Asthma, wheeze and cough in 7- to 9-year-old British schoolchildren

Coleman, Helen, McCann, Donna C., McWhirter, Jenny, Calvert, Marguerite and Warner, John O. (2001) Asthma, wheeze and cough in 7- to 9-year-old British schoolchildren. Ambulatory Child Health, 7 (3), 313-321.

Abstract

Background
Report on the characteristics of a cohort of children, aged 7–9 years, attending schools in the south of England and participating in a controlled intervention study to improve the care and knowledge of asthma in junior and primary schools and highlight problems for potential intervention.Methods
A survey employing the International Study of Asthma and Allergies in Childhood (ISAAC) asthma questionnaire was undertaken to record the prevalence of asthma and the characteristics of children with asthma and wheeze in Year 3 and 4 pupils (age 7–9 years) in 25 schools, and to define disease severity and its management.Results
Responses on 1732 children were received. Reports of asthma and wheeze in this study were similar to those in recent ISAAC studies. The frequency and severity of symptoms was associated with appropriate therapeutic intervention suggesting adherence to published British Thoracic Society (BTS) guidelines. However, 80% of children with asthma at any BTS level of treatment reported exercise-induced wheeze, indicating a need for education on pre-exercise inhaler use. One in 20 children who had wheezed in the past 12 months reported a symptom profile suggestive of unrecognised asthma. Significant associations were found between maternal smoking and both wheeze in the last 12 months [odds ratio (OR), 1.35; confidence interval (CI): 1.01–1.81, p < 0.05] and nocturnal cough [OR, 1.70; CI: 1.31–2.20, p < 0.001].Conclusions
The characteristics of this sample are similar to those found for children of a similar age group in other studies. Therapeutic intervention is appropriate for the severity of disease but there are high levels of exercise-induced wheeze despite adequate control of other symptoms. Five percent of children who reported wheezing in the previous 12 months had a symptom profile of untreated asthma. Maternal cigarette smoking was associated with wheeze and cough.Implications for practic
Recurrent untreated wheeze remains a problem for 5% of children reporting wheeze. A therapeutic hole has been identified – there is a need for further education on pre exercise inhaler use. Both these problems could be addressed by a school-based asthma management strategy. Maternal smoking and its effects on childhood asthma and wheeze need to be addressed.

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