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Asthma morbidity among children evaluated by asthma case detection
Joe K Gerald1, Yanhui Sun, Roni Grad
1Division of Public Health Policy and Management, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85725-5210, USA. geraldj@email.arizona.edu
Pediatrics
|October 21, 2009
Summary
School-based asthma case detection identified children with undiagnosed asthma. These children had fewer symptoms and less healthcare use than those with diagnosed asthma, suggesting smaller health gains from detection than anticipated.
Area of Science:
- Pediatric respiratory health
- Public health interventions
- Asthma epidemiology
Background:
- Population-based asthma detection is a strategy to decrease childhood asthma morbidity.
- The health burden in children identified through case detection is not well understood.
Purpose of the Study:
- To evaluate respiratory symptoms and healthcare utilization in children identified via school-based asthma case detection.
- To compare outcomes between children with previously diagnosed, undiagnosed, and no asthma.
Main Methods:
- A school-based asthma case detection validation study involved 3539 children.
- Questionnaires assessed respiratory symptoms, emergency department (ED) visits, and hospitalizations for children with confirmed diagnoses.
Main Results:
- Physician evaluation confirmed 420 cases: 168 previously diagnosed asthma, 39 undiagnosed asthma, and 213 no asthma.
- Children with undiagnosed asthma reported fewer symptoms than those with previously diagnosed asthma but more than those without asthma.
- Respiratory-related ED visits were 32% (previously diagnosed), 3% (undiagnosed), and 3% (no asthma). Hospitalizations were 8%, 0%, and 0%, respectively.
Conclusions:
- Despite similar physician-rated severity, children with undiagnosed asthma experienced less frequent symptoms and healthcare use compared to those with previously diagnosed asthma.
- The potential public health benefits of asthma case detection may be less significant than initially projected.
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