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ICD Code: 493. Asthma

ICD Code: 493. Article Review
Title: Goh DYT et al; "Prevalence and Severity of Asthma, Rhinitis, and Eczema in Singapore Schoolchildren." Archives of Disease in Childhood; V.74; 1996; p131
      STUDY DESIGN: The International Study of Asthma and Allergies in Children (ISAAC) was formed in 1992. In phase 1 of this ISAAC study, standardized written and video questionnaires were developed. The authors have analyzed the results of the ISAAC phase 1 written questionnaire survey of schoolchildren in Singapore. The population consists of Chinese (75%), Malays (15%), and Indians (10%), so racial differences in the prevalence and severity of asthma, rhinitis, and eczema were evaluated. The questionnaire concentrated on past and current wheezing episodes, wheezing frequency, sleep disturbance and speech limitation during attacks, exercise induced wheezing, persistent cough unrelated to respiratory infections, and a doctor's diagnosis of asthma. The authors studied two age groups of schoolchildren (6 to 7 years and 12 to 15 years). 30 schools from all parts of Singapore were randomly selected, of which 21 consented to participate.
      PREVALENCE (SINGAPORE): The self-reported prevalence of doctor-diagnosed asthma was reported as follows: overall, 20.0%; ages 6 to 7 years, 18.5%; ages 12 to 15 years, 20.7%; males, 22.1%; females, 17.5%; Chinese, 19.9%; Malay, 21.3%; Indian, 17.2%.
      DISCUSSION: The prevalence of diagnosed asthma was higher in this population (20.0%) than in a British study (13.1%). Thus the local prevalence figures probably lie somewhere between those of the West and developing countries. The reported cumulative and current prevalence of wheezing in southern China are reported to be as low as 1.9% and 1.1%. Singaporean Chinese are of southern Chinese descent, suggesting that geographical differences in wheezing and asthma prevalence may be influenced more by environment than genetics.
      A previous survey on adult asthma in Singapore showed increased prevalence in Indians and Malays compared to Chinese, but the present data indicate that the prevalence is similar in all racial groups. The Indians and Malays, however, had more severe asthma than the Chinese. Although the reasons for this difference are not evident, previous work suggests that environmental factors such as smoking and rearing of pets are important. Another possibility might be the smaller airways inherently present in Malay and Indian children.

Search Criteria: Text - Archives of Disease in Childhood; V.74; 1996; p131