Childhood asthma in South London: trends in prevalence and use of medical services 1991-2002.
BACKGROUND
Hospital admission rates for asthma in Britain rose during the 1980s and fell during the 1990s, but less is known about recent trends in the prevalence of asthma.


METHODS
In 1991 and 2002 the same questionnaire was distributed to parents of all school pupils in year 3 (aged 7-8 years) in the London borough of Croydon. Parents of currently wheezy children were then invited for home interview (100% targeted in 1991, 66% in 2002).


RESULTS
The prevalence of wheeze during the previous year increased from 12.9% in 1991 to 17.8% in 2002 (prevalence ratio 1.39 (95% CI 1.23 to 1.56)). Increases were observed in frequent (1.54 (95% CI 1.16 to 2.03)) and infrequent attacks, severe speech limiting episodes (2.25 (95% CI 1.34 to 3.77)), and night waking (1.36 (95% CI 1.07 to 1.72)), and in the reported use of steroids (19.9% v 64.1% of currently wheezy children). Nevertheless, the proportions reporting a visit to the GP at his/her surgery for wheeze in the previous year (prevalence ratio 1.15 (95% CI 0.91 to 1.45)) or an outpatient visit (0.98 (95% CI 0.49 to 1.94)) changed little and an increase in reported casualty attendance (1.66 (95% CI 0.89 to 3.07)) was non-significant.


CONCLUSIONS
There is evidence of an increase in the prevalence of asthma among British primary school children between 1991 and 2002. The absence of a corresponding increase in health service utilisation data may reflect more widespread prophylactic treatment and/or changes in the use and provision of medical services.
Butland
B K
BK
Division of Community Health Sciences, St George's, University of London, Cranmer Terrace, London SW17 ORE, UK. b.butland@sgul.ac.uk
Strachan
D P
DP
Crawley-Boevey
E E
EE
Anderson
H R
HR
D001249:Asthma / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008131:London / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012135:Respiratory Sounds / Q000209:etiology