Abstract
Epidemiological data for south Asian children in the United Kingdom are contradictory, showing a lower prevalence of wheeze, but a higher rate of medical consultations and admissions for asthma compared with white children. These studies have not distinguished different asthma phenotypes or controlled for varying environmental exposures. To compare the prevalence of wheeze and related health-service use in south Asian and white pre-schoolchildren in the United Kingdom, taking into account wheeze phenotype (viral and multiple wheeze) and environmental exposures. A postal questionnaire was completed by parents of a population-based sample of 4366 white and 1714 south Asian children aged 1-4 years in Leicestershire, UK. Children were classified as having viral wheeze or multiple trigger wheeze. The prevalence of current wheeze was 35.6% in white and 25.5% in south Asian 1-year-olds (P<0.001), and 21.9% and 20.9%, respectively, in children aged 2-4 years. Odds ratios (ORs) (95% confidence interval) for multiple wheeze and for viral wheeze, comparing south Asian with white children, were 2.21 (1.19-4.09) and 1.43 (0.77-2.65) in 2-4-year-olds after controlling for socio-economic conditions, environmental exposures and family history. In 1-year-olds, the respective ORs for multiple and viral wheeze were 0.66 (0.47-0.92) and 0.81 (0.64-1.03). Reported GP consultation rates for wheeze and hospital admissions were greater in south Asian children aged 2-4 years, even after adjustment for severity, but the use of inhaled corticosteroids was lower. South Asian 2-4-year-olds are more likely than white children to have multiple wheeze (a condition with many features of chronic atopic asthma), after taking into account ethnic differences in exposure to some environmental agents. Undertreatment with inhaled corticosteroids might partly explain their greater use of health services.
Highlights
Epidemiological data about asthma in minority ethnic groups are conflicting.[1]
After discounting 200 invalid addresses, 84% (4986/5954) of families where the mother was defined as white and 72% (1825/2546) where the mother was defined as south Asian replied
All south Asian children were born in the UK
Summary
Epidemiological data about asthma in minority ethnic groups are conflicting.[1]. A recent systematic review on ethnic variations in asthma frequency, morbidity and healthservice use in the UK concluded with the paradox that the prevalences of wheeze and diagnosed asthma were lower in south Asian than white children aged 5 years and older, but that medical consultations and hospital admissions were more common.[2]. Epidemiological data for south Asian children in the UK are contradictory, showing a lower prevalence of wheeze, but a higher rate of medical consultations and admissions for asthma compared to white children. These studies have not distinguished different asthma phenotypes or controlled for varying environmental exposures. Conclusions: South Asian 2 to 4 year-olds are more likely than white children to have multiple wheeze (a condition with many features of chronic atopic asthma), after taking into account ethnic differences in exposure to some environmental agents
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