Comparative assessment of cognitive function of asthmatic and non-asthmatic children in Ilorin, Nigeria

  • Salihu Sheni Mohammed General Hospital, Ilorin
  • Rasheedat Mobolaji Ibraheem
  • Mohammed Baba Abdulkadir
  • Muhammed Akanbi Nurudeen Adeboye
  • Aishatu Ahmed Gobir
  • Wahab Babatunde Rotimi Johnson
Keywords: asthma; cognitive function; children; Nigeria; Raven's Progressive Matrices

Abstract

Background The presence of asthma in children may negatively impact their cognitive function, possibly due to intermittent hypoxia from repeated acute exacerbations, sleep deprivation, and school absenteeism. However, conflicting reports abound on cognitive performance among children with asthma.

Objective To assess and compare the cognitive function of asthmatic and non-asthmatic children in Ilorin, Nigeria. 

Methods This cross-sectional study compared the cognitive performance scores of 66 children with asthma aged 6-17 years, and the corresponding scores of 66 healthy age- and gender-matched children without asthma. Data obtained included sociodemographic, anthropometric, and clinical details. Cognitive function was assessed with the Raven's Progressive Matrices (RPM) psychometric test.

Results  The male: female ratio was 1.3:1. The median RPM score of 50.0 [interquartile range (IQR) 25.0-75.0] in children with asthma was significantly higher than that of non-asthmatic children [32.5 (IQR 10.0-50.0)]; (P=0.016). A significantly higher proportion of asthmatic subjects (74.2%) were in the high grade RPM score category compared to the non-asthmatic children’s concomitant proportion (57.6%). Asthmatic subjects were twice as likely to belong to the high grade RPM score category than their non-asthmatic counterparts (OR=2.12; 95%CI 1.02 to 4.44; P=0.043). There was no significant association between RPM score grade and clinical severity of asthma in the subject population (P=0.554).

Conclusion  Children with asthma perform better in cognitive function assessment, using RPM test, compared to their non-asthmatic counterparts in Ilorin, Nigeria.

