Prevalence of asthma, allergic rhinitis and eczema in 6-7-year-old schoolchildren from Luanda, Angola

Background: Epidemiological data have shown that the prevalence of asthma, rhinoconjunctivitis and eczema in children is still increasing, namely in Africa. However, there are no epidemiological studies on asthma or allergic diseases in Angolan children. Objective: To study the prevalence of asthma and other allergic diseases in Angolan children. Methods: Descriptive, observational, cross-sectional study, using the ISAAC study methodology, in the province of Luanda, Angola in 6-7-year-old children. Forty-six (8.3%) public schools were randomly selected. Data were analysed using the SPSS Statistics version 24.0 software. Results: A total of 3080 children were studied. Results showed that the prevalence of asthma (wheezing in the previous 12 months) was 15.8%, that of rhinitis (sneezing, runny or blocked nose in the previous 12 months) was 19%, and that of eczema (itchy skin lesions in the previous 12 months) was 22%, without differences between sexes. Rhinitis was associated with a higher number of episodes of wheezing episodes, disturbed sleep and night cough, in children with asthma. Rhinitis, eczema, Split-type air conditioning system, antibiotic intake in the child's first year of life, frequent intake (more than once per month) of paracetamol and active maternal smoking were associated with a higher risk of having asthma, whereas electrical cooking was associated with a protective effect. Conclusion: Asthma and allergic diseases are highly prevalent in children from Luanda. A strategy for preventive and control measures should be implemented

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Prevalence of asthma, allergic rhinitis and eczema in 6-7-year-old schoolchildren from Luanda, Angola.

BACKGROUND: Epidemiological data have shown that the prevalence of asthma, rhinoconjunctivitis and eczema in children is still increasing, namely in Africa. However, there are no epidemiological studies on asthma or allergic diseases in Angolan children. OBJECTIVE: To study the prevalence of asthma and other allergic diseases in Angolan children. METHODS: Descriptive, observational, cross-sectional study, using the ISAAC study methodology, in the province of Luanda, Angola in 6-7-year-old children. Forty-six (8.3%) public schools were randomly selected. Data were analysed using the SPSS Statistics version 24.0 software. RESULTS: A total of 3080 children were studied. Results showed that the prevalence of asthma (wheezing in the previous 12 months) was 15.8%, that of rhinitis (sneezing, runny or blocked nose in the previous 12 months) was 19%, and that of eczema (itchy skin lesions in the previous 12 months) was 22%, without differences between sexes. Rhinitis was associated with a higher number of episodes of wheezing episodes, disturbed sleep and night cough, in children with asthma. Rhinitis, eczema, Split-type air conditioning system, antibiotic intake in the child's first year of life, frequent intake (more than once per month) of paracetamol and active maternal smoking were associated with a higher risk of having asthma, whereas electrical cooking was associated with a protective effect. CONCLUSION: Asthma and allergic diseases are highly prevalent in children from Luanda. A strategy for preventive and control measures should be implemented.

Prevalence of asthma and allergies in 13-14-year-old adolescents from Luanda, Angola.

SETTING: The few epidemiological studies on asthma and allergic diseases performed in Africa have shown that the prevalence of these diseases is high or increasing. No such studies have been performed in Angola. OBJECTIVE: To determine the prevalence of asthma and other allergic diseases in Angolan adolescents. DESIGN: This was a descriptive, observational, cross-sectional study in the province of Luanda, Angola, using the International Study of Asthma and Allergies in Childhood study methodology in adolescents aged 13 and 14 years. Twenty-three (12%) public schools were randomly selected. Data were analysed using the Statistical Package for the Social Sciences version 22.0 software. RESULTS: A total of 3128 adolescents were included. The prevalence of asthma (wheezing in the previous 12 months) was 13.4%. The prevalence of rhinitis (sneezing, runny or blocked nose in the previous 12 months) was 27% and that of eczema (itchy skin lesions in the previous 12 months) was 20%; both were more prevalent in girls. Rhinitis was associated with a greater number of episodes of night cough in adolescents with asthma. Rhinitis and eczema, a split-type air conditioning system, and frequent intake (more than once per month) of paracetamol were associated with a higher risk of having asthma. CONCLUSION: Asthma and related allergic diseases are a public health problem in adolescents from Luanda. Preventive and control measures should be implemented.

Distribution and etiology of chronic respiratory diseases in primary healthcare departments in Cape Verde.

