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ICD Code: 493. Asthma

ICD Code: 493. Article Review
Title: Georgy V et al; "Prevalence and Socioeconomic Associations of Asthma and Allergic Rhinitis in Northern Africa." European Respiratory Journal; V.28; No.4; 2006; p756
      STUDY DESIGN: The aims of this study are to determine the prevalence of asthma and allergic rhinoconjunctivitis in schoolchildren in Cairo, Egypt and to investigate the role of socioeconomic status on prevalence of asthma and allergic rhinoconjunctivitis. The study population was taken from among 11- to 15-year-old children in the first and second years of preparatory secondary school in the El Nozha area of Cairo. These schools comprise state schools, experimental language schools and private schools. Experimental language schools are fee-paying government schools and are classified with private schools in the analysis.
      An adapted version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used to measure symptom prevalence. The independent variable was the school type. Questionnaire delivery was controlled. Use of the ISAAC video was not within the resources available. A total of 3002 children aged 11 to 15 years were eligible to receive a questionnaire. From these, 2645 (88.1%) completed questionnaires were received.
      PREVALENCE (EGYPT): Overall, the prevalences of wheeze ever, wheeze during the last year, and physician-diagnosed asthma were 26.5% (697 out of 2631), 14.7% (379 out of 2570), and 9.4% (246 out of 2609), respectively. Children from state schools had a higher prevalence of severe asthma symptoms than those in fee-paying schools (13.1% versus 4.9%). The proportion of individuals with severe asthma symptoms but without a diagnosis of asthma is higher in state schools than in fee-paying schools (63.3% of those with severe symptoms versus 29.6%). Severity is also higher in children whose parents have not had university-level education.
      RISK FACTORS: Factors strongly associated with having severe asthma symptoms were a parent with asthma, rhinoconjunctivitis, and physician-diagnosed rhinitis. Adjusted odds ratios (OR) of the latter two variables were 2.48 and 3.01. Other significant associations with severe asthma symptoms were nose symptoms during the last year (adjusted OR 1.79) and age. Having a cat in the house was not associated with severe asthma symptoms.
      DISCUSSION: Among 11- to 15-year-old schoolchildren in Cairo, the overall prevalence of wheezing in the last year was 14.7% and of physician-diagnosed asthma was 9.4%. This study clearly shows that allergic rhinoconjunctivitis and asthma symptoms are much more prevalent among those from poorer backgrounds. Children attending state schools also showed a higher prevalence of severe asthma symptoms but were much less likely to have a physician diagnosis of asthma, which points to discrepancies in access to healthcare. Asthma is relatively common, and probably underdiagnosed and undertreated, particularly among children from less wealthy families in Cairo.

Search Criteria: Text - European Respiratory Journal; V.28; No.4; 2006; p756