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Asthma underdiagnosis in children: A school-based screening in a low socioeconomic status population
Dayan Crispin-Cruz1, Alejandro Casas-Herrera2, Camilo Rojas-Báez1
1Salud Respiratoria Comunitaria, Fundación Neumológica Colombiana, Bogotá, D. C., Colombia.
Insights
Asthma diagnosis and control are poor in low-income children in Bogotá, Colombia. School screening effectively identifies childhood asthma, reducing underdiagnosis and improving health outcomes for this vulnerable population.
Area of Science:
- Pediatric Pulmonology
- Public Health
- Epidemiology
Background:
- International asthma guidelines stress early diagnosis and control.
- These remain significant challenges, particularly for children from low socioeconomic backgrounds.
Purpose of the Study:
- To determine asthma prevalence, underdiagnosis rates, severity, and control levels.
- Focus on children with low socioeconomic status in Bogotá, Colombia.
Main Methods:
- Cross-sectional study involving 920 schoolchildren (ages 7-11) in Bogotá.
- Utilized the International Study of Asthma and Allergies Questionnaire, clinical evaluations, and spirometry.
- Assessed asthma prevalence, underdiagnosis, control, severity, and quality of life.
Main Results:
- Identified 122 children with asthma (17.2% prevalence) among 186 clinically evaluated.
- High underdiagnosis rate of 68%.
- Majority of diagnosed children had moderate to severe asthma, with 90% poorly controlled.
Conclusions:
- School-based screening is effective for detecting childhood asthma in underserved communities.
- Significant underdiagnosis and poor asthma control highlight critical public health needs.
- Interventions are needed to improve asthma management in low socioeconomic status populations.
Introduction:
International asthma management and prevention recommendations emphasize the importance of early and accurate diagnosis and adequate disease control. However, these aspects remain a serious concern, especially in children with low socioeconomic status.
Objective:
To describe asthma prevalence, underdiagnosis, severity, and control among children with low socioeconomic status in Bogotá, Colombia.
Materials And Methods:
We conducted a cross-sectional study using the International Study of Asthma and Allergies Questionnaire in children aged 7-11 in two public schools. The children with affirmative answers in the questionnaire were evaluated clinically and functionally at the mobile health care unit. Asthma prevalence, underdiagnosis, control level, severity, and patients' quality of life were assessed with validated instruments.
Results:
We screened 920 schoolchildren with an age of 9.5 ± 1.1; 186 were evaluated clinically and functionally by spirometry, and 122 of them were diagnosed with asthma (17.2%). Underdiagnosis was 68%. Most patients had moderate and severe asthma, and 90% were cases of not well or very poorly controlled asthma.
Conclusions:
Screening children in school settings is a suitable strategy for detecting asthma and reducing underdiagnosis in communities with low socioeconomic status and limited access to health care services. The asthma underdiagnosis and poor disease control were high.
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