BACKGROUND AND OBJECTIVE: Data on chronic respiratory diseases (CRD) are scarce or unavailable in most African countries. We aimed to determine the prevalence of CRD and associated risk factors in Cape Verde, at the primary healthcare level. METHODS: In the frame of the Global Alliance Against Chronic Respiratory Diseases, a cross-sectional study was carried out in October 2006 in 3256 outpatients (2142 women) (median age of 30 years) seeking care at primary healthcare departments, through a standardized interview questionnaire during two weeks. RESULTS: The prevalence of emphysema, tuberculosis, chronic bronchitis, rhinoconjunctivitis and asthma were 0.7%, 2%, 4.5%, 12.3% and 6.2%, respectively. Current smoking was associated with emphysema (OR: 3.36; 95% CI: 0.97-11.40) and tuberculosis (OR: 2.14; 95% CI: 1.07-4.30), ever exposed to a dusty workplace with chronic bronchitis (OR: 2.20; CI 95%: 1.50-3.21) and rhinoconjunctivitis (OR: 1.56; CI 95%: 1.23-1.98) and cooking or heating using an open fire with asthma (OR: 1.59; CI 95%: 1.16-2.19). The estimates of attributable risks percent indicated that, in the sample, a noticeable part of CRD could be attributed to active smoking, exposure to dust and biomass. Results varied according to gender, particularly regarding current smoking which was more important for men. CONCLUSIONS: Tobacco smoking, exposure to dust at work and using an open fire were important risk factors for CRD. Our results suggest that if actions were taken in order to reduce the aforementioned exposures, an important CRD decrease could be achieved.

Environment and Health in Children Day Care Centres (ENVIRH) - Study rationale and protocol.

BACKGROUND: Indoor air quality (IAQ) is considered an important determinant of human health. The association between exposure to volatile organic compounds, particulate matter, house dust mite, molds and bacteria in day care centers (DCC) is not completely clear. The aim of this project was to study these effects. METHODS - STUDY DESIGN: This study comprised two phases. Phase I included an evaluation of 45 DCCs (25 from Lisbon and 20 from Oporto, targeting 5161 children). In this phase, building characteristics, indoor CO2 and air temperature/relative humidity, were assessed. A children's respiratory health questionnaire derived from the ISAAC (International Study on Asthma and Allergies in Children) was also distributed. Phase II encompassed two evaluations and included 20 DCCs selected from phase I after a cluster analysis (11 from Lisbon and 9 from Oporto, targeting 2287 children). In this phase, data on ventilation, IAQ, thermal comfort parameters, respiratory and allergic health, airway inflammation biomarkers, respiratory virus infection patterns and parental and child stress were collected. RESULTS: In Phase I, building characteristics, occupant behavior and ventilation surrogates were collected from all DCCs. The response rate of the questionnaire was 61.7% (3186 children). Phase II included 1221 children. Association results between DCC characteristics, IAQ and health outcomes will be provided in order to support recommendations on IAQ and children's health. A building ventilation model will also be developed. DISCUSSION: This paper outlines methods that might be implemented by other investigators conducting studies on the association between respiratory health and indoor air quality at DCC.

Environment and Health in Children Day Care Centres (ENVIRH) - Study rationale and protocol.

BACKGROUND: Indoor air quality (IAQ) is considered an important determinant of human health. The association between exposure to volatile organic compounds, particulate matter, house dust mite, molds and bacteria in day care centers (DCC) is not completely clear. The aim of this project was to study these effects. METHODS ­ STUDY DESIGN: This study comprised two phases. Phase I included an evaluation of 45 DCCs (25 from Lisbon and 20 from Oporto, targeting 5161 children). In this phase, building characteristics, indoor CO2 and air temperature/relative humidity, were assessed. A children's respiratory health questionnaire derived from the ISAAC (International Study on Asthma and Allergies in Children) was also distributed. Phase II encompassed two evaluations and included 20 DCCs selected from phase I after a cluster analysis (11 from Lisbon and 9 from Oporto, targeting 2287 children). In this phase, data on ventilation, IAQ, thermal comfort parameters, respiratory and allergic health, airway inflammation biomarkers, respiratory virus infection patterns and parental and child stress were collected. RESULTS: In Phase I, building characteristics, occupant behavior and ventilation surrogates were collected from all DCCs. The response rate of the questionnaire was 61.7% (3186 children).Phase II included 1221 children. Association results between DCC characteristics, IAQ and health outcomes will be provided in order to support recommendations on IAQ and children's health. A building ventilation model will also be developed. DISCUSSION: This paper outlines methods that might be implemented by other investigators conducting studies on the association between respiratory health and indoor air quality at DCC.

