title: Validation of a questionnaire for asthma case identification in pre-schools in Latin America.
abstract: OBJECTIVE
  We recently developed and validated a screening questionnaire for determining which school-aged children may need further investigation to diagnose and manage asthma. In the present study we sought to extend this to pre-school aged children.
  
  
  METHODS
  Questions from the school-aged questionnaire and literature on pre-school asthma were used to inform a focus group of parents with pre-school-aged children with asthma to develop a screening questionnaire. Parents of children attending 6 randomly selected kindergartens in Trelew, Argentina (n = 639) were invited to respond to the questionnaire. A reliability test-retest was undertaken in 187 randomly selected parents who completed the same questionnaire twice within 2-5 weeks. Clinical assessment included a standardized history and physical examination, spirometry before and after a β-agonist inhaler, and chest X-ray. Asthma was diagnosed by the pulmonologist.
  
  
  RESULTS
  Completed surveys were returned for 620 children, 607 of whom underwent clinical evaluation. The mean age was 4.21 years (range of 3.01-5.50) and included 82.5% white and 49.4% male children. Asthma was diagnosed in 103 (17.0%) children); 72 (69.9%) of these children did not have a previous diagnosis of asthma. The specificity, sensitivity, positive predictive value and negative predictive value of the questionnaire were 93.2%, 86.1%, 57.8% and 98.4%, respectively.
  
  
  CONCLUSIONS
  We have demonstrated the utility of a screening questionnaire for identifying pre-school-aged children who may benefit from further assessment for asthma.
authors.affiliation: Pulmonology Committee of the Argentinean Pediatric Society, Trelew Hospital, Trelew, Argentina.|Pediatrics Department, Trelew Hospital, Trelew, Argentina.
authors.forename: Luciano E
authors.initials: LE
authors.lastname: Busi
authors.affiliation: Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Sly
authors.affiliation: Pediatrics Department, Trelew Hospital, Trelew, Argentina.
authors.forename: Lidia
authors.initials: L
authors.lastname: Llancaman
mesh_terms: D001249:Asthma / Q000175:diagnosis*; D002675:Child, Preschool; D005260:Female; D017144:Focus Groups; D006801:Humans; D007843:Latin America; D008297:Male; D008403:Mass Screening; D010290:Parents; D015203:Reproducibility of Results; D012572:School Health Services; D012680:Sensitivity and Specificity; D013147:Spirometry; D011795:Surveys and Questionnaires
keywords: asthma; case-identification; children; diagnosis; screening