{
  "abstract": "Background Limited contemporary epidemiological data exist for asthma among school-aged adolescents in Togo. This study aimed to estimate the prevalence of asthma among Togolese adolescents in Grand-Lomé (an urbanised region in the south) and Kara (a more rural area in the north). Furthermore, we explored demographics and risk factors associated with asthma diagnoses, with specific emphasis on the role of adverse childhood experiences (ACEs).Methods A cross-sectional study was conducted in secondary schools across southern and northern regions of Togo between February and March 2025. Adolescents aged 10–19 years were enrolled using multistage stratified random sampling. Asthma screening utilised International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires and spirometry with reversibility testing. ACEs were assessed using ACE-Q. A multilevel mixed-effects penalised binary logistic regression model identified factors associated with asthma.Results Among 2416 adolescents included in final analysis, median age was 16.0 years (IQR: 14.0–17.0), with 55.4% female. Overall asthma prevalence was 8.7% (95% CI: 7.6 to 9.9), with higher rates in the southern region (10.5%) compared with northern region (5.9%) (p<0.001). High childhood adversity (adjusted OR (aOR)=1.79; 95% CI: 1.09 to 2.94) was associated with asthma. Other factors significantly associated with asthma included: parental history of asthma (aOR=2.87; 95% CI: 2.03 to 4.05), and overweight/obesity (aOR=1.81; 95% CI: 1.22 to 2.68). Older age (aOR=0.93; 95% CI: 0.87 to 0.99) and male gender (aOR=0.67; 95% CI: 0.48 to 0.93) were associated with lower asthma likelihood.Conclusion Asthma prevalence among school-going adolescents in Togo is substantial and shows marked regional variation. Beyond established risk factors, the observed association with ACEs supports the need for integrated strategies addressing both physical and psychosocial determinants and for strengthening school-based surveillance and care pathways.",
  "authors": [
    {
      "affiliations": [
        "National Institute for Health and Medical Research (INSERM), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Centre, UMR 1219, Université de Bordeaux, Bordeaux, Nouvelle-Aquitaine, France",
        "Faculty of Health Sciences, Department of Public Health, Center for Training and Research in Public Health, University of Lomé, Lomé, Togo",
        "African Center for Research in Epidemiology and Public Health (CARESP), Lomé, Togo"
      ],
      "name": "Arnold Junior Sadio"
    },
    {
      "affiliations": [
        "Pneumology Department, Kara University Hospital, Kara, Togo"
      ],
      "name": "Doevi Mawuena Mawuena Biaou"
    },
    {
      "affiliations": [
        "Pneumology Department, Kara University Hospital, Kara, Togo"
      ],
      "name": "Pwemdeou Efalou"
    },
    {
      "affiliations": [
        "Faculty of Health Sciences, Department of Public Health, Center for Training and Research in Public Health, University of Lomé, Lomé, Togo",
        "African Center for Research in Epidemiology and Public Health (CARESP), Lomé, Togo"
      ],
      "name": "Fifonsi Adjidossi Gbeasor-Komlanvi"
    },
    {
      "affiliations": [
        "African Center for Research in Epidemiology and Public Health (CARESP), Lomé, Togo"
      ],
      "name": "Innocent Gabkiangbe"
    },
    {
      "affiliations": [
        "Faculty of Health Sciences, Department of Public Health, Center for Training and Research in Public Health, University of Lomé, Lomé, Togo",
        "African Center for Research in Epidemiology and Public Health (CARESP), Lomé, Togo"
      ],
      "name": "Martin Kouame Tchankoni"
    },
    {
      "affiliations": [
        "African Center for Research in Epidemiology and Public Health (CARESP), Lomé, Togo"
      ],
      "name": "Gérard Koglo"
    },
    {
      "affiliations": [
        "African Center for Research in Epidemiology and Public Health (CARESP), Lomé, Togo"
      ],
      "name": "Gilbert Aku Agbetoglo"
    },
    {
      "affiliations": [
        "Pneumology Department, Sylvanus Olympio University Hospital, Lomé, Togo"
      ],
      "name": "Boyodi Mewezinoh"
    },
    {
      "affiliations": [
        "Pneumology Department, Sylvanus Olympio University Hospital, Lomé, Togo"
      ],
      "name": "Maïssala Zoutene"
    },
    {
      "affiliations": [
        "Pneumology Department, Sylvanus Olympio University Hospital, Lomé, Togo"
      ],
      "name": "Liliane Derpeng Sam-Sam"
    },
    {
      "affiliations": [
        "Pneumology Department, Sylvanus Olympio University Hospital, Lomé, Togo"
      ],
      "name": "N’dalna Berasngar"
    },
    {
      "affiliations": [
        "Pneumology Department, Sylvanus Olympio University Hospital, Lomé, Togo"
      ],
      "name": "Yosua Aki"
    },
    {
      "affiliations": [
        "Pneumology Department, Sylvanus Olympio University Hospital, Lomé, Togo"
      ],
      "name": "Balla Bilivogui"
    },
    {
      "affiliations": [
        "Pneumology Department, Sylvanus Olympio University Hospital, Lomé, Togo"
      ],
      "name": "Atsu Koffi Aziagbe"
    },
    {
      "affiliations": [
        "Pneumology Department, Sylvanus Olympio University Hospital, Lomé, Togo"
      ],
      "name": "Abdou Gafarou Gbadamassi"
    },
    {
      "affiliations": [
        "Pneumology Department, Sylvanus Olympio University Hospital, Lomé, Togo"
      ],
      "name": "Tete Amento Stephane Adambounou"
    },
    {
      "affiliations": [
        "National Institute for Health and Medical Research (INSERM), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Centre, UMR 1219, Université de Bordeaux, Bordeaux, Nouvelle-Aquitaine, France",
        "Faculty of Health Sciences, Department of Public Health, Center for Training and Research in Public Health, University of Lomé, Lomé, Togo",
        "African Center for Research in Epidemiology and Public Health (CARESP), Lomé, Togo"
      ],
      "name": "Didier Koumavi Ekouevi"
    },
    {
      "affiliations": [
        "Pneumology Department, Sylvanus Olympio University Hospital, Lomé, Togo"
      ],
      "name": "Komi Seraphin Adjoh"
    }
  ],
  "title": "Asthma prevalence, associated factors and role of adverse childhood experiences among school-going adolescents: the national School Health Survey in Togo (SHeST-study)",
  "uid": "f352dad2-e3b9-5e81-b6f4-02647cfb45c3"
}