Greater Prevalence Of Asthma Research Articles

Medical comorbidities and endocrine dysfunction in low-weight females with avoidant/restrictive food intake disorder compared to anorexia nervosa and healthy controls.

To improve our understanding of medical complications and endocrine alterations in patients with low-weight avoidant/restrictive food intake disorder (ARFID) and how they may differ from those in anorexia nervosa (AN) and healthy controls (HC). We performed an exploratory cross-sectional study comparing low-weight females with ARFID (n = 20) with females with AN (n = 42) and HC (n = 49) with no history of an eating disorder. We found substantial overlap in medical comorbidities and endocrine features in ARFID and AN, but with earlier onset of aberrant eating behaviors in ARFID. We also observed distinct medical and endocrine alterations in ARFID compared to AN, such as a greater prevalence of asthma, a lower number of menses missed in the preceding 9 months, higher total T3 levels, and lower total T4 : total T3 ratio; these differences persisted after adjusting for age and might reflect differences in pathophysiology, acuity of weight fluctuations, and/or nutritional composition of food consumed. These results highlight the need for prompt diagnosis and intensive therapeutic intervention from disease onset in ARFID.

Asthma prevalence and control levels among Special Olympics athletes, and asthma-related knowledge of their coaches.

The prevalence of asthma among athletes with intellectual disabilities, and the asthma knowledge levels of their coaches, is unknown. Special Olympics Canada athletes completed a demographic questionnaire (n=208). Athletes who identified as having ever or current asthma completed the Asthma Control Questionnaire and the Mini Asthma Quality of Life Questionnaire and were measured for height, weight and lung function (n=73). National level coaches (n=27) completed a questionnaire pertaining to asthma knowledge. The prevalence of ever and current asthma were 35.5% (n=73) and 21.1% (n=44), respectively. Athletes with asthma reported that they had inadequately controlled asthma, but good quality of life. Coaches correctly answered 43% true/false questions on the survey, indicating suboptimal asthma knowledge. Athletes with intellectual disabilities appear to have a greater prevalence of asthma than the general population; however, coaches of these athletes appear to have limited knowledge pertaining to asthma and exercise-induced asthma.

Asthma prevalence disparities and differences in sociodemographic associations with asthma, between Native Hawaiian/Other Pacific Islander, Asian, and White adults in Hawaii – Behavioral Risk Factor Surveillance System (BRFSS), 2001–2010

ABSTRACTObjectives: Despite high asthma prevalence, relatively little is known about the epidemiology of asthma in Hawaii or among Native Hawaiian/Other Pacific Islanders (NHOPI). We sought to better characterize racial/ethnic differences in asthma prevalence and in sociodemographic factors associated with asthma among Hawaii adults.Design: We conducted multivariable logistic regression using 2001–2010 Behavioral Risk Factor Surveillance System data from Hawaii, and computed adjusted prevalence and ratios.Results: Asthma prevalence markedly varied between self-identified census categories of race in Hawaii, with NHOPI having the highest estimates of both lifetime (20.9%, 95% confidence interval [CI]: 19.5%–22.4%) and current (12.2%, CI: 11.2%–13.3%) asthma. Highest asthma prevalence among NHOPI persisted after controlling for potential confounders and within most sociodemographic categories. Among females Asians reported the lowest asthma prevalence, whereas among males point estimates of asthma prevalence were often lowest for Whites. Females often had greater asthma prevalence than males of the same race, but the degree to which gender modified asthma prevalence differed by both race and sociodemographic strata. Gender disparities in asthma prevalence were greatest and most frequent among Whites, and for current asthma among all races. Sociodemographic factors potentially predictive of adult asthma prevalence in Hawaii varied by race and gender.Conclusion: Asthma disproportionately affects or is recognized more often among women and NHOPI adults in Hawaii, and occurs less or is under-reported among Asian women. The sociodemographic characteristics included in this study’s model did not explain asthma disparities between races and/or gender. This investigation provides a baseline with which to plan additionally needed prevention programs, epidemiological investigations, and surveillance for asthma in Hawaii.

