Prevalence Of Allergic Rhinitis And Its Association With Asthma In Urban Populations.
Keywords:
united airway, Urban population, Asthma, Allergic rhinitisAbstract
ABSTRACT
Background:Allergic rhinitis (AR) is a prevalent chronic condition in urban communities, often underdiagnosed despite its significant health and economic burden. It shares pathophysiological mechanisms with asthma, forming the concept of a “united airway.” Recognizing prevalence patterns and associations with asthma can guide integrated screening and management strategies in urban populations.
Objectives:To determine the prevalence of allergic rhinitis in an urban population and to analyze its association with physician-diagnosed asthma, highlighting the burden of united airway disease in city residents.
Study Design: A Prospective Study.
Place and duration of study: Department of ENT, Pak International Medical College Peshawar, from June 2024 to July 2025.
Methods: This prospective study was conducted among 100 adults from randomly selected households in an urban area. Allergic rhinitis was diagnosed using ARIA criteria, while asthma was defined by physician diagnosis and validated symptom questionnaires. Data were collected through structured interviews and analyzed using SPSS v24.0. Prevalence estimates were calculated, and associations were tested with chi-square and logistic regression, reporting odds ratios with 95% confidence intervals and p-values <0.05.
Results: Out of 100 participants, 53 (53.0%) were male and 47 (47.0%) female. The mean age was 34.8 ± 10.6 years. The prevalence of allergic rhinitis was 28.7% (95% CI: 23.5–33.9). Asthma was present in 12.3% of participants. Allergic rhinitis was significantly associated with asthma (p=0.002). Logistic regression revealed that participants with AR had 2.6 times higher odds of having asthma (OR=2.61, 95% CI: 1.37–4.95). The findings support the “united airway” hypothesis and emphasize early recognition and integrated disease management strategies.
Conclusion:Allergic rhinitis was common in this urban population and demonstrated a strong association with asthma. The findings underscore the importance of screening for both conditions in city health programs. Integrated strategies addressing upper and lower airway diseases may improve overall disease control, reduce morbidity, and enhance quality of life. Early interventions are recommended to prevent progression and optimize health outcomes in vulnerable urban communities..
Downloads
References
1. Agüero CA, Sarraquigne MP, Parisi CAS, Mariño AI, López K, Menéndez Porfirio B, et al. [Allergic rhinitis in pediatrics: recommendations for diagnosis and treatment]. Archivos argentinos de pediatria. 2023;121:e202202894. doi: https://doi.org/10.5546/aap.2022-02894.
2. Bayar Muluk N, Cingi C. Biologics in allergic rhinitis. European review for medical and pharmacological sciences. 2023;27:43-52. doi: https://doi.org/10.26355/eurrev_202310_34069.
3. Berni Canani R, Carucci L, Coppola S, D'Auria E, O'Mahony L, Roth-Walter F, et al. Ultra-processed foods, allergy outcomes and underlying mechanisms in children: An EAACI task force report. Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. 2024;35:e14231. doi: https://doi.org/10.1111/pai.14231.
4. Bernstein JA, Bernstein JS, Makol R, Ward S. Allergic Rhinitis: A Review. Jama. 2024;331:866-77. doi: https://doi.org/10.1001/jama.2024.0530.
5. Bousquet J, Anto JM, Bachert C, Baiardini I, Bosnic-Anticevich S, Walter Canonica G, et al. Allergic rhinitis. Nature reviews Disease primers. 2020;6:95. doi: https://doi.org/10.1038/s41572-020-00227-0.
6. Cazzola M, Rogliani P, Ora J, Calzetta L, Matera MG. Asthma and comorbidities: recent advances. Polish archives of internal medicine. 2022;132:doi: https://doi.org/10.20452/pamw.16250.
7. Cohen B. Allergic Rhinitis. Pediatrics in review. 2023;44:537-50. doi: https://doi.org/10.1542/pir.2022-005618.
8. Cong S, Feng Y, Tang H. Network pharmacology and molecular docking to explore the potential mechanism of urolithin A in combined allergic rhinitis and asthma syndrome. Naunyn-Schmiedeberg's archives of pharmacology. 2023;396:2165-77. doi: https://doi.org/10.1007/s00210-023-02404-w.
