The prevalence of asthma and wheezing illnesses amongst 10-year-old schoolchildren

Abstract

Asthma and wheezing illnesses carry a significant burden of disease during childhood. Prevalence studies have the capacity to provide invaluable insights into the nature of these common conditions. As part of the Isle of Wight Whole Population Birth Cohort Study (n=1456) we have examined wheezing and asthma development amongst 10-year-old children. At this age 1373 children completed ISAAC written questionnaires whilst 1043 children performed further testing including skin-prick testing, serum inhalant IgE antibody screening, spirometry and bronchial challenge. At 10-years, prevalence of current wheeze was 18.9%, current asthma (symptomatic bronchial hyper-responsiveness--BHR) 14.4% and currently diagnosed asthma (current wheeze and asthma ever--CDA) 13.0%. Both wheezing and asthma at 10 years were associated with average symptom onset at 3 years of age indicating an early life origin for such conditions. Current wheeze (P=0.011) and CDA (P=0.008) showed significant male predominance. Considerable disease morbidity was identified for these states that tended to be greatest amongst children defined asthmatic rather than simply current wheezers. Wheezing and asthma were significantly associated with both atopy (P<0.001) and allergic co-morbidity Children with these states, particularly current asthma, also demonstrated impaired lung function (FEV1, P<0.001 and FEV1/FVC, P=0.010) and increased BHR (inverse slope, P<0.001). In conclusion, Asthma and wheezing showed substantial prevalence at 10 years of age. Strong associations to male gender, atopy, impaired lung function and BHR were seen for both wheeze and asthma. In regard to prevalence and morbidity characteristics, a questionnaire-based definition of currently diagnosed asthma gave similar results to the use of symptomatic BHR in defining current asthma.