title: Trend in asthma severity in steroid naive asthmatic children in Benin city, Nigeria.
abstract: BACKGROUND
  Asthma imposes heavy health burden on children and families worldwide. It is a chronic inflammatory airway disease and as such, treatment of the asthmatics is aimed at relieve of bronchoconstriction and inflammation. Until about a decade ago, emphasis was on the bronchoconstriction rather than the inflammation.
  
  
  OBJECTIVE
  To determine the trend in severity of asthma in steroid naive children, in an era when steroid use in the treatment of asthma was uncommon.
  
  
  METHODS
  Case notes of patients managed for asthma from 1985 to 1995 and age 5 - 16 years were retrieved and reviewed (these case notes are usually stored in Prof. O. Oviawe's office). Information extracted included age of onset of asthma, severity of asthma and drug medication at presentation and at 1 year. The GINA Guideline (2006) was used in classifying the asthma severity.
  
  
  RESULTS
  A total of 77 patients satisfied the criteria for the study. Of these, 53 were males and 24 females. Males: Female ratio was 2.3:1; age range 5 - 16 years; mean age ± SD (8.5 ± 3.13 years). At presentation, 48 (62.3%) patient had intermittent, 29 (37.7%) had persistent asthma, of these, 25 (86.2%) had mild persistent and 4 (13.8%) had moderate persistent. None had severe persistent asthma. At 1 year follow-up, 29 (37.7%) now had intermittent asthma, while 44 (57.1%) had persistent asthma, of these, 23 (52.3%) had mild persistent, 20 (45.5%) had moderate persistent, while 1 (2.3%) had severe persistent. Medication therapy was β2-agonist in 72 (93.5%) patients.
  
  
  CONCLUSIONS
  The study supports progressive pathologic process possibly inflammatory in origin. It is opined that steroid naivity led to the trend seen in this study and judicious use of corticosteroids would have arrested the trend.
authors.affiliation: Department of Child Health, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. sonofeto@yahoo.com
authors.forename: O
authors.initials: O
authors.lastname: Oviawe
authors.forename: W O
authors.initials: WO
authors.lastname: Osarogiagbon
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D017668:Age of Onset; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D012720:Severity of Illness Index; D014505:Urban Population
chemical_list: D000305:Adrenal Cortex Hormones