title: Respiratory disease screening in school-aged children using portable spirometry.
abstract: OBJECTIVE
  To assess the prevalence of respiratory disease in school-aged children and to determine the value of field spirometry.
  
  
  METHODS
  Data on 313 1st and 4th graders from four public schools in Lisbon were analyzed. A respiratory self-answered questionnaire and standard spirometry were performed. Descriptive and bivariate analysis was followed by multiple logistic regression.
  
  
  RESULTS
  Thirty-five percent of the children presented at least one episode of wheezing (18% ≥ 2 episodes), and 4% had asthma. Wheezing was more frequent with family history of atopy (adjusted OR = 2.7; 95%CI 1.4-5.1), maternal smoking during pregnancy, lower respiratory tract infection (LRTI) (adjusted OR = 2.8; 95%CI 1.2-6.2), bronchiolitis (adjusted OR = 3.3; 95%CI 1.3-8.2), and allergy to aeroallergens (adjusted OR = 3.2; 95%CI 1.4-7.2). Asthma was more frequent with previous history of LRTI (adjusted OR = 14.6; 95%CI 1.7-122.9) and allergy to aeroallergens (adjusted OR = 8.2; 95%CI 2.0-34.2). Fifty-five percent of spirometry measurements met the acceptability criteria of the American Thoracic Society and of the European Respiratory Society. Wheezers presented mean lower z scores for forced expiratory volume in 1 second (FEV1), ratio between FEV1 and forced vital capacity (FVC) (FEV1/FVC), and forced expiratory flow between 25 and 75% (FEF25-75) (p < 0.05), as well as higher percentage of abnormal FEV1, FEV1/FVC and FEF25-75/ (FEF25-75, p < 0.05).
  
  
  CONCLUSIONS
  This pilot study showed a high prevalence of obstructive airway symptoms in school-aged children in Lisbon. Symptoms assessed by the questionnaire showed good correlation with spirometric values. The small prevalence of asthma leads us to speculate that asthma is under-diagnosed in this population.
authors.affiliation: Centro Hospitalar Lisboa Norte, Rua César de Oliveira 20, Lisbon, Portugal. carolinaconstant@sapo.pt
authors.forename: Carolina
authors.initials: C
authors.lastname: Constant
authors.forename: Isabel
authors.initials: I
authors.lastname: Sampaio
authors.forename: Filipa
authors.initials: F
authors.lastname: Negreiro
authors.forename: Pedro
authors.initials: P
authors.lastname: Aguiar
authors.forename: Ana Margarida
authors.initials: AM
authors.lastname: Silva
authors.forename: Marisa
authors.initials: M
authors.lastname: Salgueiro
authors.forename: Teresa
authors.initials: T
authors.lastname: Bandeira
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D010375:Pedigree; D011174:Portugal / Q000453:epidemiology; D011247:Pregnancy; D012140:Respiratory Tract Diseases / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D012574:Schools; D012959:Socioeconomic Factors; D013147:Spirometry / Q000295:instrumentation*