|Year : 2022 | Volume
| Issue : 2 | Page : 67-72
Prevalence, knowledge, and practice regarding allergic rhinitis among Madinah Population, Saudi Arabia, in 2019–2020
Nisreen Ghazi Albouq, Rayan Ahmad Julaidan
Department of Otolaryngology, Ohoud Hospital, Madinah, Saudi Arabia
|Date of Submission||20-Mar-2022|
|Date of Decision||24-Apr-2022|
|Date of Acceptance||25-Apr-2022|
|Date of Web Publication||28-Jun-2022|
Dr. Nisreen Ghazi Albouq
Department of Otolaryngology, Ohoud Hospital, Madinah
Source of Support: None, Conflict of Interest: None
Background: Allergic rhinitis (AR) is a common chronic respiratory disorder characterized by itching, sneezing, nasal congestion, and rhinorrhea, prevalent in Saudi Arabia. Objectives: This study investigates the AR prevalence and assesses the knowledge and practices of the population about the disease. Materials and Methods: A cross-sectional study was conducted at Otolaryngology and Allergy Clinics, Ohud Hospital, Madinah in 2019–2020. The data were collected by an electronic self-administered questionnaire, grouped into four sections: demographic data, the prevalence of AR using a valid translated scoring tool, and knowledge and practice of the population about AR. Results: The study included 524 participants, of which 56.1% were aged 20–29 years. Female participants were 324.88 (62%), and male participants were 199.12 (38%). Using a valid translated scoring tool, the prevalence of AR was 27.9%, and only a family history of allergy was a significant factor associated with AR (P < 0.001). Overall, most of the participants (76.3%) had adequate knowledge about AR, in which AR (P = 0.001) or a family history of AR (P < 0.001) was significantly associated with AR adequate knowledge. Moreover, 26.3% responded that they are visiting physicians when developing symptoms. However, 31.2% of participants used steroid nasal sprays. Nearly half (47.9%) of the participants bought over-the-counter drugs without consulting a physician. Conclusion: AR is a common problem affecting a considerable proportion of the population in Madinah city, Saudi Arabia, particularly those with a positive family history. Fortunately, knowledge about the disease is adequate. However, health workers must improve the practice of the population.
Keywords: Allergic rhinitis, general population, knowledge, practice, Saudi Arabia
|How to cite this article:|
Albouq NG, Julaidan RA. Prevalence, knowledge, and practice regarding allergic rhinitis among Madinah Population, Saudi Arabia, in 2019–2020. Saudi J Otorhinolaryngol Head Neck Surg 2022;24:67-72
|How to cite this URL:|
Albouq NG, Julaidan RA. Prevalence, knowledge, and practice regarding allergic rhinitis among Madinah Population, Saudi Arabia, in 2019–2020. Saudi J Otorhinolaryngol Head Neck Surg [serial online] 2022 [cited 2022 Oct 4];24:67-72. Available from: https://www.sjohns.org/text.asp?2022/24/2/67/348717
| Introduction|| |
Allergic rhinitis (AR) is a noncontagious, heterogeneous disorder characterized by one or more of the following nasal symptoms: sneezing, itching, rhinorrhea, and/or nasal congestion. A study reported that the prevalence of AR was 15%–25% across four geographical regions (Asia, Europe, the Americas, and Africa). Risk factors associated with AR are genetic, environmental, social, and domestic pets.
In Saudi Arabia, the prevalence of AR is significantly increasing. A study investigated the prevalence of AR among the Saudi population and reported that 34% of 900 Saudi adults were found to be affected by AR. Another study reported that 26.5% of 2529 sampled children had AR.
This study investigates the prevalence of AR among the population of Madinah province, assesses their knowledge and attitude regarding the disease, and determines the most common triggering factors of AR in this population.
| Materials and Methods|| |
A cross-sectional study was conducted at Otolaryngology and Allergy Clinics, Ohud Hospital, Madinah in 2019–2020. Both clinics provide health-care services for people with AR.
subjects of the study included all visiting patients with AR, regardless of age and sex. The data were collected from the participants using a self-administered questionnaire; the participants were asked to fill out the consent forms, which explained the study's purposes. The data included in the self-administered questionnaire were grouped into four sections:
- Section one: Demographic data (age, gender, and educational level)
- Section two: Prevalence of AR using a valid translated scoring tool
- Section three: Knowledge of the AR
- Section four: Attitude toward AR.
Ethical approval was obtained from the Research Ethics Committee of Ohud Hospital. The waiver of documentation of informed consent was requested from the ethics committee, considering that data were anonymous, and only those who agreed to participate were included in the study, depending on the self-administered questionnaire tool. An introductory paragraph was included at the beginning of the questionnaire describing the aim of the study, voluntary participation, and contact information of the investigator to answer any inquiries.
