doi: 10.5455/mjhs.2025.04.010
Original Article
Knowledge and attitude regarding Pediatric Asthma among the general population in Medina, Saudi Arabia
1Women and Child Health, College of Medicine, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia · 2College of Medicine, Taibah University, Madinah 42353, Saudi Arabia · 32 College of Medicine, Taibah University, Madinah 42353, Saudi Ar
Abstract
Background and Aims: Asthma is a chronic respiratory disease affecting millions of children, causing significant morbidity and mortality worldwide. Despite its prevalence, asthma remains poorly understood, with misconceptions and stigma leading to delayed diagnosis, inadequate treatment, and poor adherence to medication. This study aims to investigate the general population’s knowledge, attitudes, and practices toward pediatric asthma, with a focus on identifying areas for education and awareness to improve asthma management and outcomes. Methods: This descriptive cross-sectional study was conducted in Medina, Saudi Arabia, between June 2023 and October 2023. The study targeted the general population residing in Medina, encompassing individuals of all sexes and nationalities, as well as caregivers of children under 18 years with asthma. A self-administered questionnaire was used for data collection, and the data were analyzed using SPSS (version 23). Results: A total of 619 participants were included. A majority of participants (92.4%) demonstrated a good understanding of asthma as a chronic condition with acute exacerbations triggered by allergens. Participants with a family history of bronchial asthma and those who suffered from bronchial asthma themselves had significantly higher knowledge scores (p≤0.001, p≤0.003, respectively). Additionally, participants living at home with a child who suffers from asthma had a statistically higher knowledge score (p ≤ 0.005). The study also found that older participants and those with a university education had higher knowledge scores (p < 0.001, p < 0.001, respectively). Conclusion: Our study reveals that a significant proportion of participants possess a moderate level of knowledge about pediatric asthma, with a strong correlation between age, educational level, and knowledge level.
Keywords Asthma · Pediatrics · Knowledge · Attitude · Perception · Madina · Medina · Saudi Arabia
Introduction
Asthma is a chronic respiratory condition that is characterized by airway inflammation, obstruction in the airflow, and bronchial hyper-responsiveness1. It poses a significant impact on children and has garnered public health attention owing to its escalating prevalence, morbidity, and mortality rates2,3. According to the Global Initiative for Asthma, it affects approximately 300 million individuals worldwide4. Meanwhile, in the case of asthma prevalence among children, there is a significant 13-fold difference between countries5. Approximately 2 million people, constituting roughly 6% of the populace, contend with asthma in Saudi Arabia4. The incidence of asthma among children was significantly higher than among adults, exhibiting regional variation from 9% to 33.7%6.] Pediatric asthma remains a major concern due to its early onset, potential developmental disruptions in children, and its impact on the family7. Furthermore, pediatric asthma also imposes a considerable burden on children's lives in ways that can lead to school absences and psychosocial issues. These problems can stem from restrictions to participation in sports and recreational activities, which may cause functional limitations, reduce self-esteem, and cause distress for both children and their families8. Despite the widespread prevalence of pediatric asthma and its significant impact on children's lives, studies have shown that many people delay seeking diagnosis and treatment, especially for children. This may be attributed to misconceptions and lack of knowledge, along with stigmatization of those affected by the asthma disease, resulting in its increased severity, and a delay in receiving medical treatment 9-12. As a lack of knowledge and perception regarding asthma is a major concern which can delay its diagnosis, the best management for asthma is the right knowledge and the right attitude13. Studies have found that parents of children with asthma who have better knowledge and health education were more likely to see an improved lifestyle and reduced morbidity in their children14,15. Therefore, proper knowledge, attitude, and perception regarding asthma can enhance medication compliance and improve the chances of medical follow-up16.
