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\begin{document}

\title{Study of Prevalence of Asthma in School Children in Pune and Its
Relation with Family History of Asthma and Allergic Disorders}



\author[1]{Patil MG}%
\author[1]{* TambolkarSA}%
\author[1]{Mishra AD}%
\author[1]{Salunkhe SR}%
\author[1]{Bharaswadkar RS}%
\author[1]{Agarkhedkar SR}%
\affil[1]{Dr D Y Patil Medical College Hospital and Research Centre}%


\vspace{-1em}



  
  \date{March 13, 2024}


\begingroup
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\selectlanguage{english}
\begin{abstract}
\textbf{Objective:} To determine prevalence of asthma in Pune and its
relation to family history of allergic disease. \textbf{Study Design:}
Cross-sectional study in two schools of Pune. \textbf{Method:}
International Study of Asthma and Allergy in Childhood (ISAAC) based
questionnaire was administered to 815 parents of students of 2 selected
schools between ages of 5-15 years. Responses were analyzed and children
with history suggestive of asthma were examined, investigated at a
tertiary teaching hospital. \textbf{Results:} prevalence of asthma was
6.13\%. Prevalence in males was 6.36\% and in females was 8.05\% (p=
0.639). Prevalence in English medium school was 7.36\% as compared to
Marathi medium school of 3.8\%. Family history of asthma and allergic
disease had strong association with asthma. PEFR at time of enrolment
was decreased in many children irrespective of symptoms.
\textbf{Conclusion:} Prevalence of asthma was 6.13\%. Family history is
strong determinant of asthma. \textbf{Keywords:} Asthma Prevalence,
Family History, PEFR Correlation.%
\end{abstract}%



\sloppy


\textbf{TITLE: Study of Prevalence of Asthma in School Children in Pune
and Its Relation with Family History of Asthma and Allergic Disorders}

\textbf{ABSTRACT}

\textbf{Objective:} To determine prevalence of asthma in Pune and its
relation to family history of allergic disease.~\textbf{Study Design:~}
~Cross-sectional study in two schools of
Pune.~\textbf{Method:}International Study of Asthma and Allergy in
Childhood (ISAAC) based questionnaire was administered to 815 parents of
students of 2 selected schools between ages of 5-15 years. Responses
were analyzed and children with history suggestive of asthma were
examined, investigated at a tertiary teaching
hospital.~\textbf{Results:} prevalence of asthma was 6.13\%. Prevalence
in males was 6.36\% and in females was 8.05\% (p= 0.639). Prevalence in
English medium school was 7.36\% as compared to Marathi medium school of
3.8\%. Family history of asthma and allergic disease had strong
association with asthma. PEFR at time of enrolment was decreased in many
children irrespective of symptoms.\textbf{Conclusion:} Prevalence of
asthma was 6.13\%. Family history is strong determinant of asthma.

\textbf{Keywords:} Asthma Prevalence, Family History, PEFR Correlation.

Authors-

TambolkarSA\textsuperscript{1} ,Mishra AD\textsuperscript{2}, Salunkhe
SR\textsuperscript{1},Patil MG\textsuperscript{1},Bharaswadkar
RS\textsuperscript{2}, Agarkhedkar SR\textsuperscript{1}

Professor, Dr. D.Y. Patil Medical College, Hospital and Research Centre
\& Dr. D. Y. Patil Vidyapeeth \{Deemed to be University\}, Pimpri, Pune,
Maharashtra, India PIN-411018

Associate Professor, Dr. D.Y. Patil Medical College, Hospital and
Research Centre \& Dr. D. Y. Patil Vidyapeeth \{Deemed to be
University\}, Pimpri, Pune, Maharashtra, India PIN-411018

\textbf{Department :Department of Pediatrics}

College address

Dr. D.Y. Patil Medical College, Hospital and Research Centre \& Dr. D.
Y. Patil Vidyapeeth \{Deemed to be University\}, Pimpri, Pune,
Maharashtra, India PIN-411018

\emph{Corresponding author:}

Dr. Manojkumar G. Patil,

Professor, Dr. D.Y. Patil Medical College, Hospital and Research Centre
\& Dr. D. Y. Patil Vidyapeeth \{Deemed to be University\}, Pimpri, Pune,
Maharashtra, India PIN-411018