Statistical Package for the Social Sciences (SPSS) Version 26.0. Armonk, NY: IBM Corp for Windows was used for statistical data analysis. Descriptive statistics were used to summarize the data in a manageable form, using frequencies and distributions. Moreover, the Chi-squared test was performed using inferential statistics. P = 0.05 was used to control the alpha error. Regarding knowledge questions (n = 7), a score of “1” was assigned to correct answers, whereas a score of “0” was assigned to incorrect answers. The total score and its percentage were estimated. The participants who scored below 50% were considered to have “inadequate knowledge” and those who scored 50% and above were considered to have “adequate knowledge.”
| Results|| |
The study included 524 participants. [Table 1] summarizes their demographic characteristics. The age of 293.96 (56.1%) participants ranged between 20 and 29 years, whereas that of 39.8 (7.6%) participants was 50 years and above. Female participants comprised 62% (324.88). About 94.3% (494.13) of the participants were Saudi nationals, and those with university/postgraduate education were 81.5% (427.06). About 55.3% (289.77) of the participants were employed.
Prevalence of allergic rhinitis
Almost two-thirds of the participants had sneeze (66.8%), runny nose (64.3%), and/or blocked nose (64.7%) within the past 12 months, apart from a common cold. Itchy watery eyes were noted in 52.3% of the participants. These problems were more common in winter (43.4%), followed by spring (24.9%). House dust mites were the most common reported trigger factor for this problem (76.7%). More than half of the participants (56.3%) thought of being allergic. However, only 12.4% of the participants had been tested for allergy; among them, 47.7% were positive for the allergic test. Almost one-third of the participants (36.3%) claimed to have been diagnosed with asthma, eczema, or AR. Family history of allergy was mentioned by most of the participants (70.2%) and by some mothers (37.8%) [Table 2].
|Table 2: Responses to questions related to the history of allergic rhinitis|
Click here to view
Overall, the prevalence of AR was 27.9% based on using the valid translated scoring tool, as illustrated in [Figure 1]. Among the factors being studied, only a family history was a significant factor associated with AR, P < 0.001 [Table 3].
Knowledge of allergic rhinitis
A total of 90.6% of the participants have the knowledge that the classic symptoms of AR are nasal congestion, nasal itch, rhinorrhea, and sneezing and that the disease could be prevented by avoiding triggering factors (89.1%). Three-quarters (76.3%) of the participants understood that AR was not a contagious disease, and 69.5% knew that nasal sprays could be used to reduce the AR symptoms. On the other hand, less than half of the participants (48.1%) understood that AR is a genetically inherited disease and is linked to asthma and conjunctivitis (42.2%) [Table 4].
Overall, most of the participants (76.3%) had knowledge of AR [Figure 2]. Among the factors under study, only having AR (P = 0.001) or a family history of AR (P < 0.001) was significantly associated with having adequate knowledge of AR [Table 5].
|Figure 2: The overall knowledge level regarding allergic rhinitis among the participants|
Click here to view
|Table 5: Factors associated with knowledge of allergic rhinitis among the participants|
Click here to view
Practice pattern regarding allergic rhinitis
A total of 26.3% of the respondents claimed to visit a physician when developing symptoms, whereas 31.2% used steroid nasal sprays. Almost half (47.9%) of the respondents bought over-the-counter drugs without consulting a physician. The majority of the respondents (84.9%) avoided house dust and smoke and 71.6% strictly followed the doctor's instructions [Table 6].
|Table 6: Practice patterns of the participants regarding allergic rhinitis|
Click here to view
| Discussion|| |
AR is a common chronic respiratory disorder that impacts patients' quality of life, social life, work and study environments, sleep quality, and socioeconomic life. This study estimated the prevalence of AR among the population of Madinah province, Kingdom of Saudi Arabia, assessed people's knowledge and practice regarding the disease, and determined the most common triggering factors of AR.
The prevalence of AR was 27.9% among the sample population. A total of 30.7% of the participants with AR were male, and 26.2% were female based on the valid translated scoring tool (presence of sneezing, runny nose, blocked nose, and itchy eyes). A similar figure has been reported previously among school children in Riyadh, KSA (26.5%). A recent Saudi study conducted in Al Baha city reported a slightly higher prevalence, being 32% and 38.6% in males and females, respectively. Moreover, an AR prevalence of 34% has been reported among adults attending primary health-care centers in Saudi Arabia. A moderate prevalence (36%) was reported among school children aged 13 years and above in the United Arab Emirates. Thus, the prevalence ranged between 15% and 25% in a study involving four geographical regions (Asia, Europe, the Americas, and Africa). From the findings of this study and those of other studies reviewed, AR is a common health problem with variable magnitude in different countries, associated with environmental and constitutional factors.
In agreement with other studies,, most nasal symptoms identified in this study occurred in winter, attributed to the indoor living style. Contrarily, Behbehani et al. observed that most of the cases of allergic nasal symptoms were encountered in summer.
As reported in this study, house dust mites are the most commonly reported triggering factor for AR. Other studies confirm this finding, revealing that the indoor living style in Saudi Arabia has been attributed to AR.,
No gender difference was observed in this study regarding the prevalence of AR. However, some other studies in Saudi Arabia and Taiwan observed that females were more affected by AR than males, which could be associated with gender differences in the immune response.