Effects of early vitamin D deficiency rickets on bone and dental health, growth and immunity.

Vitamin D deficiency is associated with adverse health outcomes, including impaired bone growth, gingival inflammation and increased risk for autoimmune disease, but the relationship between vitamin D deficiency rickets in childhood and long-term health has not been studied. In this study, we assessed the effect of early vitamin D deficiency on growth, bone density, dental health and immune function in later childhood to determine if children previously diagnosed with rickets were at greater risk of adverse health outcomes compared with healthy children. We measured serum 25-hydroxyvitamin D, calcium, parathyroid hormone, bone mineral density, anthropometric measures, dietary habits, dental health, general health history, and markers of inflammation in 14 previously diagnosed rickets case children at Children's Hospital Oakland Research Center. We compared the findings in the rickets cases with 11 healthy children selected from the population of CHO staff families. Fourteen mothers of the rickets cases, five siblings of the rickets cases, and seven mothers of healthy children also participated. Children diagnosed with vitamin D deficiency rickets had a greater risk of fracture, greater prevalence of asthma, and more dental enamel defects compared with healthy children. Given the widespread actions of vitamin D, it is likely that early-life vitamin D deficiency may increase the risk of disease later in childhood. Further assessment of the long-term health effects of early deficiency is necessary to make appropriate dietary recommendations for infants at risk of deficiency.

Pediatric asthma management within Latino and non-Latino White families.

Pediatric asthma disparities exist with Latino children, especially from Island Puerto Rico (PR), experiencing greater asthma prevalence and morbidity than non-Latino White (NLW) children. Families must balance attention to child asthma with other child and family needs, defined as the "balanced integration of asthma." This study examined the impact of culturally related factors on the balanced integration of asthma in NLW and Latino families in Rhode Island (RI) and PR, as well as associations between balanced integration and asthma morbidity. Participants included 601 caregivers and their children with asthma (7-16 years) from NLW and Latino backgrounds in RI and PR. Caregivers and children completed interview-administered assessments and a semistructured interview related to family asthma management. Balanced integration of asthma differed significantly by ethnic group/site (p < .001), with Island PR families having the lowest levels of balanced integration. Higher balanced integration was associated with fewer concerns about asthma medications, higher levels of Spanish proficiency in RI Latino families, lower levels of functional limitation, and no emergency department visits in the last year (all ps < .05). Findings suggest that Latino families may experience more difficulty adjusting to child asthma in the context of other child and family demands. Medication beliefs and language proficiency may begin to explain these differences. Our study suggests the importance of continuing to understand how families balance asthma with other aspects of daily life, as culturally appropriate interventions to improve family adjustment to asthma may serve to reduce child asthma morbidity.

Fatty acids, inflammation, and asthma

Fatty acids and consequently diet play an essential role in the formation of inflammatory mediators involved in the pathogenesis of asthma. Because intake variations of omega-6 (n-6) and omega-3 (n-3) fatty acids ultimately determine cell membrane incorporation, changes in diet have the potential to modify downstream production of inflammatory mediators derived from these compounds. It has long been hypothesized that decreasing the n-6/n-3 ratio could reduce the production of more proinflammatory mediators while increasing the formation of downstream metabolites that can serve to limit or resolve inflammation. In turn, these changes would result in improved asthma outcomes or would lower the risk for asthma incidence. This review will focus on the role of fatty acid inflammatory and resolving mediators and will summarize the clinical and epidemiologic data on how diet and obesity alter fatty acid profiles that can contribute to asthma.

Adiponectin, Leptin, and Resistin in Asthma: Basic Mechanisms through Population Studies.