Email id:\emph{drmanojgpatil@gmail.com}

Orcid ID- 0000-0003-3026-3699, Phone number: 9922417017,9011077017

\textbf{GUARANTOR OF THE MANUSCRIPT}

Dr. Sampada A. Tambolkar

Professor, Dr. D.Y. Patil Medical College, Hospital and Research Centre
\& Dr. D. Y. Patil Vidyapeeth \{Deemed to be University\}, Pimpri, Pune,
Maharashtra, India PIN-411018

Email id: drmanojgpatil@gmail.com

Orcid ID- 0000-0002-9916-Phone number: 9371012680

Email ID OF Authors-

\emph{tambolkarsampada@gmail.comOrcid ID- 0000-0002-9916-4683}

\emph{ambrish4764@gmail.com Orcid ID-} \emph{0009-0003-0288-7696}

\emph{salunkheshradha@gmail.com,} Orcid ID- \emph{0000-0001-9891-1600}

\emph{drmanojgpatil@gmail.com} , Orcid ID- 0000-0003-3026-3699

\emph{dr.rasika80@gmail.com} Orcid ID- \emph{0000-0003-4616-7167}

\emph{agarkhedkar@gmail.com Orcid ID-0000-0002-7215-5867}

SOURCE OF SUPPORT: None

CONFLICT OF INTEREST: None declared.

ACKNOWLEDGEMENT: None declared.

\textbf{INTRODUCTION}

The most common chronic respiratory disorder of childhood is Asthma . It
is characterized by airway hyper responsiveness with airway
inflammation. Asthma is more common in children (8.6 \%) than adults
(7.4 \%). (1) . Allergic rhinitis, Atopic dermatitis , food or inhalant
allergy ,family history of asthma, is common risk factors for persistent
asthma. (1). Atopy is the alone largest risk factor for development of
asthma. Nearly 80\% of atopic individuals develop asthma, allergic
rhinitis, eczema or urticarial. (2). Atopy has been associated with
increased risk of persistent and severe asthma as shown in several
studies. Allergen provocation can induce bronchial inflammation.
Children who developed early sensitization to food or aero antigen and
had eczema are at high risk for developing persistent asthma. (3)Asthma
is a global health care problem, with increasing prevalence being
observed over last few decades. (1). Prevalence of asthma in developing
countries is significantly different from developed countries. In India,
prevalence varies widely due to the vast size of the country, variable
population density, variable climate, variable pollution levels and
variable life style. (4)ISAAC, largest study determining prevalence of
asthma had showed prevalence of asthma in Pune of 2.9\% in 2003 (5). In
recent study of 2012, study conducted in Pune suggested an increase in
prevalence of asthma from 2.9\% to 6.7\%. (4.) This study defined asthma
from history provided in questionnaire and no clinical examination was
done to confirm the diagnosis. To substantiate this observation after
confirming the diagnosis with examination, this study was planned. PEFR
was performed as a marker of lung function.

\textbf{METHODOLOGY~}

It was a cross sectional study done in 815 children (5-15 yrs.), from
two urban schools (English medium and Marathi medium each).
Questionnaire - adopted from International Study of Asthma and Allergy
in Childhood (ISAAC). It contains 11 questions pertaining to the
diagnosis and risk factors of asthma. This questionnaire was adapted
from ISAAC phase 1 and phase 2 with slight modification (questions
indicating severity of asthma were excluded) and were printed in both
English and Marathi. The Marathi questionnaire was a pre validated
translation. Questions were answered as either Yes or No. After
permission from school authority, and clearance from local ethics
committee, questionnaires were distributed to 1718 children. Explanation
of each question was provided in the form. Questionnaire was to be
answered by parents. After 2 reminders, 815 children returned the form
(47.43\%). Questionnaires were analysed and 62 out of 815 who answered
yes for any question in section B were shortlisted as probable asthmatic
and were evaluated at a tertiary teaching hospital in Pune. Detailed
history and examination, PEFR was done. Out of these 62 children, 50
children were found to be asthmatic and they were included in the study
and analysed.~Asthma in this population was defined as per the ISAAC
study criteria .~Data was collected ,compiled which then evaluated using
Statistical Package for Social Sciences (SPSS) software. Chi square, p
test were used for determining statistical significance.

