Epidemiological Pattern and Management of Pediatric Asthma Review of Ain Shams Pediatric Hospital Chest Clinic Data Cairo, Egypt 1995-2004

Abstract

Background: Pediatric asthma is the leading cause of chronic illness in childhood and has an impact on child's quality of life. Objective: To describe the epidemiological and clinical data of asthmatic children followed up in the Pediatric Chest Clinic Ain Shams University during a 10 year period. Methods: Files of asthmatic children attending the Clinic in the period from1995 to 2004 were selected. Relevant data were extracted and analyzed. Results: Out of 1006 recorded cases, a total of 691 (68.7%) were asthmatic. The proportion of asthmatics among all chest patients attending the clinic was lowest in 2002 being 51.6% and highest in 1995, being 78.3%. Male to female ratio was1.6:1, mean age was 5.27 yrs (SD ±3.65), mean age of onset of disease was 1.84 yrs (SD ± 2.78). Persistent asthma was significantly more prevalent in males p < 0.01. Severe asthma; using the American Thoracic Society Classification, was found in 151 (41.1%) of cases. From 2002, using GINA Guidelines Classification, severe persistent asthma accounted for 13.5%. Episodic attacks were reported by 270 (39%) of patients, nocturnal attacks by 302 of patients (43.7%) and exercise induced asthma in 97 (14%) of patients. Exacerbations occurred in 300 (43.4%) patients after respiratory infections, in 275 (39.8%) on exposure to smoke, in 139 (20%) with special food, in 91 (13.2%) following allergen exposure and 51 (7.4%) on exposure to inhaler sprays. Half of the patients were treated by combination of drugs (49.2%), corticosteroid inhalers in 32.1%, and ß agonists (short acting) in 31.4%. Conclusion & recommendations: Asthma constitutes a main problem in the Pediatric Chest Clinic. Respiratory infection and environmental factors are major exacerbating factors. Better documentation of patient's data and complete record in the files is needed.

Keywords: pediatric asthma, epidemiology, pattern, chest clinic, hospital files

Egypt J Pediatr Allergy Immunol 2008; 6(2): 51-56