Raising public awareness and promoting positive attitudes about asthma is crucial for identifying symptoms early, diagnosing the condition, and managing it effectively, particularly in its early stages. A well-informed public is better equipped to recognize asthma signs, leading to timely medical attention and intervention, which can improve life quality. By promoting awareness and fostering a supportive environment for asthma management, individuals are equipped to take control of their condition, prevent severe attacks, seek timely medical help, and stick to their treatment plans. Despite limited studies on caregivers' knowledge of pediatric asthma in Saudi Arabia, there is a notable gap in research specifically evaluating public awareness and attitudes toward pediatric asthma, particularly in Medina, Saudi Arabia. Thus, this study was designed to determine the knowledge and attitudes toward pediatric asthma among the population in Medina, Saudi Arabia.
Materials and Methods Study design
This descriptive cross-sectional study was performed between June 2023 and October 2023. This study focused on the general population residing in Medina, including individuals of all genders and nationalities, as well as those caring for children <18 years old with asthma, to ensure adequate data collection. Study population
For the selection of study participants, eligibility criteria included residents of Medina of any nationality and of any age (adult or parents of children with asthma) who understood the questionnaire, gave consent and could respond to the questions in Arabic or English. Specific exclusion criteria included non-residents of Medina, healthcare professionals to avoid bias, and those unwilling to participate in the study. Stratified random sampling was performed for the selection of participants to ensure participation from each part of Medina.
Sample size
Data for the population in Medina was obtained from the General Authority for Statistics (GASTAT), and one person from each participating family was selected to respond to the questionnaire. The sample size was calculated by a given formula17 where N=population size (1.4 million); d = error + 5%; Z = 1.96 (confidence level of 95%); and P=probability of 50%.
Using the aforementioned formula, n=380 participants were obtained. We then increased the sample size (619) to reduce the margin of error and increase the results' precision.
Data collection tools
This study employed a self-administered questionnaire to collect data comprised of three parts. The first section focused on the individuals' demographics, including age, gender, educational level, asthma status, cohabitation with someone having bronchial asthma, and family history of bronchial asthma. The second section, comprising 25 questions, assessed asthma awareness using a Structured Asthma Knowledge Questionnaire in Arabic6. This section evaluated knowledge of childhood asthma, symptoms, prevention, management, triggers, and education. The correct response was recorded as a score of 1, an incorrect response was recorded as a score of 0. Participants' scores were calculated to determine an overall knowledge score, ranging from 0 to 25. A knowledge score >75% indicated a high level of knowledge, a score between 50%-75% denoted moderate knowledge, and a score <50% signified a low level of knowledge.[17] The third section, assessing asthma attitude, utilized Gibson et al's 18 questionnaire, consisting of 14 questions divided into four domains. Responses were recorded on a six-point scale, ranging from "strongly agree" to "strongly disagree."
Ethical consideration
The study was approved by the Majmaah University Research Ethics Committee, approval ID: STU-22-14 . Informed consent was taken from selected participants (>18 years) prior to completing the questionnaire. While, for participants aged <18 years, the informed consent was taken from their parents or guardians. All participants/parents/guardians were explained their rights and the research objectives, and their consent was duly documented.
Statistical analyses
Categorical variables were represented as frequencies and percentages, and numerical variables were summarized as the minimum, maximum, mean, and standard deviation (SD). To examine the relationship between categorical variables and knowledge scores, independent t-tests and ANOVA tests were employed. The Tukey's post-hoc test was applied to identify the specific groups exhibiting significant differences. Pearson's correlation coefficient was used to determine the correlation between numerical variables. A significance level of 0.05 was established for all tests. All analyses were performed utilizing the Statistical Package for the Social Sciences (SPSS, version 23, NY, USA).