Adipokines, factors produced by adipose tissue, may be proinflammatory (such as leptin and resistin) or anti-inflammatory (such as adiponectin). Effects of these adipokines on the lungs have the potential to evoke or exacerbate asthma. This review summarizes basic mechanistic data through population-based and clinical studies addressing the potential role of adipokines in asthma. Augmenting circulating concentrations of adiponectin attenuates allergic airway inflammation and airway hyperresponsiveness in mice. Murine data is supported by human data that suggest that low serum adiponectin is associated with greater risk for asthma among women and peripubertal girls. Further, higher serum total adiponectin may be associated with lower clinical asthma severity among children and women with asthma. In contrast, exogenous administration of leptin results in augmented allergic airway hyperresponsiveness in mice. Alveolar macrophages obtained from obese asthmatics are uniquely sensitive to leptin in terms of their potential to augment inflammation. Consistent with this basic mechanistic data, epidemiologic studies demonstrate that higher serum leptin is associated with greater asthma prevalence and/or severity and that these associations may be stronger among women, postpubertal girls, and prepubertal boys. The role of adipokines in asthma is still evolving, and it is not currently known whether modulation of adipokines may be helpful in asthma prevention or treatment.

Ambient Air Toxics and Asthma Prevalence among a Representative Sample of US Kindergarten-Age Children

BackgroundCriteria pollutants have been associated with exacerbation of children’s asthma, but the role of air toxics in relation to asthma is less clear. Our objective was to evaluate whether exposure to outdoor air toxics in early childhood increased asthma risk or severity.MethodsAir toxics exposure was estimated using the 2002 National Air toxics Assessment (NATA) and linked to longitudinal data (n=6950) from a representative sample of US children born in 2001 and followed through kindergarten-age in the Early Child Longitudinal Study - Birth Cohort (ECLS-B).ResultsOverall, 17.7% of 5.5 year-olds had ever been told by a healthcare professional they had asthma, and 6.8% had been hospitalized or visited an emergency room for an asthma attack. Higher rates of asthma were observed among boys (20.1%), low-income (24.8%), and non-Hispanic black children (30.0%) (p≤0.05). Air toxics exposure was greater for minority race/ethnicity (p<0.0001), low income (p<0.0001), non-rural area (p<0.001). Across all analyses, greater air toxics exposure, as represented by total NATA respiratory hazard index, or when limited to respiratory hazard index from onroad mobile sources or diesel PM, was not associated with a greater prevalence of asthma or hospitalizations (p trend >0.05). In adjusted logistic regression models, children exposed to the highest respiratory hazard index were not more likely to have asthma compared to those exposed to the lowest respiratory hazard index of total, onroad sources, or diesel PM.ConclusionsEarly childhood exposure to outdoor air toxics in a national sample has not previously been studied relative to children’s asthma. Within the constraints of the study, we found no evidence that early childhood exposure to outdoor air toxics increased risk for asthma. As has been previously reported, it is evident that there are environmental justice and disparity concerns for exposure to air toxics and asthma prevalence in US children.

Air pollution interacts with past episodes of bronchiolitis in the development of asthma

Exposure to ambient air pollution and bronchiolitis are risk factors for asthma. The aim of this study was to investigate the effect of air pollution on the development of asthma in children with past episodes of bronchiolitis. A prospective 2-year follow-up survey consisting of parental responses to the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, and allergy evaluations were conducted in 1743 children with a mean age of 6.8years. Recent 5-year exposure to air pollution was estimated using a geographic information system. Higher exposure to ozone was associated with airway hyper-responsiveness (PC20 ≤16mg/ml) at enrollment (odds ratio [OR]=1.60, 95% CI [confidence interval]=1.13-2.27) and with new episodes of wheezing during the 2-year period (OR=1.92, 95% CI=0.96-3.83). Past episodes of bronchiolitis were associated with both current wheezing and physician-diagnosed asthma. When the two factors were combined, the prevalence of bronchial hyper-reactivity (OR=2.96, 95% CI=1.41-6.24) and new wheezing (OR=4.17, 95% CI=0.89-19.66) as well as current wheezing and physician-diagnosed asthma was even greater (P for trend <0.05 for all). In children with both risk factors, lung function was significantly decreased, with atopic children being particularly vulnerable. In children, the interaction between air pollution and past episodes of bronchiolitis resulted in a greater prevalence of asthma and pointed to an association with bronchial hyper-reactivity and decreased lung function. These results suggest mechanisms underlying the development of asthma.

