Asthma: an increasing problem in children?

Abstract

The study of asthma trend, nonhospitalized and hospitalized cases, and factors correlated with asthma admissions were carried out at Queen Sirikit National Institute of Child Health (Children's Hospital) between 1986-1995. Asthma OPD visits had increased significantly (r = 0.9039, p < 0.001). The age distribution of the cases are 0-2, 2-5, 5-10 and > 10 years old group. The number of visits in 0-2 and 2-5 years groups were significantly increased (r = 0.908, p = 0.000, r = 0.904, p = 0.000), while in 5-10 and >10 years old groups were not (r = 0.054, p = 0.137, r = -0.565, p = 0.089). Although the OPD visits were increasing, there was a decreasing trend in the age-adjusted percentage of admissions (r = -0.798, p = 0.006). The percentage of admissions was significantly decreased in 0-2, 2-5, and >10 years old groups (r = -0.881, p = 0.001, r = -0.632, p = 0.05, r = -0.815, p = 0.004, respectively). The correlation with the environment was observed (r = 0.915, p < 0.001). There was no correlation with allergic diseases in the family (r = 0.2825, p = 0.4). The 2,312 admission charts (86.69% of total IPD cases) were reviewed and there were 1,855 cases of true asthma. Almost 70% of cases were in the under-five age group and the male to female ratio was 1.3:1. The increasing trend in steroid use was observed (r = 0.693, p = 0.026), while the use of antibiotics was unchanged (r = 0.068, p = 0.852). The percentage of admissions began to decline in 1989 when the aerosolized beta-2 agonists were introduced in the hospital and declined further in 1991 when increased use of aerosolized therapy and prophylactic drugs was observed. Better patient education and regular follow-up care during the past five years are believed to be one of the major contributions to this reduction in admissions.