Abstract

Background: Asthma continues to be one of the major causes of illness among children all over the world and is becoming a significant public health problem in Saudi Arabia as a result of the rapid social, economic, and environmental changes. This systematic review and meta-analysis were conducted to estimate the pooled national and regional prevalence of pediatric asthma in Saudi Arabia and to identify its associated risk factors.
Methods: A thorough search of PubMed, Scopus, Web of Science, and the Saudi Digital Library was performed for articles published until October 2025. Studies reporting prevalence, incidence, or burden of asthma among individuals aged ≤18 years in Saudi Arabia were considered eligible. The quality of the studies was evaluated by the Newcastle–Ottawa Scale. The pooled prevalence estimates were derived from a random-effects model, while subgroup and meta-regression analyses were used to identify the sources of heterogeneity.
Results: Ten studies published between 1991 and 2025, with a total sample of 22,701 children and adolescents, were included. The pooled prevalence of pediatric asthma in Saudi Arabia was 18% (95% CI: 14%–22%), with substantial regional variation. The Southern region had the highest prevalence at 25.1% (95% CI: 18.3%–32.4%). Risk factors that were consistently identified include family history of asthma, exposure to environmental tobacco smoke, allergic comorbidities (rhinitis and eczema), and context-specific factors such as incense (bakhoor), perfumes, and viral infections.
Conclusion: Pediatric asthma is a major public health burden in Saudi Arabia, with a prevalence that goes beyond the global averages and significant disparities between regions. These results point to the necessity for standardized national surveillance and targeted public health interventions that address modifiable environmental and behavioral risk factors.

Key words: Pediatric asthma, Saudi Arabia, Prevalence, Burden of Asthma, Systematic review, Risk factors, Environmental exposures, Global Asthma Network.