Clinical features of a paediatric asthma population in Trinidad.
OBJECTIVE
Clinical features and management of paediatric asthma, highly prevalent in the Caribbean, was explored in Trinidadian children.


METHODS
Children (2-16 years) with acute [visiting Accident and Emergency (A&E) in the past 12 months (50.2%, 120)] or stable asthma [controlled during the previous 3 months (49.8%, 119)] were studied.


RESULTS
There were more (P < 0.001) boys (71.5%) than girls. Asthma was associated with asthmatic mothers (48.5%), fathers (19.2%) and both parents (15.1%) (P < 0.001). Children's average age of first wheeze was 2.5 (standard deviation = 1.3) years; 30.1% were nebulized before 1 year. In the past 12 months, frequencies of A&E visits were once (20.6%), >1 (61.9%) and >3 times (26.4%) (P < 0.001). Sufferers of exacerbations showed negative logistic regression for age (-0.129, standard error = 0.039, P < 0.001) independent of gender. Acute asthmatics who suffered cough, fever and sore throat in the preceding week were respectively 15.2 [odds ratio (OR) = 15.2, 95% confidence interval (CI) = 6.8-34.0], 13.7 (OR = 13.7, 95% CI = 6.7-28.2) and 3.4 (OR = 3.4, 95% CI = 1.7-6.7) times more likely to suffer wheeze exacerbations than stable children. Most stable children (76.5%) inhaled corticosteroids with salbutamol reliever compared with 22.5% of acute asthmatics, whereas 40.8% of the latter group used salbutamol alone compared with 19.3% of stable children (P < 0.001).


CONCLUSIONS
Childhood wheeze occurs before 3 years and is associated with maternal asthma. Cough, fever and sore throat in the previous week are strongly associated with exacerbations. Defining these associations could enhance preventive approaches to combat childhood asthma.
Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
Jason
J
Matthew
Isaac
I
Bekele
Lexley Maureen
LM
Pinto Pereira
D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005192:Family Health / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D014300:Trinidad and Tobago / Q000453:epidemiology
D018927:Anti-Asthmatic Agents