Urbanization and the risk of asthma among schoolchildren in the Palestinian authority

The aim of the present survey was to compare the prevalence of symptoms suggestive of asthma in boys and girls aged 6-7 and 13-14 years in a rural and an urban area in the West Bank. For this purpose, the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was issued to 970 schoolchildren in the two regions. The response rate was 92.2%. The prevalences of ever wheezing in the urban and rural areas were 16.4% and 12.0%, respectively (p < 0.05); the 12-month prevalences of wheezing were 10.5% and 5.5%, respectively (p < 0.05); the prevalences of more severe wheeze were 4.5% and 1.7%, respectively (p < 0.05); and prevalences of diagnosed asthma were 4.2% and 2.8%, respectively (p = NS). When controlling for age by stratification, the significant association between prevalence rates and place of residence persisted in the 13-14-year age group. These results also show that the prevalence of asthma among Palestinian children's moderately high in comparison with that reported from developing countries, but lower than those reported from Western countries. This survey, the first epidemiological survey on asthma in the West Bank, demonstrates a marked difference between urban and rural areas. The findings emphasize the need for further study of the environmental determinants of the disease among Palestinian children.