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[Prevalence of asthma in Cuban adolescents by different clinical criteria]
Dania Fabré Ortiz1, Patricia Varona Pérez, Ramón Suárez Medina
1Hospital Pediátrico Universitario Juan Manuel Márquez, Ciudad de la Habana, Cuba. fabre@infomed.sld.cu
Background:
Despite of the knowledge about asthma, its diagnosis is clinical and its prevalence depends on the case criterion. Several methodologies have been applied to determine its prevalence; the International Study of Asthma and Allergies in Childhood (ISAAC) is the newest, although some inconsistencies have been attributed to their results.
Objective:
To estimate the prevalence of asthma according to five diagnostic criteria and according to respiratory symptoms in order to contribute to improve the diagnosis quality.
Material And Methods:
Data of the first phase of the ISAAC study made at the Centro Cubano Playa-Marianao in 2003 were collected. Three thousand twenty-six children of 13 to 14 years of age answered a survey, and prevalence of established criteria was estimated; confidence intervals were used to compare them. Estimations were presented with 95% of confidence; the chi square test and the odds ratio were applied for prevalence rates by gender.
Results:
When comparing all the prevalences among different criteria, those corresponding to criteria I and II were statistically significant. Criterion I was the least discriminatory and criterion V had the highest power to discriminate. Criterion III offered an intermediate value of prevalence, with a proper level to discern. The first three criteria had higher prevalences in women, with statistically significant values among genders (p = 0.002, p = 0.045 and p = 0.008, respectively).
Conclusions:
Using a criterion that could include several symptoms, especially in low income-countries, where hospitals do not have current and expensive diagnostic methods, would be useful and would contribute to diminish the diagnostic error.
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