Prevalence, associated factors, and temporal variation of allergic rhinitis among 13 to 14-year-old adolescents from rural Sri Lanka: An analytical cross-sectional study

Background: Allergic rhinitis is often underdiagnosed despite its high prevalence and considerable impact on academic achievement and quality of daily living. The study aims to describe the epidemiological patterns of allergic rhinitis among adolescents aged 13–14 years in Anuradhapura, Sri Lanka. Methods: An analytical cross-sectional study was conducted in 2023 among adolescents from 32 grade 8 classes in 6 government secondary schools located in the Anuradhapura municipal council area and randomly selected via multistage sampling. The prevalence and associated factors were assessed using the validated and translated International Study of Asthma and Allergy in Childhood questionnaire. Results: The study sample included 1,029 participants, of whom 528 (51.3%) were males. The prevalence of lifetime and current allergic rhinitis and eye symptoms was 37.6% (n = 387; 95% confidence interval [CI], 34.6–40.6), 25.9% (n = 266; 95% CI, 23.2-28.6), and 13.8% (n = 142; 95% CI, 11.8-16.0), respectively. Nasal symptoms negatively affected the activities of daily living in 195(18.9%; 95% CI, 16.6-21.5) adolescents, with moderate-to-severe disruption reported by 54 of them (20.3%; 95% CI, 15.6-25.6). Nasal symptoms were more common from October to February, with monthly precipitation significantly affecting the temporal variation ( P = 0.003). Severe asthma ( P < 0.01, adjusted odds ration [OR] 5.75; 95% CI, 3.79-8.72) was independently associated with allergic rhinitis, while sleeping on a rubber-mixed-coir mattress (adjusted OR 1.61; 95% CI, 0.95-2.74), and playing 4–6 times per week (adjusted OR 1.50; 95% CI 0.98-2.29) had higher odds for allergic rhinitis. Conclusions: Over a quarter of adolescents had current allergic rhinitis, and their symptom exacerbation followed a temporal pattern predicted by monthly precipitation. Severe asthma was an independent determinant of allergic rhinitis.