Assessment of the diagnosis and prevalence of asthma in Australian indigenous children.
OBJECTIVE
Although the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire has been used in many countries and has been validated previously, it has not been used in Australian Indigenous communities. We endeavoured to assess its performance when administered in Aboriginal and Torres Strait Islander communities.


METHODS
In a cross-sectional study, we assessed the ISAAC's questionnaire when administered face-to-face in Indigenous communities in the Torres Strait region, Australia.


RESULTS
Comparing responses to the questionnaire with clinical assessment of 260 Indigenous children by a pediatric respiratory physician, sensitivity (87%) was high, but specificity (51%) and positive predictive value (33%) were low. Using a logistic regression model, we determined which questions were most useful in predicting a clinical diagnosis of asthma. Using a predictive equation, asthma was detected with 79% sensitivity and 77% specificity, and the calculated weighted estimate of asthma prevalence in the region was 16.3%.


CONCLUSIONS
Our findings reveal that although the ISAAC questionnaire is a reasonably sensitive tool for both epidemiologic and clinical studies of asthma in Indigenous communities, its value is enhanced when used in conjunction with a predictive model. We have also shown that asthma is prevalent in the Torres Strait region.
Valery
Patricia C
PC
Queensland Institute of Medical Research, Population and Clinical Sciences Division, 300 Herston Road, Queensland 4006, Australia. patriciV@qimr.edu.au
Purdie
David M
DM
Chang
Anne B
AB
Masters
Ian B
IB
Green
Adèle
A
D000293:Adolescent; D001249:Asthma / Q000175:diagnosis* / Q000208:ethnology*; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D011793:Queensland / Q000453:epidemiology; D011795:Surveys and Questionnaires; D000095283:Australian Aboriginal and Torres Strait Islander Peoples