Wheeze and asthma prevalence and related health-service use in white and south Asian pre-schoolchildren in the United Kingdom
Article first published online: 22 JUL 2007
Clinical & Experimental Allergy
Volume 37, Issue 12, pages 1738–1746, December 2007
How to Cite
Kuehni, C. E., Strippoli, M.-P. F., Low, N., Brooke, A. M. and Silverman, M. (2007), Wheeze and asthma prevalence and related health-service use in white and south Asian pre-schoolchildren in the United Kingdom. Clinical & Experimental Allergy, 37: 1738–1746. doi: 10.1111/j.1365-2222.2007.02784.x
- Issue published online: 22 JUL 2007
- Article first published online: 22 JUL 2007
- Submitted 19 January 2007; revised 2 April 2007; accepted 20 June 2007
- ethnic groups;
- health-service use;
Background Epidemiological data for south Asian children in the United Kingdom are contradictory, showing a lower prevalence of wheeze, but a higher rate of medical consultations and admissions for asthma compared with white children. These studies have not distinguished different asthma phenotypes or controlled for varying environmental exposures.
Objective To compare the prevalence of wheeze and related health-service use in south Asian and white pre-schoolchildren in the United Kingdom, taking into account wheeze phenotype (viral and multiple wheeze) and environmental exposures.
Methods A postal questionnaire was completed by parents of a population-based sample of 4366 white and 1714 south Asian children aged 1–4 years in Leicestershire, UK. Children were classified as having viral wheeze or multiple trigger wheeze.
Results The prevalence of current wheeze was 35.6% in white and 25.5% in south Asian 1-year-olds (P<0.001), and 21.9% and 20.9%, respectively, in children aged 2–4 years. Odds ratios (ORs) (95% confidence interval) for multiple wheeze and for viral wheeze, comparing south Asian with white children, were 2.21 (1.19–4.09) and 1.43 (0.77–2.65) in 2–4-year-olds after controlling for socio-economic conditions, environmental exposures and family history. In 1-year-olds, the respective ORs for multiple and viral wheeze were 0.66 (0.47–0.92) and 0.81 (0.64–1.03). Reported GP consultation rates for wheeze and hospital admissions were greater in south Asian children aged 2–4 years, even after adjustment for severity, but the use of inhaled corticosteroids was lower.
Conclusions South Asian 2–4-year-olds are more likely than white children to have multiple wheeze (a condition with many features of chronic atopic asthma), after taking into account ethnic differences in exposure to some environmental agents. Undertreatment with inhaled corticosteroids might partly explain their greater use of health services.