Health Effects of Desert Dust Storms in Children With Asthma: Knowledge, Perceptions and Practices of School Health Visitors in Cyprus.

Introduction: Cyprus is located in the Eastern Mediterranean and is heavily exposed to desert dust storm (DDS) events, which diminish air quality and adversely impact paediatric asthma morbidity. School health visitors (SHVs) play a key role in asthma management in schoolchildren and are pivotal for the development of school-based intervention programs. Objectives: This study aimed to examine the knowledge, practices and perceptions of SHVs on paediatric asthma management. Additionally, we sought to determine the factors associated with SHVs' level of engagement in school-based intervention programs to mitigate DDS-associated health effects. Methods: An anonymous questionnaire on asthma management practices and perceptions was administered to all SHVs in Cyprus. We assessed the association between the perceived importance and real-life implementation of asthma management practices and, in addition, asthma management practices and preparedness of local authorities to respond to DDS events were compared across categories for different sociodemographic characteristics. A binary logistic regression analysis was carried out to determine predictors among SHVs for supporting a school-based intervention program for DDS. Results: Responses from 78/93 SHVs (84%) revealed mean estimates for perceived importance ranging between 8.20 (lowest) for performing regular check-ups and 9.6 (highest) for monitoring student health records and immunisation status. Significant differences were demonstrated between the perceived importance of most of the reported asthma management practices and the extent of their implementation. Moderate appreciation among SHVs on a 1-5 Likert scale was reported for the regulatory authorities' preparedness (M = 3.48, SD = 0,88) and current practices (M = 2.66, SD = 0.13) to respond to DDS. Conclusion: Asthma management practices in school settings in Cyprus, a country highly exposed to DDS events, are suboptimal and responses during DDS are fragmented. Despite the perceived low preparedness, from the authorities, SHVs recognise the health impact of DDS on children with asthma and support plans for desert dust-mitigation programs in schools.