Regional differences in diagnosing asthma and other allergic diseases in Estonian schoolchildren

The aim of this study was to estimate the prevalence of asthma and other allergic diseases among Estonian schoolchildren of the cities lacking special (pediatric allergological) health care.

The study, carried out through 1 March to 8 May, 2003, enrolled 5th- to 12th-grade schoolchildren of 4 schools in different regions of Estonia. A three-step protocol was followed: screening questionnaire, examination by a pulmonary resident, and consultation by a pediatric allergologist.

Of the 3132 questionnaires distributed, 1561 (49%) were returned. A total of 828 schoolchildren answered positively to any of the questions about possible allergic disease. After examination by the pulmonary resident, 255 schoolchildren (15.7%) were referred to an allergologist for final diagnosis. Asthma was diagnosed in 4.8%, allergic rhinoconjunctivitis in 4.9%, and atopic eczema in 8.3% of schoolchildren. Asthma, allergic rhinoconjunctivitis, and urticaria occurred more frequently in Narva as compared with Võru.

The 12-month prevalence of asthma among Estonian schoolchildren was 4.8%, and the prevalence of allergic diseases varied from region to region. Less than half (40%) of all asthma cases identified during the study were newly diagnosed, and this clearly indicates that there is a considerable underdiagnosis of the disease among schoolchildren living outside of the centers in Estonia.