Abstract
BackgroundThe prevalence of asthma and other allergic diseases among children living in Eastern is not well described. Our objective was to estimate and compare the prevalence of asthma, respiratory symptoms and allergic diseases in children in Belarus, Ukraine, and Poland as well as to identify risk factors for these conditions. We also sought to profile and compare children with asthma between locations.MethodsData were collected as a part of an international, multicenter, cross-sectional study of childhood asthma: The Belarus Ukraine Poland Asthma Study (BUPAS). Subjects were children aged 7–13 years attending primary and secondary schools in the urban and surrounding rural area of Grodno (Belarus), Ternopil (Ukraine) and Silesia Region (Poland). Physician-diagnosed respiratory diseases and symptoms as well as allergic diseases were ascertained using the ISAAC questionnaire completed by the parents.ResultsIn total there were 4019 children from Belarus (rural: 2018, urban: 2001), 4493 from Ukraine (1972; 2521), and 4036 from Poland (2002, 2034). The overall response rate was 76.7 %. Groups were similar in case of gender and age (p > 0.05). Almost all analyzed respiratory and allergic conditions differed significantly between countries including asthma [Poland (rural, urban): 3.5 %, 4.1 %; Ukraine: 1.4 %, 2.1 %; Belarus: 1.4 %, 1.5 %], spastic bronchitis (Poland: 2.7 %, 3.2 %; Ukraine: 7.5 %, 6.5 %; Belarus: 6.4 %, 7.9 %), and chest wheeze in the last year (Poland: 4.8 %, 5.2 %; Ukraine: 11.5 %, 13.0 %; Belarus: 10.7 %, 10.0 %). These differences remained after adjustment for potential confounders. Risk factor associations were generally similar between outcomes. Symptom characteristics of children with asthma between countries were not consistent. The ratio of current wheeze:diagnosis of asthma differed by country: (Rural areas: Belarus: 10.9:1, Ukraine: 17.3:1, Poland: 2.4:1; Urban areas: Belarus: 8.1:1, Ukraine: 7.3:1 Poland: 1.9:1).ConclusionsThe findings show large between-country differences and relatively low prevalence of asthma and allergic diseases in children of Western Belarus and Ukraine. There is evidence for underdiagnosis of asthma in these regions.
Highlights
The prevalence of asthma and other allergic diseases among children living in Eastern is not well described
While some investigation of asthma prevalence has been completed in Eastern Europe, including a regional investigation of countries from Eastern and Central Europe [3] which showed between-country variation in prevalence was more dominant than within-country variation along with some indication of diagnostic labeling explaining differences by region, there has been very little work completed in countries outside the EU including Poland Asthma Study (Ukraine) and Belarus
We have described investigations of asthma prevalence separately in Ukraine [4] and Belarus [5] as part of the Belarus, Ukraine, and Poland Asthma Study (BUPAS). In each of these locations, there was some evidence of asthma underdiagnosis [4, 5] Qualitatively, the prevalence of asthma was lower in these countries compared to Western European nations, with possible underdiagnosis occurring. These observations, along with societal changes towards a Westernized lifestyle, which has been associated with higher asthma prevalence, make it likely that the prevalence of asthma will increase in the future
Summary
The prevalence of asthma and other allergic diseases among children living in Eastern is not well described. Our objective was to estimate and compare the prevalence of asthma, respiratory symptoms and allergic diseases in children in Belarus, Ukraine, and Poland as well as to identify risk factors for these conditions. We have described investigations of asthma prevalence separately in Ukraine [4] and Belarus [5] as part of the Belarus, Ukraine, and Poland Asthma Study (BUPAS) In each of these locations, there was some evidence of asthma underdiagnosis [4, 5] Qualitatively, the prevalence of asthma was lower in these countries compared to Western European nations, with possible underdiagnosis occurring. Identification of reasons for geographic differences and risk factors for asthma, including consistency between regions, in these locations will help develop our etiologic understanding of asthma and may help our future management strategies for children with lung disease
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