We conducted a cross-sectional questionnaire based study of school going children (5-15 years) in Jaipur city during 2008-2009. We adopted International Study of Asthma and Allergy in childhood (ISAAC) with slight modification, printed in Hindi as well as English languages [7]. Questions related to severity of asthma were excluded. The questionnaires were filled by the parents for children <10 years and by the students themselves or parents in >10 years. Those who answered yes to any questions related to asthma were labeled as probable asthmatic and were evaluated further for confirmation of diagnosis including detailed history, physical examination, PEFR before and after bronchodilation in all probable case and spirometry wherever diagnosis was in doubt. Children were labeled to have asthma when they had many of the qualifier symptoms like recurrent cough or wheezing, afebrile episodes, exercise induced symptoms, night symptoms, seasonal variations, personal history of atopy or allergic rhinitis and family history of asthma or atopy.

Response rate was 68.1% (2263 of 3321 questionnaires were returned) and 98.3% (2225/ 2263) were fully filled. Children in 12-15 years age comprised the largest group (39.4%).After analyzing the questionnaires 395 children were labeled probable asthmatics. After detailed evaluation 169 of 2225 (7.59%) children were found to have asthma (in last 12 months). Prevalence of various asthma related features are depicted in Table I. Numbers of asthmatic children in different age groups were as follows: 5-8 years 49/604 (8.11%), 9-11 years 57/745 (7.65%) and 12-15 years 63/876 (7.19%). Male: female ratio in children with asthma was 1.56:1 and 1.44:1 in overall study population. Personal history of atopy or allergic rhinitis was present in 55.7% (94/169) and family history of asthma was present in 76 of 169 (44.97%), allergic disorders (rhinitis, conjunctivitis or skin allergy) were present in 61(36.09%) asthmatic children.

TABLE I	Prevalence of Asthma related Symptoms in Study Population (n=2225)

There are many studies on prevalence of childhood asthma in India with majority showing increasing trends [2-4]. The steering committee of ISAAC, in 1998, found 6.0% Current Wheeze and 4.5% ever asthma in India, however, there were wide variations in the prevalence from different regions however there are concerns that prevalence may have been underestimated due to various reasons [7]. Current wheeze in our study was 8.4% which are quite similar to the trends has seen in recent studies from Delhi [6]. Physician diagnosed asthma was 5.3% in our study which is lower than current asthma, reflecting under diagnosis. In a study in school children from rural areas of Ajmer 83 of the 2416 (3.4%) children had asthma which is quite low as compared to our data [5]. Urban rural difference, higher environmental pollution and indus-trialization seem to be the cause of this difference [1,3].

We suspect that actual prevalence in Jaipur could be even higher as we also had the limitations of questionnaire based surveys including underreporting due social stigma attached with asthma and poor perception of symptoms and also the exercise induced asthma and mild episodic cases where symptoms may not be present and physical examinations, PEFR and spirometry may be normal.

Contributors: BSS, MG and RC designed the study and were involved in data collection and analysis. MG prepared the manuscript and BSS reviewed it critically.

Funding: None; Competing interests: None stated.

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