References

1. Sparrow SS, Davies SM. Recent advances in the assessment of intelligence and cognition. J Child Psychol Psychiatry. 2000;41:117–31. PMID: 10763679.
2. Braaten EB, Norman D. Intelligence ( IQ ) Testing. Paediatr Rev. 2006;27:403–7. DOI: https://doi.org/10.1542/pir.27-11-403
3. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Updated 2012. [cited 2021 May 27]. Available from: https://ginasthma.org/wp-content/uploads/2019/01/2012-GINA.pdf
4. Masoli M, Fabian D, Holt S, Beasley R. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy. 2004;59:469–78. DOI: https://doi.org/ 10.1111/j.1398-9995.2004.00526.x
5. Falade AG, Ige OM, Yusuf BO, Onadeko MO, Onadeko BO. Trends in the prevalence and severity of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema. J Natl Med Assoc. 2009;101:414–8. DOI: https://doi.org/10.1016/S0027-9684(15)30925-1
6. Falade AG, Olawuyi JF, Osinusi K, Onadeko BO. Prevalence and severity of symptoms of asthma, allergic rhinoconjuctivitis and atopic eczema in 6- to 7-year-old Nigerian primary school children: The International Study of Asthma and Allergies in Childhood. Med Princ Pract. 2004;13:20–5. DOI: https://doi.org/10.1159/000074046
7. Ibe CC, Ele UP. Prevalence of bronchial asthma among adolescents in Anambra State, Nigeria. Nig J Int Med. 2002;5:23–6.
8. Ozoh OB, Aderibigbe SA, Ayuk AC, Desalu OO, Oridota OE, Olufemi O, et al. The prevalence of asthma and allergic rhinitis in Nigeria: a nationwide survey among children, adolescents and adults. PLoS One. 2019;14:e0222281. DOI: https://doi.org/10.1371/journal.pone.0222281
9. Menkes JH, Hurvitz CGH, McDiarmid SV, Williams RG. Neurologic manifestations of systemic disease. In: Menkes JH, editor. Textbook of Child Neurology. 5th ed. Baltimore: Williams & Wilkins; 1995; p. 873–4.
10. Bender BG, Annett RD. Neuropsychological outcomes of nocturnal asthma. Chronobiol Int. 1999;16:695–710. DOI: https://doi.org/10.3109/07420529908998736
11. Furukawa CT, Duhamel TR, Weimer L, Shapiro GG, Pierson WE, Bierman CW. Cognitive and behavioral findings in children taking theophylline. J Allergy Clin Immunol. 1988;81:83–8. DOI: https://doi.org/10.1016/0091-6749(88)90224-2
12. Annett RD, Aylward EH, Lapidus J, Bender BG, DuHamel T. Neurocognitive functioning in children with mild and moderate asthma in the childhood asthma management program. The Childhood Asthma Management Program (CAMP) Research Group. J Allergy Clin Immunol. 2000;105:717–24. DOI: https://doi.org/10.1067/mai.2000.105226
13. Lindgren S, Lokshin B, Stromquist A, Weinberger M, Nassif E, McCubbin M, et al. Does asthma or treatment with theophylline limit children’s academic performance? N Engl J Med. 1992;327:926–30. DOI: https://doi.org/10.1056/NEJM199209243271305
14. Rietveld S, Colland VT. The impact of severe asthma on schoolchildren. J Asthma. 1999;36:409–17. DOI: https://doi.org/10.3109/02770909909087283
15. Silverstein MD, Mair JE, Katusic SK, Wollan PC, O’connell EJ, Yunginger JW. School attendance and school performance: a population-based study of children with asthma. J Pediatr. 2001;139:278–83. DOI: https://doi.org/10.1067/mpd.2001.115573
16. Ghaffari J, Abaskhanian A, Jalili M. IQ scores of children with moderate asthma: A comparison with healthy children. Oman Med J. 2014;29:71–4. PMID: 24498486
17. Moonie S, Sterling DA, Figgs LW, Castro M. The relationship between school absence, academic performance, and asthma status. J Sch Health. 2008;78:140–8. DOI: https://doi.org/10.1111/j.1746-1561.2007.00276.x
18. Mansour AE, Yasein YA, Ghandour A, Zaidan O, El-Abaas MM. Prevalence of bronchial asthma and its impact on the cognitive function and academic achievement among preparatory school children in Damietta Governorate, Egypt. J Am Sci. 2014;10:119–27.
19. Samuel S, Safwat M, Morkos W, Salem S, El-Adly T, Mohammed A. Chronic asthmatic chest troubles and their effects on cognitive functions, psychosocial behaviour and academic achievement among children in Egypt. J Am Sci. 2010;6:1034–43.
20. Mitchell RG, Dawson B. Educational and social characteristics of children with asthmna. Arch Dis Child. 1973;48:467–71. PMID: 4712777
21. Cohen S, Berkman N, Picard E, Levi T, Derazne E, Tzur D, et al. Co-morbidities and cognitive status in a cohort of teenagers with asthma. Pediatr Pulmonol. 2016; 51:901-7. DOI: https://doi.org/10.1002/ppul.23443
