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Wheezing in young children: problems of measurement and management

J T Hart

    The Journal of the Royal College of General Practitioners
    |February 1, 1986
    PubMed

    Insights

    Childhood asthma affects 25% of children, with many diagnosed before age five. Management should focus on preserving respiratory function and promoting normal adult development, not just preventing rare deaths.

    Area of Science:

    • Pediatrics
    • Respiratory Medicine
    • Epidemiology

    Background:

    • Childhood asthma presents significant morbidity and mortality concerns.
    • Prevalence data for chronic or recurrent reversible airways obstruction in children is essential for understanding disease burden.

    Purpose of the Study:

    • To review literature on childhood asthma morbidity and mortality.
    • To present prevalence data from a defined population.
    • To discuss risks associated with overdiagnosis and overtreatment.

    Main Methods:

    • Literature review.
    • Analysis of data from a geographically defined population of 263 children (aged 5-16 years).

    Main Results:

    • Cumulative prevalence of chronic or recurrent reversible airways obstruction was 25%.
    • Asthma was diagnosed before age five in 47% of affected children.
    • Mortality rates from childhood asthma range from 2 to 25 per million.

    Conclusions:

    • The primary goal of childhood asthma management in general practice should be to help children with mild asthma conserve respiratory function.
    • Focusing on helping children become normal adults is more critical than preventing rare asthma-related deaths.
    • Overdiagnosis and overtreatment pose risks of iatrogenic damage.

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