\textbf{RESULTS~}

In this study 815 children were studied. Male to female ratio was 1.38
(male-57.9\%, female -42.1\%). Age wise distribution showed that 28.22\%
of children were in 5-8yrs age group, 33.12 \% children in 9-11yrs age
group and 38.65\% children in 12-15 yrs. age group. 368 children were
from Marathi medium (45.15 \%) and 447 were from English medium schools
(54.85 \%).(Table-1).Overall Prevalence of asthma in our study was 6.13
\%. Prevalence of asthma in age group of 5-8yrs (6.96\%) was more than
that in age group 9-11 yrs. (6.29\%) and in age group 12-15 yrs.
(5.39\%).~~This difference was not statistically significant. In this
study, overall male predominance was observed in the children with
asthma. Prevalence of asthma in male children was 6.36\%. Prevalence of
asthma in female children was 5.83 \%. In age group 5-8 yrs. 7.6\%
female had asthma as compared to 6.52\% males. In age group 9-11 yrs.
and 12-15 yrs. male predominance was observed (6.53\% vs 5.83\% and
6.0\% vs 5.83\% ) respectively .(table-2).~Out of 62 children labelled
as probable asthmatics, 50 children were diagnosed as asthmatic after
clinical evaluation. Out of 50 children, 30 were male and20 were female.
Family history of asthma and allergic diseases was present in 30 (60\%),
either asthma or allergic diseases in 17 (34\%), and no family history
of either in 3 (6\%). Family history of asthma is an important
predisposing factor in asthmatic children. In our study, 11.05\% (90 out
of 815) of cohort had family history of asthma, while 62\% (31 out of
50) of asthmatic children had positive family history. This difference
was statistically highly significant (X\^{}2 = 175.9, p\textless{}
0.0001) (Table-3). More number of children with decrease PEFR had family
history of asthma. 58.06\% (18/31) of children with family history of
asthma had decreased PEFR as compared to 52.6 \% (10/19) children
without family history of asthma. This difference was statistically not
significant (p: 0.70).(Table-4).In children with decreased~~~PEFR it was
found that 64.3\% had positive family history of Asthma, 35.7\% had no
such history.~Family history of other allergic diseases besides asthma
also has significant association with prevalence of asthma. In this
study 7.36\% (60/815) of children had positive family history of
allergic diseases. 56 \% (28/50) of asthmatics had history of allergic
disease in their family except asthma. This was~highly significant (
p\textless{} 0.005). (table-3)In children who do not have family history
of allergic diseases 57.1\% (16/28) had decreased PEFR. While in
children who do not have family history of allergic disease 54.5 \%
(12/22) had decreased PEFR. (P: 0.85).Of asthmatic children 58\% had
history of atopic diseases. 56\% of these had decrease in PEFR.~In this
study 8.05\% (36 out of 447) of English medium students suffered from
asthma as compared to 3.8\% (14 out of368) of students studying in
Marathi medium. This was significant(p\textless{}0.05) (table-1).
Decrease in PEFR was seen in 58.3\% of English medium students as
compared to 50\% in Marathi medium students(p\textgreater{} 0.05).

