الفهرس 
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Abstract
Asthma is the commonest chronic illness among school children and important cause of absence from school and reduced participation in sport and other activities. The prevalence of asthma is also impacted by socioeconomic and environmental factors. Environmental factors include exposure to allergens. Asthma attacks interfere with daily activities, including attending school and going to work.
Prevalence of asthma in Egypt was 9.4%. There is a higher prevalence and increased severity of asthma symptoms in children of lower socioeconomic group. Asthma affected as many as 10-12% of children in the USA and, for unknown reasons, is steadily increasing. It can begin at any age, but most children have their first symptoms of asthma. There are over five hundred thousand hospitalizations each year.
Increased morbidity rates of asthma are still unacceptable due to lack in caregivers’ knowledge and practices at home and lack of awareness of school nurse, teachers, and administrators in school, that lead to increase absenteeism. So, school environment should be improved to decrease severity of asthma.
The present study was aiming to assess factors affecting bronchial asthma among primary school children. This is aim was achieved through assessing the school environment for asthmatic children, assessing caregiver (mother/father) knowledge about bronchial asthma as a disease and assessing caregiver (mother/father) practices regarding to care of asthmatic children .
The study was conducted in governmental primary schools at Manshiet Naser District affiliated to EL-Waily zone in abasia, and home visits of the study group. Data collection was carried out in the period from October 2010 and completed by April 2011. A purposeful sample including 150 school children with asthma and their caregivers were recruited in study.
Data were collected by using:
- Interviewing Questionnaire sheet to assess socio-demographic characteristics of the study group’s, knowledge and practices regarding care of asthmatic children.
- Child’s physical assessment sheet to assess the school child health condition with asthma.
- Observational checklist to assess school environment of study group.
The study reveals that:
- As for allergic factors; slightly less than three quarters (73.3%) of them were exposed to dust mites, while less than one fifth (17.3%) were exposed to dandruff animals. As for non allergic factors; the most (90%) of them inhaled smoke from burning waste products followed by the majority (82%) of them were exposed to cold air, and 80% of them were exposed to chalk dust, while slightly more than one quarter(26.7%) of them had genetic factors
- More than three quarters (76.7%) of asthmatic children have irregular attendance in school, and 52% of children have poor school achievements.
- Slightly more than two thirds (67.3%) of caregivers didn’t known warning signs that indicate need for emergency hospitalization for asthmatic children.
- Less than three quarters (71.3%) have unsatisfactory knowledge about asthmatic children and 80.7% have unsatisfactory practices regarding asthmatic child care.
- There were highly statistically significant correlations between playground and asthma severity, statistically significant correlations between classroom ventilation, passive smoking, and asthma severity. A highly statistically significant correlation was detected between caregivers’ practices and recurrence of asthma, and significant correlation was found between knowledge and recurrence of asthma. A highly statistically significant correlations between total score of caregivers practices, total score of caregivers knowledge and asthma severity.
The study recommended that:
o For education:
- Improving knowledge and practices of asthmatic children by applying a health program for caregivers, students, nurses, and teachers.
- Raising school administration awareness about the importance of healthy physical environment and how to eliminate environmental factors among asthmatic children.
- Increase awareness about the importance of healthy physical environment among school team by asthma education for students, staff, caregivers, and train school staff to recognize signs of an asthma attack.
o For practices:
- Positive coordination between school health staff and school administration to improve quality of school health.
- Emphasize the availability of an oriented school nurse with physical school environment and apply an action plan for asthmatic children
o Further study:
- Apply similar study in other schools, with deferent districts.
- Apply health program for nurses about how dealing with asthmatic children, how eliminate asthma triggers.