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ICD Code: 493. Asthma

ICD Code: 493. Article Review
Title: de Marco R et al; "Trends in the Prevalence of Asthma and Allergic Rhinitis in Italy between 1991 and 2010." European Respiratory Journal; V.39; 2012; p883     DOI:10.1183/09031936.00061611
      DISEASE BURDEN (WORLDWIDE): Asthma is the most common chronic respiratory disease in the world and is a significant cause of morbidity worldwide. Approximately 300 million people in the world currently have asthma.
      STUDY DESIGN: The present study is aimed at quantifying the temporal change in the prevalence of asthma and allergic rhinitis in the past 20 years in the adult population of Italy, a country that is characterized by a medium-to-low level of asthma prevalence. The same screening questionnaire was administered by mail or phone to random samples of the general population (age 20-44 years) in Italy, in the frame of three multicenter studies: the European Community Respiratory Health Survey (ECRHS) (1991-1993; 6,031 subjects); the Italian Study on Asthma in Young Adults (ISAYA) (1998-2000; 18,873 subjects); and the Gene Environment Interactions in Respiratory Diseases (GEIRD) study (2007-2010; 10,494 subjects). Between 1991-1993 and 2007-2010, 35,398 subjects in 12 Italian centers answered the screening questionnaire.
      PREVALENCE (2007-2010): The medians of the adjusted prevalence of current asthma symptoms in Italy was reported as follows based on data from the 2007-2010 GEIRD: current asthma, 6.6%; allergic rhinitis, 25.8%; wheezing, 13.9%; shortness of breath, 8.5%; tightness in the chest, 10.2%.
      PREVALENCE TRENDS: The increase in asthma prevalence in the past 20 years was substantial. In 1991-1993, the median prevalence recorded in the three Italian centers that participated in the ECRHS survey was 4.1%, ranging 3.3%-5.0%. According to this figure, Italy was classified as a country with a low-medium prevalence of asthma. 20 years later, when exactly the same questions were administered in the frame of the GEIRD study, the median prevalence was 6.6%, ranging 4.5%-8.0%. Interestingly, a cross-sectional survey performed by the Italian College of General Practitioners in December 2009 found similar prevalence values.
      ATOPIC AND NON-ATOPIC ASTHMA: Due to the strong association of asthma with atopic diseases reported in several studies, the role of non-atopic asthma has generally been underestimated, even if its prevalence in some countries is similar to, or even greater than, that of atopic asthma. The present study, in agreement with other studies, documents that in Italy non-atopic asthma affects about 1 out of 3 current asthmatics and that the greatest increase in asthma prevalence observed in the past 20 years is due to nonallergic asthma.
      TREATMENT: In the four centers with at least two repeated surveys, the percentages of subjects with current asthma who reported being on treatment were 48.0%, 64.1%, and 58.1% in 1991-1993, 1998-2000, and 2007-2010, respectively.

Search Criteria: Text - European Respiratory Journal; V.39; 2012; p883