A study to assess the risk factors of bronchial asthma in children below 10 years of age

Children are profoundly powerless against the negative wellbeing resulting in numerous ecological exposures. Children get proportionately more signi icant portions of natural toxicants than grown-ups, and the way that their organs and tissues are quickly creating makes them especially vulnerable to synthetic abuse. Asthma is a constant iery infection of the aviation routes at present in luencing over 300 million individuals around the world. The risk factors of asthma include genetic predisposition, irresistible respiratory contamination, allergens, environment, workouts, medications, additives, and occupational stimuli. The descriptive research design was used with 100 samples, which matched Nonprobability convenience sampling techniques selected the inclusion criteria. Demographic variableswere collected by interviewmethod followed by assessed the risk factors of bronchial asthma in children (below ten years of age) by using a self-structured questionnaire. Out of 100 samples, 50(50%) risk factor of heredity, 71(71%) have problems in taking asthma medications, 44(44%) only use zipped pillow covers, 34(34%) do not use gas stoves in the kitchen, 10(10%) have moisture in the walls, 6(6%) have cases of asthma emergencies, 56(56%) ind helpless in dealing with an asthma child.


INTRODUCTION
Children's wellbeing incorporates the investigation of conceivable ecological reasons for sicknesses and disorders in Children's and newborns. Children are profoundly powerless against the negative welfare, resulting in numerous environmental exposures. WHO estimates for about 1 in every 250 deaths in the World (Pearce et al., 2007). In genetically susceptible children, such interactions can lead to the development of airway in lammation, atopy and bronchial hyper-responsiveness. An expected 300 million people globally are in luenced by asthma (Heinrich, 2011). WHO evaluated that 15 million Disability Adjusted Life Years (DALYs) are lost, and more than 180 000 asthma-related deaths are accounted for around the world. It is evaluated that 80% of asthma deaths happen in low salary and centre pay nations. It is anticipated that by 2025 an extra 100 million people will have asthma (Lemanske and Busse, 2010).
Asthma is a chronic in lammatory disease of the airways currently affecting more than 300 million individuals around the world. It is likewise the most pervasive among childhood everywhere across the globe, highlighting the marked disparity in prevalence between developed and developing countries (Global Initiative for Asthma, 2019). Like other resistant intervened sicknesses, asthma pathogenesis has hereditary and natural parts. The genomewide af iliation has yielded a few quality loci related with asthma; however, these don't clarify the most signi icant extent of asthma (Vonk and Boezen, 2006). Epidemiologic investigations has discovered various ecological exposures related with asthma that may better specify the sharp increase in asthma over the 30 years (Pedersen et al., 2011;Masoli et al., 2004;Anandan et al., 2010).
Asthma is a chronic in lammatory disorder of the airways in which many cells and cellular elements play a role.
The chronic in lammation is the causes an associated increase in airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night or early morning. These episodes are usually a result of widespread but variable air low obstruction that is often reversible either spontaneously or with treatment (Marco et al., 1991;Asher et al., 1995). The symptoms include wheezing, chest tightness, breathlessness and sputum production. The risk factors of asthma include genetic predisposition, infectious-respiratory infection, allergens environment, exercise, drugs, preservatives, and occupational stimuli (Group, 1997).
An expected 6.3 million children under 15 years of age died in 2017, or 1 at regular intervals, for the most part from preventable causes, as per new mortality estimates released by WHO, UNICEF, the United Nations Population Division and the World Bank Group. By far most of these death's ( 5.4 million), happened in the initial ive years of life, with infants representing around half, all-inclusive, half of all death's under ive years old occurred in sub-Saharan Africa and another 30% in Southern Asia. In sub-Saharan Africa, 1 out of 13 kids died before their ifth birthday celebration. In highsalary nations, that number was 1 in 185 (Renzoni et al., 1999). WHO propelled Standards for improving nature of care for children and young adolescents in health facilities, in Entebbe, Uganda, in a gathering by the Network for Improving Quality of Care for Maternal, Newborn and Child Health (Quality of Care Network) and WHO, in an organization with USAID, and facilitated by the Uganda Government. Wellbeing specialists from 12 nations, remembering all the nations for the Quality of Care Network, assembled to share how they are attempting to improve the nature of care for children and young adolescents, discuss about how they can weave these models in their current national projects, and what sort of help they will require to do so (Galassi, 1994).

Objectives
1. To assess the risk factor of bronchial asthma in children (below ten years) 2. To identify risk factors associated with uncontrolled asthma symptoms in children

MATERIALS AND METHODS
The research approach adopted in the study was a quantitative approach by using descriptive research design. The formal permission was obtained from the Authority of Saveetha Medical College Hospital, Chennai. After getting approval, the sample was selected by using inclusion criteria. One hundred parents of children below ten years of age from pediatric OPD and pediatric ward were chosen by using a non-probability convenience sampling technique. After the sample selection, informed consent was obtained from each sample. After the general instruction, demographic variables were collected by interview method followed by assessing the risk factors of bronchial asthma in children (below ten years of age) by using a self-structured questionnaire. The data were analyzed using descriptive and inferential statistics.

RESULTS AND DISCUSSION
Out of 100 samples, 61% were females, 60% had secondary education, 53% were working as skilled labour, 51% had monthly income Rs.11000-15000. 81% had a history of asthma. Regarding the smoking habit of the caretaker, 29% of samples had cigarette smoking. Regarding cooking habit, 34% of samples cook with kerosene/solid fuel. Regarding residence, 68% live in a rural area.  The signi icant indings of the study were 50(50%) risk factor of heredity, 71(71%) have problems in taking asthma medications, 44(44%) only use zipped pillow covers, 34(34%) do not use gas stoves in the kitchen, 10(10%) have moisture in the walls, 6(6%) have cases of asthma emergencies, 56(56%) ind helpless in dealing with asthma child. The current investigation is upheld by Murray et al. (2017), who directed an examination to survey the forestalling extreme Asthma Exacerbations in youngsters, a randomized preliminary of parasite impermeable bedcovers.
Bug sharpened youngsters with asthma (3-17 years) after crisis emergency clinic participation with an asthma fuel to get bug impermeable or control bed encasings. Over a 12 Month intercession period, the event of severe asthma intensiications was explored. Of 434 kids were taken as tests. Vermin impermeable encasings are successfully diminishing the number of sharpened bug youngsters with asthma going to the medical clinic with asthma; however, it is not the number requiring oral prednisolone. This straightforward measure may decrease asthma worsening in children.
The current investigation is likewise upheld by Vermeulen et al. (2018), who learned about the Food hypersensitivity is a signi icant hazard factor for youth asthma, independent of whether it settles. A sum of 5,276 12month-old newborn children was enrolled utilizing a populace based inspecting outline. Babies experienced skin prick test to egg, nut, and sesame and those with a noticeable skin prick test result had oral nourishment challenges.
At four years of age, nourishment challenges were rehashed to decide perseverance or goals of nourishment sensitivity. Transient nourishment sensitivity and diligent nourishment hypersensitivity were both related with an expanded danger of asthma. Asthma at four years is twice as normal in those with challenge-demonstrated nourishment sensitivity at age one, independent of whether the nourishment hypersensitivity accordingly settles. Youngsters with at least two nourishment hypersensitivities and those with concurrent dermatitis were right around multiple times as liable to create asthma contrasted and those with no nourishment allergies.

CONCLUSION
Asthma was a inancial and social burden to both children and guardians. Hazard elements of asthma advancement may incorporate cesarean birth, personal history of sensitivity and associative and susceptible maladies. Selective breastfeeding in the ini-tial half-year may be securing factors.