Epidemiological pattern and management of pediatric asthma review of Ain Shams pediatric hospital chest clinic data Cairo, Egypt 1995-2004

ABSTRACT

Pediatric asthma is the leading cause of chronic illness in childhood and has an impact on child's quality of life. To describe the epidemiological and clinical data of asthmatic children followed up in the Pediatric Chest Clinic Am Shams University during a 10 year period. Files of asthmatic children attending the Clinic in the period from1995 to 2004 were selected. Relevant data were extracted and analyzed. Out of 1006 recorded cases, a total of 691 [68.7%] were asthmatic. The proportion of asthmatics among all chest patients attending the clinic was lowest in 2002 being 51.6% and highest in 1995, being 78.3%. Male to female ratio was] .61, mean age was 5.27yrs [SD +/- 3.65], mean age of onset of disease was 1.84 yrs [SD +/- 2.78]. Persistent asthma was significantly more prevalent in males p<0.01. Severe asthma; using the American Thoracic Society Classification, was found in 151 [41.1%] of cases. From 2002, using GINA Guidelines Classification, severe persistent asthma accounted for 13.5%. Episodic attacks were reported by 270 [39%] of patients, nocturnal attacks by 302 of patients [43.7%] and exercise induced asthma in 97 [14%] of patients. Exacerbations occurred in 300 [43.4%] patients after respiratory infections, in 275 [39.8%] on exposure to smoke, in 139 [20%] with special food, in 91 [13.2%] following allergen exposure and 51 [7.4%] on exposure to inhaler sprays. Half of the patients were treated by combination of drugs [49.2%], corticosteroid inhalers in 32.1%, and beta agonists [short acting] in 31.4%. Asthma constitutes a main problem in the Pediatric Chest Clinic. Respiratory infection and environmental factors are major exacerbating factors. Better documentation of patient's data and complete record in the files is needed