22. Gutstadt LB, Gillette JW, Mrazek DA, Fukuhara JT, Labrecque JF, Strunk RC. Determinants of school performance in children with chronic asthma. Am J Dis Child. 1989;143:471–5. DOI: doi:10.1001/archpedi.1989.02150160101020
23. Moonie SA, Sterling DA, Figgs L, Castro M. Asthma status and severity affects missed school days. J Sch Health. 2006;76:18–24. DOI: https://doi.org/10.1111/j.1746-1561.2006.00062.x
24. Ayuk AC, Oguonu T, Ikefuna AN, Ibe BC. Effect of asthma on school function in school-aged children in Enugu, South-east Nigeria: a crosssectional study. South African Respir J. 2013;19:41–5.
25. Neisser U, Boodoo G, Bouchard Jr TJ, Boykin AW, Brody N, Cesi SJ, et al. Intelligence: knowns and unknowns. Am Psychol. 1996;51:77–101. DOI: https://psycnet.apa.org/doi/10.1037/0003-066X.51.2.77
26. Raven JC. Standard progressive matrices. London: H.K. Lewis; 1958.
27. Campbell JM, Brown RT, Cavanagh SE, Vess SF, Segall MJ. Evidence-based assessment of cognitive functioning in pediatric psychology. J Pediatr Psychol. 2008;33:999–1014. DOI: https://doi.org/10.1093/jpepsy/jsm138
28. Alderton DL, Larson GE. Dimensionality of Raven’s Advanced Progressive Matrices items. Educ Psychol Meas. 1990;50:887–900. DOI: https://doi.org/10.1177/0013164490504019
29. O´Leary UM, Rusch KM, Guatello SJ. Estimating age-stratified WAIS-R IQs from scores on Raven’s Standard Progressive Matrices. J Clin Psychol. 1991;47:277–84. DOI: https://doi.org/10.1002/1097-4679(199103)47:2%3C277::AID-JCLP2270470215%3E3.0.CO;2-I
30. Oyedeji GA. Socio-economic and cultural background of hospitalised children in Ilesa. Niger J Paediatr. 1985;12:111–7.
31. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Revised 2006 [cited 2019 November 16]. Available from: https://ginasthma.org/wp-content/uploads/2019/01/2006-GINA.pdf
32. Benbow CP. Physiological correlates of extreme intellectual precocity. Neuropsychologia. 1986;24:719–25. DOI: https://doi.org/10.1016/0028-3932(86)90011-4
33. Strachan DP. Hay fever, hygiene, and household size. BMJ. 1989;299:1259–60. DOI: https://doi.org/10.1136%2Fbmj.299.6710.1259
34. Bach JF. The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med. 2002;347:911–20. DOI: https://doi.org/10.1056/NEJMra020100
35. Farfel A, Tirosh A, Derazne E, Garty BZ, Afek A. Association between socioeconomic status and the prevalence of asthma. Ann Allergy Asthma Immunol. 2010;104:490–5. DOI: https://doi.org/10.1016/j.anai.2010.03.019
36. Toga AW, Thompson PM. Genetics of brain structure and intelligence. Annu Rev Neurosci. 2005;28:1–23. DOI: https://doi.org/10.1146/annurev.neuro.28.061604.135655
37. Lang DM, Butz AM, Duggan AK, Serwint JR. Physical activity in urban school-aged children with asthma. Pediatrics. 2004;113:341–346. DOI: https://doi.org/10.1542/peds.113.4.e341
38. Meyer A, Machnick MA, Behnke W, Braumann KM. Participation of asthmatic children in gymnastic lessons at school. Pneumologie. 2002;56:486–92. DOI: https://doi.org/10.1055/s-2002-33314
39. Williams B, Hoskins G, Pow J, Neville R, Mukhopadhyay S, Coyle J. Low exercise among children with asthma: a culture of over protection? A qualitative study of experiences and beliefs. Br J Gen Pract. 2010;60:e319–e326. DOI: https://doi.org/10.3399/bjgp10X515070
40. Fisher EP. The impact of play on development: a meta-analysis. Play Cult. 1992;5:159–81.
41. Kedar-Barnes I, Rozen P. The Jewish people: their ethnic history, genetic disorders and specific cancer susceptibility. Fam Cancer. 2004;3:193–9. DOI: https://doi.org/10.1007/s10689-004-9544-0
42. Cochran G, Hardy J, Harpending H. Natural history of Ashkenazi intelligence. J Biosoc Sci. 2006;38:659–93. DOI: https://doi.org/10.1017/s0021932005027069
43. Fowler MG, Davenport MG, Garg R. School functioning of US children with asthma. Pediatrics. 1992;90:939–44. DOI: https://doi.org/10.1542/peds.90.6.939
44. Daramola O, Ayoola OO, Ogunbiyi AO. The comparison of intelligence quotients of atopic and nonatopic children in Ibadan, Nigeria. Indian J Dermatol. 2010;55:221–4. PMID: 21063510.
Published
2024-02-21
How to Cite
1.
Mohammed S, Ibraheem R, Abdulkadir M, Adeboye M, Gobir A, Johnson W. Comparative assessment of cognitive function of asthmatic and non-asthmatic children in Ilorin, Nigeria. PI [Internet]. 21Feb.2024 [cited 20Jun.2024];64(2):97-05. Available from: https://www.paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/3219
Section
Pediatric Respirology
Received 2022-10-28
Accepted 2024-02-21
Published 2024-02-21