Results
Demographic characteristics
A total of 619 participants were included in the study, and the response rate was 100%. Regarding age distribution, 76 (12.3%) were less than 18 years of age, 223 (36%) were 18-29, 249 (40.2%) were 30-50, and 71 (11.5%) were > 50 years old. In terms of gender, the majority, 495 (80%), were females, while 124 (20%) were males. Regarding education, the participants' backgrounds varied, with 11 (1.8%) having primary school education, 32 (5.2%) having intermediate school education, 169 (27.3%) having high school education, and a significant proportion, 407 (65.8%), having had a university education. In addition, 240 (38.8%) participants had a family history of bronchial asthma (Table 1).
| Table 1. Socio-Demographic Profile of The Participants (n=619), and Children with asthma profile (n=177). | ||
|---|---|---|
| Demographic Characteristics | Frequency | % |
| Age group | ||
| Less than 18 years | 76 | 12.30 |
| 18-29 years | 223 | 36.00 |
| 30-50 years | 249 | 40.20 |
| <50 years | 71 | 11.50 |
| Gender | ||
| Male | 124 | 20.00 |
| Female | 495 | 80.00 |
| Education | ||
| Primary school | 11 | 1.80 |
| Intermediate school | 32 | 5.20 |
| High school | 169 | 27.30 |
| University education | 407 | 65.80 |
| Do you have family history of bronchial asthma? | 240 | 38.80 |
| Do you have bronchial asthma? | 127 | 20.50 |
| Do you live with children who suffer from asthma? | 177 | 28.6 |
| What is relationship between you and this child? | ||
| Father | 13 | 7.3 |
| Mother | 67 | 37.9 |
| Sibling | 42 | 23.7 |
| Relative | 53 | 29.9 |
| No relation | 2 | 1.1 |
| Gender of the child | ||
| Male | 111 | 62.7 |
| Female | 66 | 37.3 |
| Age of child (Mean±SD) | 8.93±4.52 years | |
Also, Table 1 shows the demographic characteristics of participants cohabiting with a pediatric patient diagnosed with asthma. Regarding the relationship between the participants and the child with asthma, 13 (7.3%) identified as fathers, 67 (37.9%) as mothers, 42 (23.7%) as siblings, 53 (29.9%) as relatives, and 2 (1.1%) reported no familial relationship with the child. The gender distribution of the pediatric patients revealed a predominance of males 111 (62.7%), over females 66 (37.3%). The mean age of the children was 8.93±4.52 years.
Knowledge
The research findings indicate a varied level of knowledge among participants regarding asthma-related concepts. Analysis of the survey responses revealed that a significant majority (572, 92.4%) correctly identified asthma as a chronic condition with acute exacerbations triggered by allergens. Similarly, a substantial proportion (552, 89.2%) recognized the role of genetic, hereditary, and environmental factors in asthma progression. However, there were notable misconceptions among 165 (26.7%) participants, such as the belief that symptoms like fever, runny nose, and throat inflammation are related to asthma (Table 2). Regarding treatment and management, while a considerable number (545, 88.0%) acknowledged the importance of follow-up with a physician for better outcomes, there were misconceptions regarding the cessation of medication after an acute asthma attack (163 (26.3%). Additionally, there was a lack of awareness about the need for specialized centers to provide education and awareness about asthma (511, 82.6%). Overall, the mean knowledge score of 16.08 indicates a moderate level of understanding among participants, although with considerable variability (SD=4.18).
