Prevalence of nasal and sinus diseases in atopic asthmatic children in Behera

ABSTRACT

Most patients with asthma also have rhinitis, and the same inflammatory cells and mechanisms are present in bronchial and nasal mucosa, thus leading to the concept of "one airway, one disease". The aim of the present study was to determine the prevalence of rhinitis and sinusitis in children with varying severities of bronchial asthma and its relation to the degree of asthma severity among children residing in semi urban semi rural areas in Behira, Egypt. Our study was a matched case control cross sectional study. It included one hundred asthmatic children whose ages ranged from 5-12 years, attendants of the allergy and chest diseases, pediatric outpatient clinic, and 100 matched controls, attending pediatric outpatient clinic in Damanhour Medical National Institute during the period from the first of February 2004 to 31[st]of August 2004. Asthmatic children were judged atopic or non atopic on the basis of skin tests to common allergens and were graded as having mild, moderate and severe asthma. All children were subjected to complete physical and medical examinations, radiography of chest and paranasal sinuses, pulmonary function test. Laboratory investigations included complete blood picture and examination of nasal secretions for eosinophils. In the present study, there was significantly higher prevalence of both allergic rhinitis [63%] and sinusitis [19%] among allergic asthmatic children than controls [9% and 6% respectively] with a statistically significant difference at p< 0.01. Other nasal diseases among asthmatics were insignificantly different from controls. The chronic severe asthmatics had higher rate of sinusitis [62.5%] than other asthmatic children [12%] in children with frequent moderate and 8.8% in those with mild asthma with a statistically significant difference at p< 0.01. Proper examination of the upper airways including nose and paranasal sinus should be an essential and routine part when evaluating a child with bronchial asthma, even if symptoms of the upper respiratory tract diseases are not present