Abstract
Asthma prevalence in children and adolescents in Spain is 10-17%. It is the most common chronic illness during childhood. Prevalence has been increasing over the last 40 years and there is considerable evidence that, among other factors, continued exposure to cigarette smoke results in asthma in children. No statistical or simulation model exist to forecast the evolution of childhood asthma in Europe. Such a model needs to incorporate the main risk factors that can be managed by medical authorities, such as tobacco (OR = 1.44), to establish how they affect the present generation of children. A simulation model using conditional probability and discrete event simulation for childhood asthma was developed and validated by simulating realistic scenario. The parameters used for the model (input data) were those found in the bibliography, especially those related to the incidence of smoking in Spain. We also used data from a panel of experts from the Hospital del Mar (Barcelona) related to actual evolution and asthma phenotypes. The results obtained from the simulation established a threshold of a 15-20% smoking population for a reduction in the prevalence of asthma. This is still far from the current level in Spain, where 24% of people smoke. We conclude that more effort must be made to combat smoking and other childhood asthma risk factors, in order to significantly reduce the number of cases. Once completed, this simulation methodology can realistically be used to forecast the evolution of childhood asthma as a function of variation in different risk factors.
Highlights
Asthma, which affects between 10% and 17% of children and adolescents in Spain [1], especially in cities, is a chronic inflammatory alteration of the airway with consequent narrowing of the bronchial conducts, leading to a feeling of breathlessness, coughing and difficulty breathing
The aim of this study was to create a discrete event simulation (DES) model which would reproduce the current situation of child asthma in Spain, in order to reproduce this pattern from birth to adolescence
A DES simulation model for childhood asthma was validated with respect to data in the bibliography, with a prevalence of asthma of around 10% to 17%, based on published studies [1, 3, 5, 14]
Summary
Asthma, which affects between 10% and 17% of children and adolescents in Spain [1], especially in cities, is a chronic inflammatory alteration of the airway with consequent narrowing of the bronchial conducts, leading to a feeling of breathlessness, coughing and difficulty breathing. It has become the leading cause of consultation in emergency hospitals and primary health centres in Spain at state level. The prevalence of childhood asthma makes this disease the most common chronic condition in childhood and adolescence, it is essential to predict its future evolution. Its mode of transmission (inheritance) is polygenic (several genes on several chromosomes), which explains why children of parents with asthma may or may not have asthma and that among those who have the condition the severity and presentation varies [3,4,5]
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