title: Asthma-like symptoms, diagnostic tests, and asthma medication use in children and adolescents: a population-based nationwide survey.
abstract: OBJECTIVE
  This study aimed to estimate the prevalence of asthma-like symptoms, current asthma (CA), asthma diagnostic tests, and inhaled medication use in a nationwide pediatric population (<18 years).
  
  
  METHODS
  Pediatric-specific data from a cross-sectional, population-based telephone survey (INAsma study) in Portugal were analyzed. CA was defined as lifetime asthma and (1) wheezing, (2) waking with breathlessness, or (3) asthma attack in the previous 12 months, and/or (4) taking asthma medication at the time of the interview.
  
  
  RESULTS
  In total, 716 children were included. The prevalence of asthma-like symptoms was 39.4% [95% confidence interval (95% CI): 35.7-43.3]. The most common symptoms were waking with cough (30.9%) and wheezing (19.1%). The prevalence of CA was 8.4% (95% CI: 6.6-10.7). Among children with CA, 79.9% and 52.9% reported prior allergy testing and pulmonary function testing (PFT), respectively. Inhaled medication use in the previous 12 months was reported by 67.6% (reliever inhalers, 40.1%; controller inhalers, 41.5%). Those who only used inhaled reliever medications experienced more asthma attacks [odds ratio (OR): 2.69]. Significantly fewer children with CA living in rural areas than those living in urban areas had undergone PFT or used inhaled medication (OR: 0.06 for PFT, 0.20 for medication].
  
  
  CONCLUSIONS
  The prevalence of CA in the Portuguese pediatric population was 8.4%. Only half of children with CA had ever undergone PFT; more than half did not use controller inhalers, and those who only used reliever inhalers reported more asthma attacks. These findings suggest that asthma management has been substandard, mainly in rural areas.
authors.affiliation: a Pediatric Department , Centro Hospitalar de S. João , Porto , Portugal .|b Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto University , Porto , Portugal .|c Pediatric Department , Faculty of Medicine, Porto University , Porto , Portugal .
authors.forename: Manuel
authors.initials: M
authors.lastname: Ferreira-Magalhães
authors.affiliation: b Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto University , Porto , Portugal .
authors.forename: Ana
authors.initials: A
authors.lastname: Sá-Sousa
authors.affiliation: d Allergy Centre, CUF Descobertas and CUF Infante Santo Hospital , Lisbon , Portugal .|e Sociedade Portuguesa de Alergologia e Imunologia Clínica , Lisbon , Portugal .
authors.forename: Mário
authors.initials: M
authors.lastname: Morais-Almeida
authors.affiliation: d Allergy Centre, CUF Descobertas and CUF Infante Santo Hospital , Lisbon , Portugal .|f CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa , Lisboa , Portugal .
authors.forename: Helena
authors.initials: H
authors.lastname: Pité
authors.affiliation: b Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto University , Porto , Portugal .|g Health Information and Decision Sciences Department (CIDES), Faculty of Medicine, Porto University , Porto , Portugal , and.
authors.forename: Luis Filipe
authors.initials: LF
authors.lastname: Azevedo
authors.affiliation: a Pediatric Department , Centro Hospitalar de S. João , Porto , Portugal .|c Pediatric Department , Faculty of Medicine, Porto University , Porto , Portugal .
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Azevedo
authors.affiliation: d Allergy Centre, CUF Descobertas and CUF Infante Santo Hospital , Lisbon , Portugal .
authors.forename: António
authors.initials: A
authors.lastname: Bugalho-Almeida
authors.affiliation: b Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto University , Porto , Portugal .|g Health Information and Decision Sciences Department (CIDES), Faculty of Medicine, Porto University , Porto , Portugal , and.|h Allergy Unit, CUF Porto Institute & Hospital , Porto , Portugal.
authors.forename: João Almeida
authors.initials: JA
authors.lastname: Fonseca
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000175:diagnosis; D003430:Cross-Sectional Studies; D003948:Diagnostic Techniques, Respiratory System; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis; D007158:Immunologic Techniques; D007223:Infant; D008297:Male; D009330:Nebulizers and Vaporizers; D016017:Odds Ratio; D011174:Portugal; D015995:Prevalence; D012111:Residence Characteristics; D012135:Respiratory Sounds / Q000175:diagnosis
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents
keywords: Cough; epidemiology; pediatrics; prevalence; respiratory function tests; treatment; wheezing