Leptin, adiponectin and pulmonary diseases

Adipose tissue produces leptin and adiponectin - energy-regulating adipokines that may also play a role in inflammatory pulmonary conditions, as suggested by some murine studies. Leptin and adiponectin and their respective receptors are expressed in the human lung. The association between systemic or airway leptin and asthma in humans is currently controversial, particularly among adults. The majority of the evidence among children however suggests that systemic leptin may be associated with greater asthma prevalence and severity, particularly among prepubertal boys and peripubertal/postpubertal girls. Systemic and airway leptin concentrations may also be disproportionately higher in chronic obstructive pulmonary disease (COPD) patients, particularly among women, and reflect greater airway inflammation and disease severity. Quite like leptin, the association between systemic and airway adiponectin and asthma in humans is also controversial. Some but not all studies, demonstrate that serum adiponectin concentrations are protective against asthma among premenopausal women and peripubertal girls. On the other hand, serum adiponectin concentrations are inversely associated with asthma severity among boys but positively associated among men. Further, systemic and airway adiponectin concentrations are higher in COPD patients than controls, as demonstrated by case-control studies of men. Systemic adiponectin is also positively associated with lung function in healthy adults but inversely associated with lung function in subjects with COPD. It is therefore possible that pro-inflammatory effects of adiponectin dominate under certain physiologic conditions and anti-inflammatory effects under others. The adipokine-lung disease literature has critical gaps that include a lack of adequately powered longitudinal or weight-intervention studies; inadequate adjustment for confounding effect of obesity; and unclear understanding of potential sex interactions. It is also uncertain whether adipokine derangements precede pulmonary disease or are a consequence of it. Future research will determine whether modulation of adipokines, independent of BMI, may allow novel ways to prevent or treat inflammatory pulmonary conditions.

Associations of Age, Gender, and BMI with Prevalence of Allergic Diseases in Children: PATCH Study

Background. Little is known about the prevalence of allergic diseases in children of different ages. This study aimed to investigate the prevalence of allergic diseases and allergic sensitization in children over a wide age range, with emphasis on the influence of age, gender, and body mass index (BMI). Methods. In a cross-sectional study, we assessed 5351 Taiwanese children aged 4–18 years using an International Study of Asthma and Allergies in Childhood questionnaire, BMI, and total and specific serum immunoglobulin E. Results. Forty-eight percent were currently symptomatic for at least one of three allergic diseases. Prevalence of wheeze ever, current wheeze, and diagnosed asthma were 17.0%, 7.5%, and 9.8%, respectively; analogous features for rhinitis were 47.8%, 44.2%, and 39.8%. Allergic sensitization was very common (57.3%). Half of the children (50.6%) with current wheeze had not been diagnosed with asthma by physicians, whereas undiagnosed rates were 32.3% for rhinitis and 25.3% for eczema. The male-to-female prevalence ratios of current wheeze increased with age from <1 at 4–5 years, peaked at 10–11 years (2.24), then reversed to 0.57 at 16–18 years. Childhood wheezing tended to remit with age, but rhinitis and eczema were more persistent. Total immunoglobulin E levels increased with age until 14–15 years, and declined thereafter. Elevated BMI was associated with greater prevalence of wheezing and eczema, with no evidence of significant effect modification by either gender or age. Multivariate analyses revealed that younger age, boys, and obesity were significantly and independently associated with current wheezing in children (all p < .01). Conclusions. The burden and co-morbidity of childhood allergies are substantial. There are striking age-dependent gender differences in asthma prevalence, exhibiting an inverted U-shaped curve for male-to-female prevalence ratios by age. Obesity is associated with a greater prevalence of asthma in children with no evidence of a significant modulation by either gender or age.

