Preschool wheeze among a retrospective cohort of Egyptian children

Abstract

Background: Prevalence of recurrent wheeze in the preschool age was reported to affect one third of children in the developed world, with even more  frequency and severity in the developing countries. Epidemiological studies on this subject in Egypt are lacking. We sought to investigate the frequency  and different phenotypes of preschool wheeze (PSW) among a group of Egyptian children and their relation to different risk factors.

Methods: A retrospective cohort study was conducted on 1209 children, aged 6-10 years, recruited from the Outpatients’ Clinics of Ain Shams University  Hospitals from March 2019 to March 2021. Children with underlying chronic disease or suspected to be immunodeficient were excluded. The main study  tool was a survey composed of 30 questions and presented to the parent/caregiver via direct interviewing by the investigator and included  sociodemographic data details of wheezing episodes before the age of 6, wheezing risk factors and comorbidities. Skin prick test (SPT) was done for the  prolonged early, persistent early and late onset wheezers, while pulmonary function tests were done for the currently asthmatics patients .

Results: History of PSW was positive in 298/1209 (24.6%) of the participants. According to the onset, duration and course of wheezes, preschool wheezers  were classified as transient wheezers (10.4%), prolonged early wheezers (3.9%), late onset wheezers (3.2%) and persistent wheezers (7.1%) relevant to the  whole cohort. Fifty percent of PSW were multi-trigger wheeze while 39.3% were episodic viral wheeze. Twenty-five patients out of 148 wheezers (16.9%)  who underwent SPT were found to be atopic.

Conclusion: PSW is commonly reported among Egyptian children, paralleling international reports with  transient and persistent early wheezing being the most common phenotypes in Egypt.