| Table 2. Knowledge Assessment of Participants toward Pediatric Asthma. | |||
|---|---|---|---|
| Questions | Responses (Frequency, %) | ||
| True (correct answer) | False | I don't know | |
| Asthma is a chronic disease with acute exacerbations on exposure to allergens | 572 (92.40) | 4 (0.60) | 43 (6.90) |
| Genetic, hereditary and environmental factors play a role in the progression of asthma | 552 (89.20) | 7 (1.10) | 60 (9.70) |
| There is a difference between asthma and chest allergies in children | 433 (70.00) | 49 (7.90) | 137 (22.10) |
| Asthma can be a fatal disease | 388 (62.70) | 66 (10.70) | 165 (26.70) |
| Symptoms of asthma include dyspnea and nocturnal cough | 541 (87.40) | 19 (3.10) | 59 (9.50) |
| Symptoms of asthma include fever, runny nose and throat inflammation | 165 (26.70) | 276 (44.60) | 178 (28.80) |
| Severe symptoms of asthma in children include inability to talk in sentences or lie on their back, aggression, and altered consciousness | 281 (45.40) | 107 (17.30) | 231 (37.30) |
| The frequent use of antibiotics helps in diminishing the complications of asthma | 167 (27.00) | 211 (34.10) | 241 (38.90) |
| Eating fish at an early age helps in slowing down the progress of asthma | 95 (15.30) | 110 (17.80) | 414 (66.90) |
| Infectious respiratory diseases increase the chances of asthma progression | 397 (64.10) | 38 (6.10) | 184 (29.70) |
| Direct or indirect exposure to cigarette smoke could lead to acute attacks of asthma | 537 (86.80) | 17 (2.70) | 65 (10.50) |
| Exposures to sudden changes in environment (dust or cold weather) affect the progression of asthma | 560 (90.50) | 15 (2.40) | 44 (7.10) |
| Exposure to perfumes, incense or paint fumes could lead to acute asthma attacks | 540 (87.20) | 20 (3.20) | 59 (9.50) |
| An asthmatic patient should constantly follow-up with a physician for better results | 545 (88.00) | 17 (2.70) | 57 (9.20) |
| The patient’s physician should inform him or her about the symptoms of asthma and how to handle the disease, by avoiding all triggers, in accordance with a preset plan | 561 (90.60) | 10 (1.60) | 48 (7.80) |
| The patient should be educated about how to manage an acute asthma attack | 575 (92.90) | 3 (0.50) | 41 (6.60) |
| The patient can stop taking medication after an acute asthma attack (betaagonists and inhaled steroids) | 163 (26.30) | 114 (18.40) | 342 (55.30) |
| One patient’s asthma medication can be used by another asthmatic, without referral to a doctor | 104 (16.80) | 416 (67.20) | 99 (16.00) |
| An asthmatic patient can be treated in a primary care clinic without referral to a pulmonology clinic, since it’s a common disease (excluding severe disease) | 318 (51.40) | 115 (18.60) | 186 (30.00) |
| Inhaled medications for asthma can cause addiction (inhaled BA can cause tolerance) | 159 (25.70) | 219 (35.40) | 241 (38.90) |
| Prophylactic asthma treatment can cause dangerous side effect if used without an acute asthma attack | 249 (40.20) | 93 (15.00) | 277 (44.70) |
| For better treatment of asthma, specialized centers are required to provide education and awareness to the patients and the community | 511 (82.60) | 21 (3.40) | 87 (14.10) |
| Asthma could lead to increased school absenteeism in children | 518 (83.70) | 26 (4.20) | 75 (12.10) |
| There is a need for including scientific content about asthma in students’ curricula | 492 (79.50) | 36 (5.80) | 91 (14.70) |
| There is a need for creating educative programs for schools, aiming to increase awareness about asthma | 545 (88.00) | 15 (2.40) | 59 (9.50) |
| Knowledge Score Toward Asthma (Lowest possible score = 0, Highest possible score = 25) | Maximum | Mean | Standard deviation |
| 23 | 16.08 | 4.18 | |
Figure 1 shows the knowledge level toward pediatric asthma. A total of 83 (13.4%) selected participants had low knowledge level, 352 (56.9%) had moderate knowledge score, and 184 (29.7%) had high knowledge level.
Perception and attitude
Table 3 presents participants' perceptions and attitudes toward pediatric asthma. This shows the diversity of opinions across different domains. The majority (282, 45.6%) strongly agreed that good self-care can help people avoid asthma symptoms, reflecting a positive awareness. However, only 47 (7.6%) strongly disagreed or disagreed (163, 26.3%) that asthma attacks at school are the result of carelessness. During school and sports, external factors were seen as affecting health. Many agreed and strongly agreed that positive reinforcement from teachers played an important role. Most participants rejected the idea that asthma management was purely based on luck (disagree: 195, 31.5%; strongly disagree: 161, 26%) and that there was no need to consult a physician regularly (disagree: 138, 22.3%; strongly disagree: 72, 11.6%). The social stigma and embarrassment associated with using inhalers in class remains a concern, with 25% agreeing and 15.8% strongly agreeing that students feel embarrassed. Opinions about the attitudes of teachers and peers are divided, with most viewing them as having a negative effect on asthmatic patients.
