TY - JOUR T1 - Underestimation of pediatric asthma in Belarus, Poland, and Ukraine JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P4096 AU - Jan Zejda AU - Grzegorz Brozek AU - Andrei Shpakou AU - Olga Fedortsiv AU - Joshua Lawson AU - Donna Rennie Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P4096.abstract N2 - Introduction: There is a relatively low prevalence of pediatric asthma in Eastern Europe with some evidence of a diagnostic labeling effect where ”spastic bronchitis“ is used as a surrogate diagnosis for asthma.Objective: To investigate the role of diagnostic labelling in the regional variation of childhood asthma prevalence in Eastern Europe.Methods: A population-based lung health survey using ISAAC questions was completed in Belarus (BR: n= 3404), Ukraine (UE: n = 3846), and Poland (PL: n = 3385). Surveys were completed by parents of 7-12 year olds.Results: Ever diagnosed asthma prevalence differed between the three regions: BR=1.47%, UE=2.08%, PL = 4.11% (p=0.0001). The prevalence of spastic bronchitis followed the opposite pattern: BR=7.46%, UE=6.79%, PL=2.92% (p=0.0001). The mean age of asthma diagnosis also differed by country [BR=5.1+/-2,7 years, UE=4.1+/-2.6 years, and PL=3.5+/-2.3 years (p=0.001)]. Trends in regional variation of asthma and spastic bronchitis prevalence stratified by age group (7-8 years, 9-10 years, and 11-12 years) matched those seen in the overall population (p=0.03). Having either asthma or spastic bronchitis occurred in 8.02% in BR, 7.77% in UE and 5.67% in PL (p=0.0002). Few children without either diagnosis reported current (last 12 months) attacks of breathlessness together with chest wheeze outside infections (BR: 1.12%, UE: 3.10%, PL: 1.57%; p=0.0001).Conclusions: Pediatric asthma prevalence was underestimated, most likely due to nozologic preferences. Regional differences could result from a delay in the final diagnosis of asthma. A low prevalence of symptoms in children without either diagnosis support a true asthma prevalence reflected by a composed rate of both diseases. ER -