Characteristics of children with asthma who are enrolled in a Head Start program.
BACKGROUND
Asthma is an increasing public health concern that disproportionally affects children. In 1998, the Centers for Disease Control identified children aged 0 to 4 years as the "driving force" behind climbing rates of asthma-related emergency department visits and hospitalizations. Despite the significant asthma burden in preschool children, few studies characterize this population.


OBJECTIVE
This study identifies and characterizes children at risk for asthma who are enrolled in a local Head Start program.


METHODS
Caregivers of 368 children aged 3 to 5 years who were identified by using an asthma survey were recruited. Data were collected on demographics, health care use and access, medication use, symptoms, and trigger exposure. Exposure to tobacco smoke was determined by urinary cotinine and allergen sensitization by skin prick test.


RESULTS
At baseline, 64% of the children had more than 1 emergency department visit for asthma in their lifetime, whereas 31% had more than 1 visit in the previous 6 months. Caretakers reported smoking in 37% of households with cotinine exceeding 20 ng/mg in 27% of the sample. Twenty-one percent reported symptoms consistent with intermittent asthma, and 79% reported symptoms consistent with persistent asthma. Forty-five percent of the children reported nighttime symptoms more than 1 night per week. Seventy-one percent had positive test results for more than 1 allergen, and 42% had positive test results for more than 3 allergens. Only 32% of children with persistent asthma had both rescue and controller medications.


CONCLUSIONS
Children with asthma enrolled in a Head Start program have significant environmental tobacco smoke exposure, are highly atopic and symptomatic, and do not receive appropriate medication treatment. Overall, children in the study had poor asthma control. This high-risk group could benefit from case management programs.
Vargas
Perla A
PA
Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, AR 72202-3591, USA. VargasPerlaA@uams.edu
Simpson
Pippa M
PM
Gary Wheeler
J
J
Goel
Rajiv
R
Feild
Charles R
CR
Tilford
John M
JM
Jones
Stacie M
SM
D001741:Black or African American; D001131:Arkansas / Q000453:epidemiology; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D002675:Child, Preschool; D018479:Early Intervention, Educational; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014028:Tobacco Smoke Pollution
D014028:Tobacco Smoke Pollution