| Table 3. Perception and Attitude Assessment of Participants toward Pediatric Asthma. | ||||||
|---|---|---|---|---|---|---|
| Questions | Responses (Frequency, %) | |||||
| 1 | 2 | 3 | 4 | 5 | 6 | |
| If someone with asthma takes care of him/herself, he/she can avoid most asthma symptoms | 7 (1.10) | 20 (3.20) | 28 (4.50) | 92 (14.90) | 190 (30.97) | 282 (45.60) |
| When someone has an attack of asthma symptoms at school, it is usually because he/she has been careless | 47 (7.60) | 163 (26.30) | 131 (21.20) | 116 (18.70) | 96 (15.50) | 66 (10.70) |
| How soon someone recovers from an attack of asthma at school depends mainly on how well the teacher takes care of him/her | 15 (2.40) | 71 (11.50) | 83 (13.40) | 145 (23.40) | 192 (31.00) | 113 (18.30) |
| When someone has an attack of asthma during sport, it is because the teacher hasn't checked up on whether the student has taken his/her medication | 16 (2.60) | 88 (14.20) | 88 (14.20) | 141 (22.80) | 181 (29.20) | 105 (17.00) |
| If someone is going to have an attack of asthma, it will happen no matter what anyone does. | 27 (4.40) | 119 (19.20) | 132 (21.30) | 112 (18.10) | 140 (22.60) | 89 (14.40) |
| How soon someone recovers from an attack of asthma symptoms is mostly a matter of luck | 161 (26.00) | 195 (31.50) | 93 (15.00) | 60 (9.70) | 58 (9.40) | 52 (8.40) |
| Most people can control their asthma well without seeing a doctor regularly | 72 (11.60) | 138 (22.30) | 84 (13.60) | 121 (19.50) | 127 (20.50) | 77 (12.40) |
| Someone with asthma should not use his/her puffer in class | 200 (32.30) | 219 (35.40) | 57 (9.20) | 44 (7.10) | 50 (8.10) | 49 (7.90) |
| Students are embarrassed about using their inhalers in class. | 48 (7.80) | 85 (13.70) | 90 (14.50) | 143 (23.10) | 155 (25.00) | 98 (15.80) |
| Students without asthma have a negative attitude to students with asthma. | 114 (18.40) | 186 (30.00) | 104 (16.80) | 88 (14.20) | 72 (11.60) | 55 (8.90) |
| There would be few problems with asthma at school if students could carry their puffers around with them. | 36 (5.80) | 44 (7.10) | 46 (7.40) | 92 (14.90) | 218 (35.20) | 183 (29.60) |
| Teachers are worried about taking someone with asthma on a school camp or excursion | 26 (4.20) | 30 (4.80) | 79 (12.80 ) | 151 (24.40) | 208 (33.60) | 125 (20.20) |
| Students with asthma are just as fit as students without asthma. | 50 (8.10) | 172 (27.80) | 146 (23.60) | 101 (16.30) | 91 (14.70) | 59 (9.50) |
| School teachers have a negative attitude to students with asthma. | 128 (20.70) | 179 (28.90) | 109 (17.60) | 85 (13.70) | 66 (10.76) | 52 (8.40) |
Association between knowledge scores and demographic parameters
Increasing age of the adult participants was significantly associated with knowledge scores about pediatric asthma (p<0.001). Participants older than 50 had significantly higher knowledge scores (17.3) than all the other age groups. Education and knowledge had a significant association with pediatric asthma (p<0.001). Similarly, individuals with a university education had significantly higher (0.001) knowledge scores (16.63) than other education levels. Participants with a family history of bronchial asthma had a significantly higher knowledge scores toward pediatric asthma than those without a family history (16.75 ± 3.82 vs 15.66 ± 4.35, p=0.001). Participants with bronchial asthma also had significantly higher knowledge scores about pediatric asthma than those who did not have asthma (17.06 ± 3.87 vs 15.83 ± 4.23, p=0.003). Moreover, participants living with a child who suffers from asthma had a statistically higher knowledge score than those who did not (16.83 ± 3.34 vs 15.78 ± 4.45, p=0.005). The age of the child suffering from asthma, with whom the participant was living, had a significant negative correlation with the knowledge score about pediatric asthma (p=0.008, correlation coefficient = -0.198). The participant's (adults) gender, the asthmatic child's gender, and the relationship between participants and the child with asthma were all not significantly associated with knowledge scores about pediatric asthma (Table 4).
