Kumari MV, Amarasiri L, Rajindrajith S, Illangasinghe T, Devanarayana NM. Asthma burden and its impact on health-related quality of life among school adolescents in Anuradhapura district, Sri Lanka. World J Clin Pediatr 2026; 15(4): 124311 [DOI: 10.5409/wjcp.124311]
Corresponding Author of This Article
Niranga Manjuri Devanarayana, Professor, Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Western Province, Sri Lanka. niranga@kln.ac.lk
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
research-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Kumari MV, Amarasiri L, Rajindrajith S, Illangasinghe T, Devanarayana NM. Asthma burden and its impact on health-related quality of life among school adolescents in Anuradhapura district, Sri Lanka. World J Clin Pediatr 2026; 15(4): 124311 [DOI: 10.5409/wjcp.124311]
Manori Vijaya Kumari, Thilini Illangasinghe, Department of Physiology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura 50008, North Central Province, Sri Lanka
Lakmali Amarasiri, Department of Physiology, Faculty of Medicine, University of Colombo, Colombo 00800, Western Province, Sri Lanka
Shaman Rajindrajith, Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo 00800, Western Province, Sri Lanka
Niranga Manjuri Devanarayana, Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama 11010, Western Province, Sri Lanka
Author contributions: Kumari MV conceptualized the study, developed the methodology, collected the data, provided funding, analyzed and interpreted data and drafted the initial manuscript; Illangasinghe T analyzed and interpreted the data and contributed to the first draft; Devanarayana NM, Rajindrajith S, and Amarasiri L contributed to the study design and critically revised the manuscript for important intellectual content; and all authors reviewed and approved the final manuscript.
AI contribution statement: No AI tool was used to generate research data, interpret results, or formulate conclusions.
Institutional review board statement: Ethical approval was obtained from the ethics review committee of the Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka (ERC/2016/19).
Informed consent statement: The school administration was informed prior to the distribution of the questionnaire, and approval was obtained from the school principal and the director of the provincial educational Department in Anuradhapura. Parental written consent and student assent were obtained from all adolescents who participated in the study.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data are available on reasonable request. Please contact the first author (manoadikari@med.rjt.ac.lk).
Corresponding author: Niranga Manjuri Devanarayana, Professor, Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Western Province, Sri Lanka. niranga@kln.ac.lk
Received: June 11, 2026 Revised: August 5, 2026 Accepted: September 4, 2026 Published online: December 9, 2026 Processing time: 100 Days and 14.6 Hours
Abstract
BACKGROUND
Asthma is a common chronic airway disease in adolescents, causing respiratory symptoms such as wheeze, shortness of breath, chest tightness, and cough. Asthma significantly impacts health-related quality of life (HRQoL). Its prevalence and symptom patterns in Southeast Asia, particularly among Sri Lankan adolescents, are not well known.
AIM
To assess the prevalence of asthma and its impact on the quality of life in Sri Lankan adolescents.
METHODS
A cross-sectional survey was conducted among 1099 adolescents aged 13-15 years in mixed-gender schools in the Anuradhapura district, Sri Lanka (46.4% boys, mean age 14.03 years). The International Study of Asthma and Allergies in Childhood questionnaire was used to assess asthma prevalence. Students with physician-diagnosed asthma and wheezing in the previous 12 months were categorized as having current asthma. The PedsQL inventory was used to assess HRQoL.
RESULTS
The prevalence of current asthma, physician-diagnosed asthma, and severe asthma was 13.8% [95% confidence interval (CI): 11.8-15.8], 20.2% (95%CI: 17.8-22.5), and 4.6% (95%CI: 3.4-5.8), respectively. Exercise-induced wheeze, sleep, and speech disturbances were significantly associated with asthma (P < 0.001). Overall, HRQoL was consistently reduced across all asthma diagnostic categories (current asthma, physician-diagnosed asthma, and severe asthma) compared with adolescents without asthma (P < 0.001).
CONCLUSION
There is a significant burden of asthma among adolescents, with 13.8% having current asthma and 4.6% having severe asthma. Adolescents with current asthma have reduced HRQoL compared to non-asthmatics, highlighting the need for comprehensive management strategies beyond symptom control.
Core Tip: This population-based study among 1099 Sri Lankan adolescents revealed a substantial burden of asthma, with prevalences of current asthma, physician-diagnosed asthma, and severe asthma of 13.8%, 20.2%, and 4.6%, respectively. Wheezing during play or exercise, sleep disturbance, and speech disturbance were significantly more common among adolescents with asthma. Importantly, asthma was consistently associated with reduced health-related quality of life across all asthma diagnostic categories, highlighting its wider physical and psychosocial impact. These findings emphasize the need for early identification, regular monitoring, and comprehensive asthma management strategies that address not only symptom control but also the overall well-being of affected adolescents.
