Prevalence of asthma and associated factors among 6- and 7-year-old schoolchildren: a cross-sectional study in Santiago Island, Cabo Verde, 2022.

Asthma and wheezing are important pediatric health problems in Africa, yet recent data from Portuguese-speaking countries remain scarce. The objective of this cross-sectional study is to estimate the prevalence of current asthma and associated factors among 6- and 7-year-old children on Santiago Island, Cabo Verde. From April to July 2022, 1,044 pupils from 43 randomly selected primary schools were surveyed using the validated ISAAC questionnaire and a 33-item risk-factor module completed by trained professionals based on caregiver reports, with current asthma defined as wheeze in the previous 12 months. The prevalence of current asthma was 10.5% (95% CI 8.7-12.4), while only 5% of children had a physician diagnosis; boys were more affected than girls (12.6% vs. 8.5%, p = 0.034), and the prevalence of rhinitis and eczema was 20.1% and 12.2%, occurring in 59% and 18% of asthmatic children, respectively. Complex sample logistic regression analysis indicates that current rhinitis [adjusted odds ratio (aOR): 7.86; 95% confidence interval (CI): 4.25-14.54] is a strongly associated comorbidity and antibiotic exposure in the first year of life (aOR: 2.10; 95% CI: 1.19-3.71) a risk factor for asthma development, whereas breastfeeding (aOR: 0.19; 95% CI: 0.06-0.55) is a protective factor. These findings indicate that about one in ten children has asthma in Santiago, with substantial under-diagnosis, and highlight the need for integrated management of allergic diseases, promotion of breastfeeding, rational antibiotic use, and strengthened primary care screening to reduce the burden of childhood asthma in Cabo Verde.