| Table 4. Factors Associated with Knowledge Score of Pediatric Asthma. | |||
|---|---|---|---|
| Factor | Knowledge Score | P-value | |
| Mean | Standard Deviation | ||
| Age group | |||
| <18 years | 13.17 | 5.43 | <0.001* |
| 18-29 years | 15.83 | 4.32 | |
| 30-50 years | 16.85 | 3.42 | |
| > 50 years | 17.3 | 3.06 | |
| Gender | |||
| Male | 16.29 | 4.45 | 0.536 |
| Female | 16.03 | 4.12 | |
| Education | |||
| Primary school | 15.18 | 3.22 | < 0.001* |
| Intermediate school | 15.16 | 3.85 | |
| High school | 15.01 | 5.21 | |
| University education | 16.63 | 3.63 | |
| Do you have family history of bronchial asthma? | |||
| Yes | 16.75 | 3.82 | 0.001* |
| No | 15.66 | 4.35 | |
| Do you suffer from bronchial asthma? | |||
| Yes | 17.06 | 3.87 | 0.003* |
| No | 15.83 | 4.23 | |
| Do you live at home with children who suffer from asthma? | |||
| Yes | 16.83 | 3.34 | 0.005* |
| No | 15.78 | 4.45 | |
| What is relationship between you and this child? | |||
| Father | 17.62 | 2.90 | 0.229 |
| Mother | 17.31 | 2.83 | |
| Sibling | 15.88 | 4.41 | |
| Relative | 16.81 | 3.00 | |
| No relation | 16.00 | 2.83 | |
| Gender of the child suffering from asthma | |||
| Male | 17.14 | 2.91 | 0.106 |
| Female | 16.30 | 3.93 | |
| Correlation between Knowledge toward Pediatric Asthma and Age of the Child Suffering from Asthma | |||
| P-value | 0.008* | ||
| Correlation coefficient | -0.198 | ||
Discussion
The adult participants (56.9%) living in Medina had moderate-level knowledge scores (16.10) about pediatric asthma. However, many misconceptions were found regarding bronchial asthma in the pediatric population. This may be due to cultural beliefs and stigma as highlighted in the present study, or due to lacking or limited public health education campaigns addressing pediatric asthma. Meanwhile, our findings are in agreement with previously published studies, and we have observed how participants possessed varying levels of knowledge regarding pediatric asthma. Specifically, 45.6% of the participants demonstrated good knowledge, 46.5% exhibited fair knowledge, and 8% had poor knowledge regarding pediatric asthma19. Moreover, a study performed in the Tabuk region of Saudi Arabia about caregivers' knowledge and practices for children with asthma revealed that most caregivers had a higher knowledge (62%) regarding pediatric asthma3. In a contrasting study, 116 mothers and caretakers of their children were assessed for their basic knowledge regarding pediatric asthma, and results found 72.4% of the participants had basic knowledge20.
