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a Instituto de
Investigación Nutricional, Lima, Perú, b Department of Public Health Sciences,
Guy's, King's and St Thomas' School of Medicine and Dentistry,
London, UK, c Clinica Ricardo
Palma, Lima, Perú
Correspondence to: Dr M E Penny mpenny@iin.sld.pe
Received 8 August 2000; Returned to authors 21 October 2000; Revised version received 2 April 2001; Accepted for publication 23 April 2001
BACKGROUND
Little is
known about the associations between symptoms of asthma, pulmonary
function tests, and atopy in developing countries. While asthma in
children is often associated with atopy, some studies of wheezing
illness have found little or no association, leading to suggestions
that there are subgroups of wheezing illness. The ISAAC study recently
reported that the prevalence of reported asthma symptoms in Lima, Peru
was among the highest in the world, but did not report on the atopic
status of the subjects.
METHODSA cross
sectional survey was conducted of children aged 8-10 years who had
previously participated in a cohort study of respiratory and diarrhoeal
illnesses in infancy. Questionnaires were administered asking about
respiratory symptoms and asthma diagnoses, pulmonary function tests
were performed before and after exercise on a treadmill, and atopy was
determined from skin prick tests and specific serum IgE levels.
RESULTSA total of 793 children participated in the survey. The prevalence of asthma related
symptoms in the last 12 months was 23.2%, but only 3.8% of children
reported a recent asthma attack. The mean differences in pretest
percentage predicted forced expiratory volume in one second
(FEV1) were 8.1% (95% CI 2.4 to 13.8) between children
who did and did not report an asthma attack in the last 12 months, and
5.3% (95% CI 2.8 to 7.9) in children who did and did not report
respiratory symptoms. The corresponding differences in mean percentage
fall in FEV1 after exercise were 3.1% (95% CI -1 to 7.1)
and 5.1% (95% CI 3.4 to 6.8). Recent asthma or respiratory symptoms
were not associated with atopy in this population (odds ratios 1.29 (95% CI 0.56 to 2.97) and 0.91 (95% CI 0.61 to 1.37), respectively).
CONCLUSIONSMost
asthma in these children was unrecognised and mild. Asthma and asthma
symptoms in this population do not seem to be related to atopy.
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