title: Prevalence and risk factors for early presentation of asthma among preschool children in Taiwan.
abstract: BACKGROUND
  Traditional asthma prevalence surveys were based on the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, which focuses on children aged 6-7 and 13-14. However, asthma-like symptoms usually commence in preschool aged children, in whom it is difficult to make a definite diagnosis of asthma. It is worth determining the prevalence rate of asthma or asthma-like symptoms and analyzing the risk factors for this phenomenon among preschool aged children.
  
  
  METHODS
  Children aged 3-6 years were recruited from kindergartens in Keelung City, northern Taiwan. The questionnaire used was based on the ISAAC phase III core and environmental questionnaires and included questions on asthma, rhino-conjunctivitis, and eczema, along with questions to elicit common and early presentations of asthma, as well as other demographic and environmental data. The questionnaires were delivered and completed by parents.
  
  
  RESULTS
  2395 questionnaires were delivered to parents with children at 50 kindergartens, of which 2170 questionnaires were returned (return rate 90.6%). 9.9% of these preschool children had physician-diagnosed asthma. However, 20.4% of them experienced asthma like symptoms while attending kindergarten. Both the physician-diagnosed asthma and asthma-like symptoms groups had more clinical symptoms in all seasons except summer, compared to children without asthma. It was significant that the asthma-like symptoms commenced after joining a kindergarten (p < 0.001), and 66.5% of the children started to experience the symptoms within one month of beginning kindergarten. Using antibiotics or antipyretics in young infancy and mothers having asthma were the risk factors for developing asthma and asthma-like symptoms (p < 0.001), but parental smoking was not contributory to asthma development in preschool children. More frequent use of antipyretics in a year had a higher risk for the development of asthma and asthma-like symptoms.
  
  
  CONCLUSIONS
  Asthma and asthma-like symptoms were common in preschool children. Early infection of the respiratory tract and use of antibiotics were associated with presentation of symptoms. Attending a kindergarten is also a risk factor for early presentation of asthma among preschool children.
authors: Division of Allergy Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Kuo-Wei
authors: KW
authors: Yeh
authors: Liang-Shiou
authors: LS
authors: Ou
authors: Tsung-Chieh
authors: TC
authors: Yao
authors: Li-Chen
authors: LC
authors: Chen
authors: Wen-I
authors: WI
authors: Lee
authors: Jing-Long
authors: JL
authors: Huang
mesh_terms: D017668:Age of Onset; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D058633:Antipyretics / Q000009:adverse effects; D001249:Asthma / Q000150:complications / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000150:complications / Q000453:epidemiology*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013624:Taiwan
chemical_list: D000900:Anti-Bacterial Agents; D058633:Antipyretics