Regarding the perception of asthma, our study finds that most of the selected participants were aware of asthma being a chronic condition with genetic, hereditary, and environmental factors playing a role in its progression. In support of our results, a previous study in Saudi Arabia investigating the perceptions of parents toward asthma found 53% reported that asthma is a hereditary disease, and 77% reported that environmental factors are potent triggers21. Furthermore, two studies performed in the USA and India documented that asthma was considered a hereditary disease22,23. On the other hand, 70% of participants believe that there is no difference between asthma and chest allergies in children. In contrast, a separate study conducted in Turkey indicated that 51% of the participants were aware that asthma is a genetic disease, and 58% of the respondents correctly stated that it is not an infectious disease24. Furthermore, our findings also showed that participants were well aware that direct or indirect exposure to cigarette smoke, perfumes, or paint fumes can lead to acute attacks (86%-87%, respectively). Additionally, 64% are knowledgeable that respiratory infections can increase asthma progression. Similar findings can be seen in a study conducted by Al-Harbi et al4. One study revealed that smoking is the main factor that harms children with asthma in Saudi Arabia25.
Meanwhile, several studies performed globally found a strong association between antibiotic consumption and a higher risk of pediatric asthma15,16. There are convergent results about addiction to asthma medication in our study, with only 35-40% of selected participants knowing that inhaled asthma medications do not cause addiction. Similarly, in the study conducted by Binsaaed et al25 when asked if asthma medications lead to drug dependency, only 27% answered "No," while 55% said they did not know. Additionally, in this study, only 25% correctly understood that prophylactic asthma treatment does not cause dangerous side effects. Studies have indicated that adhering to the recommended guidelines for prophylactic treatment is crucial to prevent any significant adverse effects4. Regarding follow-up in the clinic for better outcomes, our results show that many participants have good awareness (88%), discuss their symptoms with their primary caregivers, and are educated on managing an acute asthma attack (92%). Similarly, most of our participants agreed (67.2%) that asthma medicine cannot be used until advised by a doctor. While 79.5% of our sample supported the addition of scientific information about asthma to the school curriculum, 88% of the participants expressed the need for educational and awareness programs about asthma in schools. Another study showed similar results regarding the need for educational school programs with the purpose of increasing knowledge and reducing misconceptions about the condition10. A study performed in Jizan, Saudi Arabia, has similar results26. Another study observed a significant difference in students' knowledge about asthma before and after they took part in a school-based educational program about the condition27.
Furthermore, Al-Harbi et al4 found that asthma knowledge was statistically higher with age (p<0.001, CI [−0.60, 1.41]), indicating that the higher age group had a higher awareness score4, which aligns with our study. Regarding education, individuals with a university education demonstrated higher knowledge scores compared to those with a high school education (p<0.05). The current study supports the results of a prior investigation carried out in Iraq by Mohammed et al.,28 which established a significant link between parents' educational level and their performance on the asthma knowledge questionnaire, and observed that parents with higher education are more likely to acquire knowledge more rapidly. Furthermore, participants with a family history of bronchial asthma have higher knowledge scores compared to those without a family history. This finding correlates with another study, which showed that participants with asthmatic family members exhibited a higher mean score on the knowledge scale, reaching statistical significance (p=0.005)19. Similarly, the same study also indicated significant correlation between asthma knowledge and two factors: individuals who themselves suffer from bronchial asthma (P=0.003) and those who live with a child diagnosed with asthma19.
Study limitation
When interpreting the findings of the present study, it is important to consider the limitations of this cross-sectional study. Potential recall bias may exist in self-administered questionnaires, despite our efforts to employ an accurate method. This introduces the possibility of some inaccuracies in the results. Additionally, the prevalence of asthma was determined based on data from the ISAAC questionnaire, which focuses on symptoms or previous diagnoses of asthma. Furthermore, while the response rate was excellent, it is worth noting that the reported prevalence may still be comprehensive.
Conclusions
Based on our findings, it is evident that more than half of our participants possess a moderate level of knowledge about asthma. Furthermore, we observed a clear correlation between age, educational level, and knowledge level. Consequently, prioritizing the allocation of resources towards educational programs tailored to asthma patients and their caregivers is essential. Such interventions are likely to enhance understanding of the condition and its management, thereby improving overall outcomes.
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Note: 1= Strongly disagree, 2= Disagree, 3= Lean more to disagreeing, 4= Lean more to agreeing, 5= Agree, 6= Strongly agree