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ICD Code: 493. Asthma

ICD Code: 493. Article Review
Title: Mahboub BH et al; "Population Prevalence of Asthma and Its Determinants Based on European Community Respiratory Health Survey in the United Arab Emirates." BMC Pulmonary Medicine; V.12; 2012; p4     DOI:10.1186/1471-2466-12-4
      STUDY DESIGN: No population study has explored the population distribution of adult asthma in the United Arab Emirates (UAE). The objective of the present study is to estimate asthma prevalence in the general population in UAE. Using standard European Community Respiratory Health Survey (ECRHS) questionnaires and tools, the present study is a cross-sectional assessment of a random sample of the population in established quotas of the seven Emirates in the UAE. The authors surveyed 1220 participants, of whom 63.2% were male, and 20.1% were UAE Nationals, with a mean age of 32.9 years. A random sample of the population aged 20-44 years was contacted and requested to complete a short screening questionnaire on respiratory symptoms. In a second phase of the study, a 20% random sub-sample of the sample population and all remaining subjects reporting respiratory symptoms in the screening questionnaire and not yet included in the random sub-sample were asked to complete a long questionnaire and other tests.
      ASTHMA SYMPTOMS (UNITED ARAB EMIRATES): The frequency of selected symptoms according to the ECRHS screening questionnaire in all 1220 participants was reported as follows (ages 19 years or less, ages 20-44 years, and ages 45 years or older, respectively, in parentheses): wheezing/whistling, 10.0% (13.1%, 8.1%, 12.1%); attack of asthma, 8.0% (11.8%, 6.0%, 9.6%); currently taking asthma medications, 8.0% (9.3%, 6.6%, 10.3%); nasal allergies (including hay fever), 6.8% (9.3%, 6.6%, 5.3%).
      Among participants aged 20-44 years, the frequency of selected symptoms was reported as follows in males versus females: wheezing/whistling, 6.8% vs 10.3%; attack of asthma, 4.8% vs 8.0%; currently taking asthma medications, 5.9% vs 7.6%; nasal allergies (including hay fever), 4.8% vs 9.5%.
      Prevalence of individual respiratory symptoms according to the ECRHS screening questionnaire in all participants ranged from 8% to 10%, except for lower for nasal allergies (6.8%). However, when stratified by age band, it can be seen that in participants younger than 20 years, as well as those older than 44 years, prevalence of nearly all symptoms are 10% or higher, while those participants 20-44 years presented lower prevalence in all symptoms.
      Overall, there were 184 (15.4%) participants who fulfilled screening criteria for asthma. The asthmatics were more frequently male (56.5%), but there were no significant differences by age in male versus female asthmatics.
      For consistency with ECRHS sampling methodology, results are presented for participants who responded YES to the following three questions: (1) Have you been awoken by an attack of shortness of breath at any time in the last 12 months? (2) Have you had an attack of asthma in the last 12 months? (3) Are you currently taking any medicine (including inhalers, aerosols or tablets) for asthma? There were 146 (12.1%) participants who fulfilled the ECRHS asthma definition in all ages. Specifically, the ECRHS asthma prevalence in 702 participants with 20-44 years was 9.8%, that is, in males 8.6% and in females 11.8% participating.
      DISCUSSION: The present authors report the first population study assessing the distribution of adult asthma in the UAE. Using standard ECRHS questionnaires and tools, they determined that the prevalence of asthma is at least 9.8% in young adults 20-44 years, and participating women reported more individual respiratory symptoms than men.
      The authors recently participated in an international endeavor to explore the insights and realities of already diagnosed and treated asthmatics within the Gulf region. Similar to asthmatics in other regions, it was concluded from surveying 200 asthmatics in the UAE that asthma burden and uncontrolled asthma were frequent, with 52.8% of the children and 17.1% of the adults missing school and work due to asthma in the past year, respectively. The percentage of Emirati asthmatics that had emergency room visits within the past year was 27.5%, and 4% were hospitalized. Only 5.5% used inhaled corticosteroids in the past year, and 47.5% were on short-acting beta-2-agonists. % of participating asthmatics were male.
      The present authors conclude that asthma in the study sample of the UAE population is frequent, 8.6% in male and 11.8% in female young adults 20-44 years, and that gender differences in asthma deserve further research.

Search Criteria: Text - BMC Pulmonary Medicine; V.12; 2012; p4