found to have poor asthma control.