9. Gao H, Niu Y, Wang Q, Shan G, Ma C, Wang H, et al. Analysis of Prevalence and Risk Factors of Adult Self-Reported Allergic Rhinitis and Asthma in Plain Lands and Hilly Areas of Shenmu City, China. Frontiers in public health. 2021;9:749388. doi: https://doi.org/10.3389/fpubh.2021.749388.
10. Han X, Krempski JW, Nadeau K. Advances and novel developments in mechanisms of allergic inflammation. Allergy. 2020;75:3100-11. doi: https://doi.org/10.1111/all.14632.
11. Jiang Y, Nguyen TV, Jin J, Yu ZN, Song CH, Chai OH. Bergapten ameliorates combined allergic rhinitis and asthma syndrome after PM2.5 exposure by balancing Treg/Th17 expression and suppressing STAT3 and MAPK activation in a mouse model. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. 2023;164:114959. doi: https://doi.org/10.1016/j.biopha.2023.114959.
12. Lin TL, Fan YH, Fan KS, Juan CK, Chen YJ, Wu CY. Reduced atopic march risk in pediatric atopic dermatitis patients prescribed dupilumab versus conventional immunomodulatory therapy: A population-based cohort study. Journal of the American Academy of Dermatology. 2024;91:466-73. doi: https://doi.org/10.1016/j.jaad.2024.05.029.
13. Moitra S, Mahesh PA, Moitra S. Allergic rhinitis in India. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. 2023;53:765-76. doi: https://doi.org/10.1111/cea.14295.
14. Paljarvi T, Forton J, Luciano S, Herttua K, Fazel S. Analysis of Neuropsychiatric Diagnoses After Montelukast Initiation. JAMA network open. 2022;5:e2213643. doi: https://doi.org/10.1001/jamanetworkopen.2022.13643.
15. Ponda P, Carr T, Rank MA, Bousquet J. Nonallergic Rhinitis, Allergic Rhinitis, and Immunotherapy: Advances in the Last Decade. The journal of allergy and clinical immunology In practice. 2023;11:35-42. doi: https://doi.org/10.1016/j.jaip.2022.09.010.
16. Schuler Iv CF, Montejo JM. Allergic Rhinitis in Children and Adolescents. Immunology and allergy clinics of North America. 2021;41:613-25. doi: https://doi.org/10.1016/j.iac.2021.07.010.
17. Shamji MH, Sharif H, Layhadi JA, Zhu R, Kishore U, Renz H. Diverse immune mechanisms of allergen immunotherapy for allergic rhinitis with and without asthma. The Journal of allergy and clinical immunology. 2022;149:791-801. doi: https://doi.org/10.1016/j.jaci.2022.01.016.
18. Siddiqui ZA, Walker A, Pirwani MM, Tahiri M, Syed I. Allergic rhinitis: diagnosis and management. British journal of hospital medicine (London, England : 2005). 2022;83:1-9. doi: https://doi.org/10.12968/hmed.2021.0570.
19. Tosca MA, Trincianti C, Naso M, Nosratian V, Ciprandi G. Treatment of Allergic Rhinitis in Clinical Practice. Current pediatric reviews. 2024;20:271-7. doi: https://doi.org/10.2174/1573396320666230912103108.
20. Wang J, Janson C, Malinovschi A, Holm M, Franklin KA, Modig L, et al. Asthma, allergic rhinitis and atopic dermatitis in association with home environment - The RHINE study. The Science of the total environment. 2022;853:158609. doi: https://doi.org/10.1016/j.scitotenv.2022.158609.
21. Xu X, Li S, Chen Y, Deng X, Li J, Xiong D, et al. Association between allergic diseases and mental health conditions: An umbrella review. The Journal of allergy and clinical immunology. 2025;155:701-13. doi: https://doi.org/10.1016/j.jaci.2024.10.030.
22. Zhou W, Cai J, Li Z, Lin Y. Association of atopic dermatitis with autoimmune diseases: A bidirectional and multivariable two-sample mendelian randomization study. Frontiers in immunology. 2023;14:1132719. doi: https://doi.org/10.3389/fimmu.2023.1132719
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