Medical Comorbidities for Paradoxical Vocal Fold Motion (Vocal Cord Dysfunction) in the Military Population

This study aimed to describe the demographic characteristics of patients diagnosed with paradoxical vocal fold motion (PVFM) at Walter Reed Army Medical Center (WRAMC), and to document common medical comorbidities. The military population was expected to differ from the general population because of a presumed association between high physical demands and PVFM. Retrospective chart review of active-duty (AD) military personnel compared with a natural control group of non-AD patients. Reports of asthma, allergy, gastroesophageal reflux disease (GERD), and postnasal drip (consequent to chronic sinusitis) were recorded for patients referred to the Speech Pathology Clinic at WRAMC with a diagnosis of PVFM from 1996 to 2001. The cohort consisted of 265 patients, 127 of whom were on AD status. The AD group was significantly younger and represented a narrower age range (17-53 years) than the non-AD patients (8-80 years), and had a more balanced sex ratio (1.2:1 vs 2.9:1). Eighty percent of all patients had at least one of the medical comorbidities surveyed, and 51% had two or more factors. GERD and allergies were reported most commonly by both groups; only asthma occurred significantly more in non-AD than AD patients. PVFM referrals of AD personnel of the US military are characterized by younger patients and a smaller female:male ratio as compared with non-AD patients. Based on the preponderance of men in the military, the number of females in the AD group remained disproportionately large. Multiple medical comorbidities were commonly documented by both groups; the only significant difference was a greater prevalence of asthma in the non-AD group. These data reinforce the need for appropriate differential diagnosis in all patients.

Prevalence of Asthma among Adult Females and Males in the United States: Results from the National Health and Nutrition Examination Survey (NHANES), 2001–2004

Background. The prevalence of asthma has increased over the last three decades with females exhibiting a higher prevalence of asthma than males. The objective of this study was to obtain gender-specific estimates of the prevalence of current and ever asthma and describe the relationships between risk factors and asthma by gender in US men and women ages 20 to 85. Methods. Data for this study came from two cycles (2001–2002 and 2003–2004) of National Health and Nutrition Examination Survey (NHANES) and included 9,243 eligible adults: 4,589 females and 4,654 males. Multiple logistic regression was used to investigate gender-specific associations between race/ethnicity, body mass index (BMI), sociodemographic characteristics, and smoking habits for current asthma and ever asthma. Results. The prevalence of current asthma was 8.8% for women and 5.8% for men, while the prevalence of ever having been diagnosed with asthma was higher (13.7% and 10.4% for women and men, respectively). Current asthma was less prevalent in Mexican American women (1.9%) and men (0.9%) born in Mexico as compared to Mexican Americans born in the U.S. (8.7% and 5.2% for women and men, respectively) or for any other ethnic group. Approximately 20% of extremely obese women and men had ever been diagnosed with asthma; among this group, 15% reported they had current asthma. Results from multiple logistic regression models indicate that extreme obesity and living in poverty were strongly associated with current and ever asthma for both women and men, as was former smoking and ever asthma for men. Conclusion. As compared to previous NHANES reports, our results indicate that the prevalence of asthma among U.S. adults continues to increase. Further, our findings of marked differences among subgroups of the population suggest asthma-related disparities for impoverished persons and greater prevalence of asthma among obese and extremely obese US adults.

TACI‐Ig prevents the development of airway hyperresponsiveness in a murine model of asthma

