Prevalence of Asthma and Allergy and Their Risk Factors Among An–Najah National University ...

155 Pages·2010·1.73 MB·English

An-Najah National University
Faculty of Graduate Studies

Prevalence of Asthma and Allergy and Their Risk
Factors Among An–Najah National University
Students - Nablus - Palestine

By
Wafa Allam Theeb Minawi

Supervisor
Dr. Mohammad Musmar

Co-supervisor
Dr. Samar Ghazal/ Musmar

Submitted in Partial Fulfillment of the Requirements for the Degree of
Master in Public Health, Faculty of Graduate Studies, at An – Najah
National University, Nablus, Palestine.
2005

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TO

MY PARENTS

SISTERS, BROTHERS, AND FRIENDS

WITH LOVE AND RESPECT
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Acknowledgment

I would like to express my special, deep thanks to my supervisor Dr.
Mohamed Musmar and co-supervisor Dr. Samar Ghazal \ Musmar, for
their supervision, guidance, support and help throughout this study.
I am also grateful to An – Najah University staff and students, Arabic
computer Technicians, volunteers and managers who continue to make this
study possible.
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Table of Contents
Subject Page
Dedication III
Acknowledgments IV
Table of contents V
List of tables IX
List of figures XI
Glossary XIII
Abstract XIV
Chapter One: Literature Review & Aim of the Study 1
1.1. Definitions of asthma and allergy 2
1.2. Pathophysiology of asthma and allergy 2
1.3. Common types of allergies 3
1.4. Prevalence of asthma and allergy 4
1.5. Causes and triggers of asthma and allergy 8
1.6. Asthma 15
1.7. Rhinitis 19
1.8. Food allergies 21
1.9. Stinging insect allergy 23
1.10. Anaphylaxis 24
1.11. Eczema 25
1.12. Allergic conjunctivitis 26
1.13. Drug allergies 27
1.14. Asthma and Allergy In Palestine 28
1.15. Cost of allergy 28
1.16. Prevention 29
1.17. Treatment 31
1.18. Public health challenges 34
1.19. Aim of the study 36
1.20. Research hypothesis 37
Chapter Two: Methodology 38
2.1. Introduction 39
2.2. Population of the study 39
2.3. Data collection 39
2.3.1. Questionnaire Component 40
2.3.2. Experimental Part : Peak Flow Meter 41
2.4. Procedure 42
2.5. Data analysis 44
2.5.1. Analysis of descriptive studies 44
2.5.2. Analysis of medical history 44
2.5.3. Analysis of relationship 44
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Chapter Three: Results 45
3.1 Profile of the study population 47
3.1.1 Anthropometric characteristics and General profile 47
3.1.2. Social profile 48
3.1.3. Place of living profile 48
3.1.4 Health profile 52
3.1.4.1. Triggers of asthma and allergy 52
3.1.4.2. Percentage of asthma and allergy 54
3.1.4.3. Prevalence rate of asthma and allergy 54
3.2. Peak Expiratory Flow Result 57
3.2.1. Comparison between Persian percent prediction & 57
Nunn, and Gregg percent prediction equations.
3.3. Relationships Results 59
3.3.1. Allergic Rhinitis & social, environmental, 59
health profile
3.3.2. Asthma& social, environmental, health profile 60
3.3.3. Skin allergy & social, environmental, health profile 61
3.3.4. BMI categorized & Persian percent prediction for 63
male categorized
3.3.4.1. BMI categorized & Persian percent prediction for 63
male less than 21 categorized
3.3.4.2. BMI categorized & Persian percent prediction for 64
male equal or more than 21 categorized
3.3.5. Sport practicing & Persian percent prediction for male 65
categorized
3.3.5.1. Sport practicing& Persian percent prediction for male 65
less than 21categorized
3.3.5.2. Sport practicing & Persian percent prediction for male 66
equal or more than 21categorized
3.3.6. Smoking & Persian percent prediction for male 67
categorized
3.3.6.1. Smoking & Persian percent prediction for male less 67
than 21 categorized
3.3.6.2. Smoking & Persian percent prediction for male equal 68
or more than 21categorized
3.3.7. Residence & Persian percent prediction for male 69
categorized
3.3.7.1. Residence & Persian percent prediction for male less 69
than 21 categorized
3.3.7.2. Residence & Persian percent prediction for male equal 70
or more than 21categorized
3.3.8. Asthma & Persian percent prediction for male 71
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categorized
3.3.8.1. Asthma & Persian percent prediction for male less 71
than 21 categorized
3.3.8. Asthma & Persian percent prediction for male equal or 72
more than 21 categorized
3.3.9. BMI & Persian percent prediction for female 73
categorized
3.3.9.1. BMI & Persian percent prediction for female less than 73
21 categorized
3.3.9.2. BMI & Persian percent prediction for female equal or 74
more than 21 categorized
3.3.10. Sport practicing & Persian percent prediction for 75
female categorized
3.3.10.1. Sport practicing & Persian percent prediction for 75
female less than 21 categorized
3.3.10.2. Sport practicing & Persian percent prediction for 76
female equal or more than 21 categorized
3.3.11. Residence & Persian percent prediction for female 77
categorized
3.3.11.1. Residence & Persian percent prediction for female less 77
than 21 categorized
3.3.11.2. Residence & Persian percent prediction for female 78
equal or more than21categorized
