RT Journal Article
SR Electronic
T1 Underestimation of pediatric asthma in Belarus, Poland, and Ukraine
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4096
VO 44
IS Suppl 58
A1 Jan Zejda
A1 Grzegorz Brozek
A1 Andrei Shpakou
A1 Olga Fedortsiv
A1 Joshua Lawson
A1 Donna Rennie
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P4096.abstract
AB 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.