Increased levels of serum IgE are associated with greater asthma prevalence and disease severity. IgE depletion using an anti-IgE monoclonal antibody has met with success in the treatment of moderate-to-severe and severe persistent allergic asthma. To test whether B cell-targeted therapy is a more effective treatment for airway hyperresponsiveness (AHR) in a murine model compared with IgE-depletion. We delivered soluble mTACI-Ig, a receptor for the B cell survival factors BLyS (B Lymphocyte Stimulator) and APRIL (A PRoliferation-Inducing Ligand), or anti-IgE to allergen-sensitized mice before airway challenge with allergen. mTACI-Ig treatment reduced circulating mature B cell levels in the blood, while anti-IgE treatment had no effect on B cell counts. Both mTACI-Ig and anti-IgE decreased the levels of total and allergen-specific IgE in the serum. Histopathologic analysis of lungs showed a reduction in disease severity scores for both treatment groups, but results were more pronounced in mTACI-Ig-treated mice. Neutrophil and eosinophil numbers in the bronchoalveolar lavage (BAL) were significantly reduced following mTACI-Ig treatment, but not after anti-IgE delivery. BLyS and APRIL blockade also resulted in a significant decrease in IL-4 and eotaxin mRNA and IL-4 and KC protein levels in total lung homogenates and BAL fluid, respectively. Finally, mTACI-Ig treatment was more effective than anti-IgE treatment in reducing AHR to inhaled antigen. Our data demonstrate that delivery of mTACI-Ig is a more effective treatment than anti-IgE mAb in a murine model of AHR.

Prevalência de asma no Distrito Federal Brasília

I congratulate the authors on their article “Prevalence of bronchial asthma and related symptoms in schoolchildren in the Federal District of Brazil: correlations with socioeconomic levels” which enriches the knowledge of the epidemiology of asthma in Brazil.(1) I would like to make a few comments regarding the article. First, despite the fact that the sampling was probabilistic and the sample was apparently representative, the substitution of incomplete questionnaires with those from other students from the same schools could have created a selection bias, creating a sample consisting of participants that were more interested in filling out the questionnaires, whether because they were more well educated or because they were asthmatic. Second, the interaction between asthma and socioeconomic condition, as seen for other risk factors, appears in a multicausal form, and the association found in this study was not corrected for confounding factors. Third, the authors apparently made a mistake when citing our study of asthma prevalence in Recife, stating that we had found an association between greater asthma prevalence and lower level of maternal education. What we found was in fact the opposite, that greater asthma prevalence was associated with a higher level of maternal education. (2) This is in agreement with the observations made by Chew et al.(3) in Singapore using the International Study of Asthma and Allergies in Childhood protocol. Wandalsen,(4) studying school children in the south-central region of the city of Sao Paulo, found no association between asthma symptoms and maternal schooling, a finding echoed by Moraes et al.(5) in a case control study conducted in Cuiaba. According to the hygiene theory, children exposed to unhygienic conditions at an early age

Opportunities for health promotion in the Queensland women's prison system

Objective: To compare the health of Queensland women prisoners with that of community women using the target areas of public health promotion identified by Health Determinants Queensland as a framework.Methods: Data from the Queensland Women Prisoners' Health Survey was compared with published community data in each of the target areas.Results: Queensland women prisoners had poorer nutrition, did less exercise, had higher rates of smoking and had a greater prevalence of asthma and diabetes than women in the community. They seemed to have a greater prevalence of mental health disorders.Conclusions: Within the framework, women prisoners had significantly poorer measured outcomes than community women in all areas except cervical screening, breast cancer screening and overweight and obesity.Implications: The Health Determinants Queensland target areas for Queensland women are of even greater priority in the subgroup of women prisoners. Benefits for the health of prisoners, and therefore the community, could be gained by expanding existing community health promotion activities to prisons through collaboration and partnerships.