3.3.12. Smoking & Persian percent prediction for female 79
categorized
3.3.12.1. Smoking & Persian percent prediction for female less 79
than 21 categorized
3.3.12.2. Smoking & Persian percent prediction for female 80
equal or more than 21 categorized
3.3.13. Asthma & Persian percent prediction for female 81
categorized
3.3.13.1. Asthma & Persian percent prediction for female less 81
than 21 categorized
3.3.13.2. Asthma & Persian percent prediction for female equal 82
or more than 21 categorized
Chapter Four: Discussion 83
4.1. Social profile 84
4.1.1. Socio demographic profile 84
4.2. Triggers that worsen or cause symptoms for population 87
sample
4.3. The prevalence of asthma and allergy 89
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4.4. Relationships 91
4.4.1. The relationship between allergic and social, 91
environmental, and health profile
4.4.1.1. Allergic rhinitis and social, environmental and health 91
profile relationship
4.4.1.2. Relationship between asthma and social, environmental 92
and health profile
4.4.1.3. The relationship between skin allergy and social, 95
environmental health profile
4.4.2 PEF relationships 97
4.4.2.1. Comparison between two based equations for PEF, 97
Persian and Nunn and Gregg for the study sample
4.4.2.2 BMI & PEF Persian percent prediction for males & 99
females
4.4.2.3. Sport practice& PEF Persian percent prediction for 99
males & females
4.4.2.4. Smoking & PEF Persian percent prediction for males & 100
females
4.5.2.5. Residence & PEF Persian percent prediction for male 100
& female
4.4.2.6. Asthma & PEF Persian percent prediction for males & 101
females
4.5. Limitation 102
4.6. Conclusions 103
4.7. Recommendations 105
References 107
Appendix 126
Questionnaire 127
Peak flow meters group 134
Mean peak expiratory flow in normal adults chart 135
Abstract in Arabic ( صخلملا) -ب -
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Lists of Tables
Table Title Page
Table 1 Guide to asthma severity 19
Table 2 The number of cases of asthma and allergy according
28
to Palestinian Ministry of Health
Table 3 Summery of approach for treating common allergic
33
disorders
Table 4 Derived predicted equations for PEF measuring by
44
Golshan et al.
Table 5 Anthropometric characteristics and General profile 47
Table 6 Body mass index measurements profile of the study
47
population
Table 7 Social profile (marital statues, job, smoker, smokers
48
in the house)
Table 8 Residence profiles (housing, environments, healthy,
49
#of house members, ect)
Table 9 Triggers that worsen or cause symptoms of population
52
samples
Table 10 Percentage of asthma and allergy 54
Table 11 Prevalence rate of asthma and allergy 54
Table 12 Distribution of allergic disease according to the study
55
sample genders
Table 13 Distribution of allergic disease according to the study
56
sample residence
Table 14 Comparison between Persian percent prediction,
Nunn, and Gregg percent prediction equations for 57
males groups.
Table 15 Comparison between Persian percent prediction and
Nunn and Gregg percent prediction equations for 58
females groups
Table 16 Allergic rhinitis& social, environmental, health
59
profile relationships
Table 17 Asthma & social, environmental, health profile
60
relationships
Table 18 Skin allergy & social, environmental, health profile
61
relationships
Table 19 BMI categorized & Persian percent prediction for
63
male less than 21 categorized
Table 20 BMI categorized & Persian percent prediction for
64
male equal or more than 21 categorized
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Table 21 Sport practicing & Persian percent prediction for male
65
less than 21 categorized
Table 22 Sport practicing & Persian percent prediction for male
66
equal or more than 21 categorized
Table 23 Smoking & Persian percent prediction for male Less
67
than 21 categorized
Table 24 Smoking & Persian percent prediction for male equal
68
or more than 21 categorized
Table 25 Residence & Persian percent prediction for male less
69
than 21 categorized
Table 26 Residence & Persian percent prediction for male equal
70
or more than 21 categorized
Table 27 Asthma & Persian percent prediction for male less
71
than 21 categorized
Table 28 Asthma & Persian percent prediction for male equal
72
or more than 21 categorized
Table 29 BMI & Persian percent prediction for female less than
73
21 categorized
Table 30 BMI & Persian percent prediction for female equal or
74
more than 21 categorized
Table 31 Sports & Persian percent prediction for female less
75
than 21 categorized
Table 32 Sports & Persian percent prediction for female equal
76
or more than 21 categorized
Table 33 Residence & Persian percent prediction for female
77
less than 21 categorized
Table 34 Residence & Persian percent prediction for female
78
equal or more than 21 categorized
Table 35 Smoking & Persian percent prediction for female less
79
than 21 categorized
Table 36 Smoking & Persian percent prediction for female
80
equal or more than 21 categorized
Table 37 Asthma & Persian percent prediction for female less
81
than 21 categorized
Table 38 Asthma & Persian percent prediction for female equal
82
or more than 21 categorized