Pediatric Pulmonology Estimating Pediatric Asthma Prevalence in Rural Senegal: A Cross-Sectional Survey Laura G. Hooper, MD, MPH, 1 * Yakou Dieye, MD, MPH, 2 Assane Ndiaye, MBA, 3 Aldiouma Diallo, MD, MPH, 3 Vincent S. Fan, MD, MPH, 1,4 Kathleen M. Neuzil, MD, MPH, 1,5,6 and Justin R. Ortiz, MD, MS 1,5,6 Summary. Rationale: In Senegal, the prevalence of childhood asthma and utilization of appropriate asthma therapies is unknown. Methodology: We used the International Study of Asthma and Allergies in Childhood (ISAAC) survey instrument to assess childhood respiratory health in rural Senegal. We interviewed the caregivers of children aged 5 through 8 years of age in the four largest Niakhar villages in August 2012. Results: We interviewed 1,103 primary caregivers for 1,513 children, representing 91% of all age-eligible children in the study area. Overall, 206 (14%) children had wheeze at any time in the past, 130 (9%) had wheeze within the past year, and only 41 (3%) reported a clinical diagnosis of asthma. Among children with wheeze within the past year, 81 (62%) had symptoms of severe asthma. Nocturnal cough was reported in 186 (14%) children who denied any history of wheezing illness. Only four (3%) children with wheeze in the past year had ever received bronchodilator therapy. Children with wheeze in the past year were significantly more likely to seek medical care for respiratory symptoms and to be perceived as less healthy than their peers. Children of lower socioeconomic status were significantly more likely to have wheeze. Conclusions: Nearly one in ten children in Niakhar, Senegal had symptoms suggestive of asthma; however, few children have a diagnosis of asthma or use appropriate therapies. This study highlights an opportunity to raise community awareness of asthma in rural Senegal and to increase access to appropriate medical therapies. Pediatr Pulmonol. 2016; 9999:XX–XX. ß 2016 Wiley Periodicals, Inc. Key words: children; Africa; Senegal; epidemiology; asthma; international health. Funding source: UW International Respiratory and Severe Illness Center (INTERSECT) Ellison Fellowship; Thrasher Research Fund Early Career Award. INTRODUCTION Globally, an estimated 334 million people have asthma, and it is the most common chronic disease among children worldwide. 1 The prevalence of asthma is increasing among children. 2 Symptoms of severe asthma disproportionately affect children in low- and middle- income countries (LMICs) compared to those in high- income countries (HIC). 3 The vast majority of the data comprising the global asthma map for children comes from the International Study of Asthma and Allergies in Childhood (ISAAC), a multiphase, international study of asthma and allergies. Over three study phases since 1991, a total of 306 centers in 105 collaborating countries have contributed to the ISAAC dataset. However, there remains a paucity of data on childhood asthma prevalence in many LMICs, including much of West Africa. Only four centers in West Africa (Cote d’Ivoire, Guinea, Togo, Nigeria), were included in the most recent ISAAC study, all of which represented urban populations. 3 In Senegal, childhood asthma symptom prevalence is unknown. 1 Department of Medicine, University of Washington, Seattle, Washington. 2 PATH, Dakar, Senegal. 3 Institute de Recherche pour le Developpement, Dakar, Senegal. 4 VA Puget Sound Health Care System, Seattle, Washington. 5 Department of Global Health, University of Washington, Seattle, Washington. 6 PATH, Seattle, Washington. This study was presented as an abstract at the American Thoracic Society conference, 2015, Denver, Colorado. Conflict of interest: None.  Correspondence to: Laura G. Hooper, MD, MPH, Department of Medicine, University of Washington, 1959 NE Pacific St, Box 356522, Seattle, WA 98195. E-mail: lghooper@u.washington.edu Received 21 March 2016; Revised 12 July 2016; Accepted 22 July 2016. DOI 10.1002/ppul.23545 Published online in Wiley Online Library (wileyonlinelibrary.com). ß 2016 Wiley Periodicals, Inc.