Abstracts

Abstracts

Environmental factors and quality of life among poor children with asthma

Rationale Poor and minority children have greater asthma prevalence and morbidity, than their same-aged counterparts in more privileged groups. This may be due in part to difficulties controlling asthma triggers at home. We measured the prevalence of asthma triggers in the homes of poor, predominately African-American children and determined if the presence of triggers was associated with low health-related quality of life (QOL). Methods Parents/guardians of children with asthma, insured by Maryland Medicaid, were identified through healthcare claims and recruited. In-home interviews (n=162) were conducted by trained interviewers; both the child (8-18 years old) and adult caregiver were surveyed. Adults reported the presence or absence of common asthma triggers in the primary home, and if applicable, a second home. The following factors, if present in either home, were assigned 1 point each and summed to create an “environmental burden” score: cigarette smoking, carpet/rugs in the child's bedroom, mold or water leaks, cockroaches, mice or rats, having a dog or cat, and using a humidifier. Health-related quality of life was assessed using the 28-Item Child Health Questionnaire. Results Potential asthma triggers were common; scores averaged 2.7 (SD ± 1.4) factors present (range 0-7), with under 5% reporting 0 and 11% reporting 5-7 factors. The relationships between environmental burden and QOL were complex, varying by race (physical subscale) and asthma severity (psycho-social subscale). Dogs in the home were associated with higher, and humidifier use, lower QOL scores. Conclusions In this cohort, living with potential asthma triggers was common and may affect health-related quality of life.

Stabilization of an Increasing Trend in Physician-Diagnosed Asthma Prevalence in Saskatchewan, 1991 to 1998

To determine the prevalence of asthma, bronchitis, and COPD using the physician services database of the Saskatchewan Health Department from 1991 to 1998. Descriptive population-based study. The Province of Saskatchewan, Canada. Residents of Saskatchewan covered by universal health care in the province. In all age groups, asthma prevalence increased between 1991 and 1995 and either was stable or declined between 1996 and 1998. Preschool children had the highest asthma prevalence during the study period, followed by children aged 5 to 14 years, young adults aged 15 to 34 years, and adults aged 35 to 64 years. Children aged 0 to 4 years and adults aged 35 to 64 years in the Registered Indian population had greater asthma prevalence than persons in other urban or rural populations during the study period. Asthma prevalence rates in rural populations were less than or similar to the rates of urban populations in all age groups during the study period. The prevalence of bronchitis was greater in the Registered Indian population than in urban and rural populations in all age groups throughout the study period. When persons who had visited a physician for bronchitis were excluded from the prevalence calculation, the original increases seen in asthma prevalence among very young children and older adults of Registered Indian origin disappeared, with the urban population having greater asthma prevalence in all age groups. In the Registered Indian population, adults aged 35 to 64 years had almost twofold increases in the prevalence of COPD in comparison to other Saskatchewan populations. Asthma prevalence, which had been on the increase in the 1980s and early 1990s, was either stable or declining during the latter part of 1990s in Saskatchewan. Preschool children and older adults from the Registered Indian population had greater asthma prevalence than did those from other Saskatchewan populations. Asthma prevalence among the rural populations was either similar or lower in comparison to the rates for the urban populations in all age groups during the study period. Further research is required to elucidate the findings in this study.

Asthma prevalence in schoolchildren in a city in north-east Brazil.

Asthma is a disease of increasing prevalence all over the world. The objectives of this study were to describe the prevalence of asthma and aspects of its morbidity in schoolchildren in Recife, and to evaluate the relationship between maternal schooling and asthma prevalence during 1994-1995. This is part of an international, multicentre research project, the International Study of Asthma and Allergies in Childhood (ISAAC). In a cross-sectional design, a probabilistic sample of 1410 children of 6 and 7 years of age and 3086 teenagers of 13 and 14 years were studied by questionnaire. The yearly prevalences of asthma symptoms in these two groups were 27.2% (CI 95%: 24.9-29.5%) and 18.1% (CI 95%: 16.4-19.8%), respectively; the cumulative prevalences of diagnosed asthma were 20.4% (CI 95%: 17.8-23.0%) and 19.7% (CI 95%: 19.4-22.2%), respectively, and the prevalences of asthma according to severity were: mild--68.9% and 81.3%, moderate--24.2% and 13.5%, severe--6.80% and 5.3%. During the previous year, the frequencies of crises with sleeping disorder were 23.2% and 13.0% and of disorder that limited speech 9.6% and 4.8%, respectively. There was a significant relationship between maternal education and cumulative prevalence of symptoms in both groups. It is concluded that asthma is a common disease which causes much morbidity in schoolchildren in Recife. The results suggest a relationship between low maternal education and a greater prevalence of asthma.