Are risk factors of childhood asthma predicting disease persistence in early adulthood different in the developing world?

Allergy. 2006 Jul;61(7):869-77. doi: 10.1111/j.1398-9995.2006.01082.x.

Abstract

Background: Predictive factors of childhood asthma for favorable prognosis may differ between populations where a variety of genetic and environmental factors are present.

Objectives: To document the factors predicting disease persistence in early adulthood in Turkey.

Methods: An outpatient cohort (n = 115) with a mean follow-up duration of 11.4 +/- 0.2 years was evaluated. Complete remission was defined as no asthma symptoms, no use of controller medication, no airflow limitation and no airway hyper-responsiveness, and clinical remission as no symptoms and no use of controller medication, within the past year.

Results: The mean ages during referral and at the final visit were 5.8 +/- 0.2 and 17.1 +/- 0.2 years, respectively. Thirty-one (27%) were in complete remission, and a further 30 (26%) in clinical remission. In multivariate logistic models, diminished airflow [forced expiratory volume in 1 s (FEV1) < 80% vs > or = 80%] at the initial lung function test predicted current diminished airflow (8.422; 2.202-32.206) (odds ratio; 95% confidence interval), and presence of obstructive pattern (FEV1/forced vital capacity (FVC) < 80% vs > or = 80%) predicted current obstructive pattern (29.333; 3.022-284.724). Furthermore, female gender appeared to predict persistence of asthma symptoms (3.330; 1.250-8.333) and absence of clinical remission (2.398; 1.038-5.254); eosinophilia predicted persistence of symptoms (4.271; 1.080-16.889) and presence of airway hyper-responsiveness (3.723; 1.129-12.278).

Conclusions: Diminished airflow, female gender and eosinophilia appear to predict an adverse outcome of childhood asthma, supporting the concept that variability may exist between populations.

MeSH terms

  • Adolescent
  • Asthma / epidemiology*
  • Asthma / etiology*
  • Asthma / physiopathology
  • Bronchial Hyperreactivity / diagnosis
  • Bronchoconstrictor Agents / pharmacology
  • Child
  • Developing Countries
  • Eosinophils / immunology
  • Female
  • Forced Expiratory Volume
  • Humans
  • Immunoglobulin E / blood
  • Leukocyte Count
  • Male
  • Methacholine Chloride / pharmacology
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Skin Tests
  • Spirometry
  • Turkey
  • Vital Capacity

Substances

  • Bronchoconstrictor Agents
  • Methacholine Chloride
  • Immunoglobulin E