The narrowing or obstruction of the airways is caused by airway inflammation and broncho-constriction. Its prevalence has been reported to be increasing everywhere in the world. Asthma is a considerable burden, not only in terms of health care costs but also of decreased productivity and diminished participation in family life. While for children who were asthmatic, the condition attributed significantly in causing absenteeism of these children as compared to those who were not asthmatic; asthmatic children showed higher mean period of school absenteeism (1)
During the past two decades, we have witnessed many scientific advances that have improved our understanding of asthma and our ability to manage it effectively. Still, the variation of national health care systems and of asthma therapies necessitates that recommendations for asthma care should be adapted to local conditions throughout the global community. Saudi Arabia has been one of the nations that had seen an increase in the prevalence of asthma. The country is located in the Middle East, bordering the Persian Gulf and the Red Sea, north of Yemen; the terrain is mostly uninhabited sandy desert. Generally the climate is harsh with a dry desert and with great temperature extremes.
Saudi Arabia's 2005 population is estimated to be about 26.5 million; including about 5.5 million resident foreigners. Until the 1960s, most of the population was nomadic or semi nomadic; due to rapid economic and urban growth, more than 95% of the population now is settled. Some cities and oases have densities of more than 1,000 people per square kilometer (2,600/mile) (2). The estimated birth and death rates for 2005 were .29.56-births/1,000 population 2.62 deaths/1,000 population. The age structure of the population for the same year for age group 0-14 years: 38.2% (male 5,149,960/female 4,952,138), 15-64 years: 59.4% (male 8,992,348/female 6,698,633), and 65 years and over: 2.4% (male 334,694/female 289,826) (3).
Asthma has been rising in prevalence for the past two to three decades in the country and even in different parts of the globe. A survey conducted for the number of asthma cases among children between the ages of 8 and 16 for a 9-year period revealed that there was a significant increase in the prevalence of bronchial asthma from 8% in 1986 to 23% in 1995 (4). Moreover, another study comparing the symptoms of asthma in urban and rural Saudi Arabia in 1998 showed that a greater number of allergic symptoms were found in urban than in rural children and in Saudi than non-Saudi Arab children (5). Likewise, a survey of the socioclinical profile of children with asthma in Al-Majmaah province showed that male children represented 69% of the sample and children under one year of age manifested significantly severe degree of asthma (6). In the United Kingdom, a number of studies have shown a rising incidence of asthma up to 32.2% (7). Similarly, in the United States of America the prevalence of self-reported asthma has increased by 42% (8).
Factors associated with asthma are countless. They have been categorized in many groups based on some common characteristics. In the following paragraphs the matter is discussed under specific topics as it is concerned with asthma.
Role of genetics in this regard has been universal and it attributes to a