\textbf{DISCUSSION~}

Asthma is chronic childhood disease with increasing prevalence over past
decades. Environmental factors and genetic factors are contributing for
the same. Pune is one of the most rapidly growing cities of India. In
Pune, prevalence reported in 2004 by ISAAC phase 3 was 2.9\%. While a
study by Maria Cheraghi et. al. in 2009 and 2012 showed a prevalence of
5.4\% and 6.7\% respectively. (4).There was an increase in the
prevalence of asthma by 130\%in a decade. These were questionnaire based
studies, where diagnosis of probable asthma was done by analysis of
response sent by parents. The diagnosis was not confirmed by clinical
examination.~Prevalence of Asthma in present study was 6.13\% .In our
study, prevalence of asthma in age group 5-8 yrs. was 6.96\%, in age
group 9-11 yrs. was 6.29\% and in age group 12-15 yrs. was 5.39\%. A
similar age wise prevalence of asthma of 7\% among 6-7 yrs. old and 6.3
\% amongst 13-14 yrs. olds was reported from Pune .(4).An Iranian study
by HadiBazzazi et al found prevalence of 7\% in children aged 12-13 yrs.
(6).As compared to 2012 Pune study, there was no increase in prevalence
of asthma in our study. Unlike previous study,we had taken a detailed
history and done examination and investigations of 62 probable
asthmatics diagnosed by the questionnaire. We excluded 12 probable
asthmatics as on examination we could not confirm the diagnosis of
asthma in them .In spite of excluding 12 probable asthmatics from 62
probable asthmatics the prevalence of asthma in this study was 6.13\%
.We found male predominance in asthmatics. Prevalence of asthma in males
was 6.36\% and females were 5.83\%. Male to female ratio was 1:1.5 .Most
of the studies have reported male predominance in prevalence of asthma.
(7,8,9).Jain~\emph{et.al}. considered that to increase bronchial
responsiveness in males. (10).S. K. Chhabra reported prevalence of 12\%
in males as compared to 11.2\% in females. (8).Similarly Renata Gontijo
et. al .reported prevalence of 8.1\% and 6.1\% respectively in males and
females. (11).In our study 11.5\% of children in cohort of 815 had
family history of asthma. While in asthmatic group 62\% children had
family history of asthma. This correlation was highly significant
(p\textless{} 0.0001). Similar strong relationship between family
history of asthma and asthma has been reported previously. (8,10).First
detailed study for asthma inheritance was conducted by Cook and Vander
Veer in year 1916 . They came to conclusion that familial association
was due to genetic component. (7,12). In this study we found strong
association between family history of allergic diseases and asthma. 7.36
\% of 815 children had family history of allergic disorder, while 56\%
of asthmatic had family history of allergic disorders.~Anzhela V.
Glushkovaet .al.found that family history of allergic disease had highly
significant association with prevalence of asthma in children. (13).
Hadi Bazzaziet. al. that 30.2\% of asthmatic children had family history
of allergic disorders with strong association between family history of
allergic disorders and asthma. (6)PEFR was performed at the time of
confirmation of diagnosis. This was a baseline PEFR irrespective of the
clinical symptoms. Hence the difference in PEFR value was not
significant in children with predisposing factor and children without
them.Out of 28 children with family history of allergic disorders 57.1
\% had decreased PEFR as compared to 42.9\% of children with no family
history of allergic disorders.~58.06\% of children with family history
of asthma had decrease in PEFR as compared to 41.9\% of children In
children who do not have family history of ashtma. We discovered that
children who had both family history of asthma and family history of
allergic disease had higher incidence of low PEFR as compared to those
who had either or none. This may indicate higher chance of asthma being
triggered by minor triggers in these children.~Prevalence of asthma was
8.05\% in students of English medium school, and was 3.8\% in students
of Marathi medium school. Children from

Marathi medium were from lower socioeconomic class as they were from
government school and were from an area away from the city. Students
from English medium were from a private school located in the crowded
area of city. Dr Strachan's theory that children in larger families were
exposed to more infection , resulting in healthier immune system that
were less likely to mistake harmless substances for allergen . A similar
difference of 7.3\%and 5.8 \% in private and public schools respectively
was reported by Maria Cheraghi~\emph{et.al}. (4).They stated that this
was because students of private schools were from higher socioeconomic
class as compared to public schools catering to lower socioeconomic
class.The strength of this study was that after screening using ISAAC,
probable asthmatics were examined and investigated. Children not
confirming to diagnosis of asthma were not included. PEFR was performed
in all asthmatic children, which was not the feature of other studies.
Doing study in two schools was the limitation.

\textbf{Conclusion :-}

Prevalence of asthma was 6.13\%. Family history is strong determinant of
asthma.~Socioeconomic difference can be contributory to the
manifestation of asthma .We feel that more schools should be screened in
this manner to get better representation of prevalence in the city. Such
studies should be done at regular intervals so that trends in burden of
disease can be determined and preventive methods be implemented. Future
studies correlating air quality and life style with asthma is required
for prevention planning.

SOURCE OF SUPPORT: None

CONFLICT OF INTEREST: None declared.

