Asthma symptoms and control improving in children
MedWire News: Children with asthma now have fewer respiratory symptoms and greater control over their disease than they did a decade ago, results from a Swedish study suggest.
Previous research has shown that, despite an increase in the prevalence of childhood asthma and use of asthma medications over the past few decades, there has been no significant increase in several asthma-related symptoms including wheeze, say Eva Rönmark (Umeå University) and team.
They explain: “This discrepancy between prevalence trends in symptoms common in asthma and the diagnosis of asthma might be the result of more effective treatment and/or an improved environment. Another explanation could be changes in diagnostic practice and increased awareness, resulting in more physician diagnoses of asthma among children with mild symptoms.”
To investigate further, the researchers studied data from questionnaires completed by the parents of 3430 children in 1996 and by the parents of 2585 children in 2006. All the children lived in northern Sweden and were aged 7–8 years at the time of the surveys.
Overall, 5.7% of the children had physician-diagnosed asthma in 1996 compared with 7.4% in 2006.
The proportion of children with physician-diagnosed asthma who were using inhaled corticosteroids (ICSs) increased from 54.8% in 1996 to 67.0% in 2006, while the proportion of asthmatic children who were using short-acting β-agonists decreased from 85.3% to 77.0%.
Among children with asthma, there was a significant decrease in the prevalence of severe symptoms such as disturbed sleep because of wheeze, from 49% in 1996 to 38% in 2006, and troublesome asthma, from 21% to 11% over the same time period.
In children with asthma who were using ICSs, the prevalence of current wheeze remained relatively stable, at 89.8% in 1996 and 85.9% in 2006. However, among asthmatic children who were not using ICSs, the prevalence of current wheeze decreased significantly from 70.8% in 1996 to 36.5% in 2006.
The researchers also note in the journal Pediatric Allergy and Immunology that, among children with asthma, the prevalence of maternal smoking decreased significantly, from 38.7% in 1996 to 18.6% in 2006, as did the proportion of asthmatic children living in damp homes, from 28.3% to 19.0%, respectively.
Rönmark and team conclude: “Although asthma remains a major public health issue in school age children, children with asthma had less respiratory symptoms and better asthma control in 2006 compared to 1996.”
They add: “This parallels with an increase in treatment with ICSs and an improved indoor environment, and to an increased diagnostic intensity resulting in a greater proportion being diagnosed as having asthma.”
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By Mark Cowen