Contrary to some studies,,, most of the participants in this study had adequate knowledge of AR. In this regard, comparison between various studies is impractical because of the different tools used to assess knowledge. However, in this study, most of the participants had a positive family history of allergy disease, which was significantly associated with the knowledge level and partially explained the high level of knowledge observed in this study.
The findings of this study revealed that AR and/or family history were indicators of having adequate knowledge of the disease. In another Saudi study, the educational level of the participants was the only significant predictor of adequate knowledge.
In our study, 26.3% of the participants claimed of visiting physicians when developing symptoms, 31.2% used steroid nasal sprays, and 47.9% bought drugs over the counter without consulting a physician. These findings agreed with those reported by the previous studies conducted in Al Baha city, Saudi Arabia, and Canada.
Some limitations are identified in this study. First, the cross-sectional design adopted proves only association and not causality. Second, a single-center study adopted could impact the ability to generalize the results. Despite those limitations, this study offers public health significance in exploring the magnitude, determinants, knowledge, and practice associated with a common problem affecting the quality of life in our community.
| Conclusion|| |
AR is a common problem affecting a considerable proportion of the population in Madinah city, Saudi Arabia, particularly those with positive family history. Fortunately, knowledge about the disease is adequate. However, health-care workers should improve practice considerably. We recommend mass screening of the population for early identification and management of the disease.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Skoner DP. Allergic rhinitis: Definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol 2001;108:S2-8.
Small P, Kim H. Allergic rhinitis. Allergy Asthma Clin Immunol 2011;7 Suppl 1:S3.
Wright AL, Holberg CJ, Martinez FD, Halonen M, Morgan W, Taussig LM. Epidemiology of physician-diagnosed allergic rhinitis in childhood. Pediatrics 1994;94:895-901.
Al Frayh AR, Shakoor Z, Gad MO, Hasnain SM. Increased prevalence of asthma in Saudi Arabia. Ann Allergy Asthma Immunol 2001;86:292-6.
Alreshidi F, Alrashidi A, Alshammari F, Qadi A, Alrashidi A, Alghaythi S, et al.
Attitude and practice about allergic rhinitis in Saudi Arabia, 2017. Egypt J Hosp Med 2017;69:2199-203.
Sobki SH, Zakzouk SM. Point prevalence of allergic rhinitis among Saudi children. Rhinology 2004;42:137-40.
Alharethy S, Wedami MA, Syouri F, Alqabbani AA, Baqays A, Mesallam T, et al.
Validation of the Arabic version of the score for allergic rhinitis tool. Ann Saudi Med 2017;37:357-61.
Pawankar R, Bunnag C, Khaltaev N, Bousquet J. Allergic rhinitis and its impact on asthma in Asia Pacific and the ARIA Update 2008. World Allergy Organ J 2012;5:S212-7.
Alzahrani R, Alrayah M, Alzaidi AA, Almalki A, Althaqafi A, Alswat F, et al.
Prevalence of allergic rhinitis among the population in Al Baha city, Saudi Arabia. Int J Med Dev Ctries 2020;4:001-5.
Alsowaidi S, Abdulle A, Shehab A, Zuberbier T, Bernsen R. Allergic rhinitis: Prevalence and possible risk factors in a Gulf Arab population. Allergy 2010;65:208-12.
Annus T, Riikjärv MA, Rahu K, Björkstén B. Modest increase in seasonal allergic rhinitis and eczema over 8 years among Estonian schoolchildren. Pediatr Allergy Immunol 2005;16:315-20.
Behbehani N, Arifhodzic N, Al-Mousawi M, Marafie S, Ashkanani L, Moussa M, et al.
The seasonal variation in allergic rhinitis and its correlation with outdoor allergens in Kuwait. Int Arch Allergy Immunol 2004;133:164-7.
Albaloushi NN, Alyahya K. The prevalence of allergic rhinitis and its complications: A survey from Al-Ahssa, Saudi Arabia. J Nat Sci Med 2019;2:57-60. [Full text]
Hwang CY, Chen YJ, Lin MW, Chen TJ, Chu SY, Chen CC, et al.
Prevalence of atopic dermatitis, allergic rhinitis and asthma in Taiwan: A national study 2000 to 2007. Acta Derm Venereol 2010;90:589-94.
Vallirajasekaran PG. Knowledge, attitude and practice about allergic rhinitis in a rural population. Int J Otorhinolaryngol Head Neck Surg 2017;2:3-8.
Nolte H, Nepper-Christensen S, Backer V. Unawareness and undertreatment of asthma and allergic rhinitis in a general population. Respir Med 2006;100:354-62.
Hossenbaccus L, Linton S, Garvey S, Ellis AK. Towards definitive management of allergic rhinitis: Best use of new and established therapies. Allergy Asthma Clin Immunol 2020;16:39.
[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]