ACKNOWLEDGEMENT: None declared.

\textbf{REFERENCES}

\emph{Morbidity and mortality report NCHS 2014- Health United States -
Tables - 2014 Complete List} .Available at:
https://www.cdc.gov/nchs/hus/contents2014.htm

Assessed On 05/02/2021

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\tightlist
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  Beasley, R., Ellwood, P. and Asher, I. International patterns of the
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http://dx.doi.org/10.3325/cmj.2008.49.741 Assessed On 23/02/2021

\emph{Table No.1- Demographic Data of Study Population}\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
\begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
Cohort\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
Asthma\strut
\end{minipage} & \begin{minipage}[b]{0.17\columnwidth}\raggedright\strut
p value\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
N=815\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
N=50\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
Age (years)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
5-8\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
230 (28.22\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
16 (32\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
0.7483\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
9-11\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
270 (33.12\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
17 (34\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
12-15\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
315 (38.65\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
17 (34\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
Sex\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
Male\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
472 (57.91\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
30 (60\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
0.7578\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
Female\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
343 (42.08\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
20 (40\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Male : Female\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.38 :1\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1.5 :1\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
Medium of education\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
Marathi\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
368 (45.15\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
14 (28\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
0.01188\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
English\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
447 (54.85\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
36 (72\%)\strut
\end{minipage} & \begin{minipage}[t]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

\textbf{Table No.2 Prevalence of Asthma}\selectlanguage{english}
\begin{longtable}[]{@{}llllllllllll@{}}
\toprule
\begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Age (years)\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Male\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Male\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Male\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
p value\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Female\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Female\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Female\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
p value\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Total\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Total\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Total\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Total\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Asthmatic\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Prevalence\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Total\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Asthmatic\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Prevalence\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Total\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Asthmatic\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Prevalence\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
5-8\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
138\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
9\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
6.52\%\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
0.9810\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
92\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
7\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
7.60\%\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
0.6122\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
230\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
16\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
6.96\%\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
9-11\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
153\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
10\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
6.53\%\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
117\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
7\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
5.98\%\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
270\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
17\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
6.29\%\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
12-15\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
181\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
11\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
6.08\%\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
134\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
6\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
4.48\%\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
315\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
17\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
5.39\%\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
Total\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
472\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
30\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
6.36\%\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
343\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
20\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
5.83\%\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
815\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
50\strut
\end{minipage} & \begin{minipage}[t]{0.06\columnwidth}\raggedright\strut
6.13\%\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

\textbf{Table No.3- Risk Factors for Asthma}\selectlanguage{english}
\begin{longtable}[]{@{}llll@{}}
\toprule
\begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
Cohort\strut
\end{minipage} & \begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
Asthma\strut
\end{minipage} & \begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
P value\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
N=815\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
N=50\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Family history of asthma\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
90 (11.05\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
31 (62\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
P\textless{}0.0001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Family history of allergic disorder\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
60 (7.36\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
28 (56\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
P\textless{}0.0001\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

\textbf{Table No.4 -- Association of Risk Factors for Asthma\& PEFR}\selectlanguage{english}
\begin{longtable}[]{@{}llll@{}}
\toprule
\begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
LOW PEFR\strut
\end{minipage} & \begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
NORMAL PEFR\strut
\end{minipage} & \begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
P value\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
28\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
22\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Family history of asthma\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
18 (64.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
13 (59.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
0.7072\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
No Family history of asthma\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
10 (35.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
9 (40.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Family history of allergic disease\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
16 (57.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
12 (54.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
0.8543\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
No Family history of allergic disease\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
12 (42.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
10 (45.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
Medium of Education: English\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
21 (75\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
15 (68.18\%)\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
0.5940\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Medium of Education: Marathi\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
7 (25\%)\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
7 (31.81\%)\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

\textbf{Hosted file}

\verb`Tables Study of Prevalence of Asthma in School Children in Pune and Its Relation (1).docx`  available at \url{https://authorea.com/users/754886/articles/724783-study-of-prevalence-of-asthma-in-school-children-in-pune-and-its-relation-with-family-history-of-asthma-and-allergic-disorders}

\selectlanguage{english}
\FloatBarrier
\end{document}