ANTECEDENTES: A qualidade do ar interior (IAQ) é considerada um determinante importante da saúde humana. A associação entre a exposição a compostos orgânicos voláteis, partículas, ácaros, bolores e bactérias em creches (DCC) não é perfeitamente clara. O objectivo deste estudo foi estudar esses efeitos. METODOLOGIA ­ DESENHO DO ESTUDO: Este estudo decorreu em duas Fases. A Fase I incluiu uma avaliação de 45 DCCs (25 em Lisboa e 20 no Porto, visando 5.161 crianças). Nesta Fase, foram avaliadas as características dos edifícios, o CO2 e a temperatura ambiente/humidade relativa no interior. Também foi distribuído um questionário de saúde respiratória das crianças derivado do ISAAC (Estudo Internacional sobre a Asma e Alergias em Crianças). A Fase II englobou duas avaliações e incluiu 20 DCCs seleccionadas da fase I, após uma análise de clusters (11 em Lisboa e 9 no Porto, visando 2.287 crianças). Nesta Fase, foram recolhidos dados sobre a ventilação, IAQ (qualidade do ar interior), parâmetros de conforto térmico, saúde em termos respiratórios e alérgicos, marcadores biológicos de inflamação das vias respiratórias, padrões de infecção de vírus respiratórios e stress dos pais e crianças. RESULTADOS: Na Fase I, foram recolhidas as características dos edifícios, o comportamento dos ocupantes e os marcadores de ventilação, para todas as DCCs. A taxa de resposta ao questionário foi de 61,7% (3.186 crianças).A Fase II incluiu 1.221 crianças. Os resultados da associação entre as características dos DCC, a IAQ e os resultados para a saúde serão fornecidos para apoiar as recomendações sobre a IAQ e a saúde das crianças. Um modelo de ventilação de edifícios também será desenvolvido. DISCUSSÃO: Este documento destaca a metodologia que pode ser implementada por outros investigadores que realizam estudos sobre a associação entre a saúde respiratória e a qualidade do ar interior, em creches e infantários.

Airways changes related to air pollution exposure in wheezing children.

In this study, we aimed to evaluate the relationship between individual total exposure to air pollution and airway changes in a group of 51 wheezing children. Respiratory status was assessed four times (January 2006, June 2006, January 2007 and June 2007) during a 1-week period through a standardised questionnaire, spirometry, exhaled nitric oxide fraction and pH in exhaled breath condensate (EBC). Concentrations of particles with a 50% cut-off aerodynamic diameter of 10 µm (PM(10)), O(3), NO(2) and volatile organic compounds were estimated through direct measurements with an ad hoc device or air pollution modelling in the children's schools and at their homes in the same 4 weeks of the study. For each child, total exposure to the different air pollutants was estimated as a function of pollutant concentrations and daily activity patterns. Increasing total exposure to PM(10), NO(2), benzene, toluene and ethylbenzene was significantly associated with a decrease of forced expiratory volume in 1 s (FEV(1)) and with an increase of change in FEV(1). Increasing exposure to NO(2) and benzene was also related to a significant decrease of FEV(1)/forced vital capacity. Increasing exposure to PM(10), NO(2), benzene and ethylbenzene was associated with acidity of EBC. This study suggests an association in wheezing children between airway changes and total exposure to air pollutants, as estimated by taking into account the concentration in the various microenvironments attended by the children.

Under-report and underdiagnosis of chronic respiratory diseases in an African country.

BACKGROUND: Chronic respiratory diseases (CRD) are greatly underestimated. The aim of this study was to assess the burden associated with reported CRD and chronic obstructive pulmonary disease, as defined on the basis of various standardized criteria, by estimating their point prevalence in a sample of individuals attending the Primary Health Care (PHC) level and Emergency Room (ER) Departments in Cape Verde (CV) archipelago. The second aim of the study was to identify factors related to airways obstruction and reported CRD in this population. METHODS: A cross-sectional study was carried out in CV during 2 weeks. Outpatients aged more than 20 years seeking care at PHC level and ER answered a standardized questionnaire and were subjected to spirometry, independently of their complaint. Two criteria for airways obstruction were taken into account: forced expiratory volume (FEV(1)) <80% of the predicted value and FEV(1)/forced vital capacity (FVC) ratio <0.70. RESULTS: A total of 274 individuals with a satisfactory spirometry were included. 22% of the individuals had a FEV(1) < 80%. Individuals older than 46 years had a higher risk of having airways obstruction. Asthma diagnosis (11%) had a clear association with airways obstruction. Smoking was a risk factor for a lower FEV(1). Working in a dust place and cooking using an open fire were both related to chronic bronchitis and asthma diagnosis. CONCLUSION: Under-report and underdiagnosis of chronic respiratory conditions seem to be a reality in CV just as in other parts of the world. To improve diagnosis, our results reinforce the need of performing a spirometry.

Lung function and clinical risk factors for asthma in infants and young children with recurrent wheeze.

BACKGROUND: Although several risk factors for asthma have been identified in infants and young children with recurrent wheeze, the relevance of assessing lung function in this group remains unclear. Whether lung function is reduced during the first 2 years in recurrently wheezy children, with and without clinical risk factors for developing subsequent asthma (ie, parental asthma, personal history of allergic rhinitis, wheezing without colds and/or eosinophil level >4%) compared with healthy controls was assessed in this study. METHODS: Forced expiratory flows and volumes in steroid naïve young children with >or=3 episodes of physician confirmed wheeze and healthy controls, aged 8-20 months, were measured using the tidal and raised volume rapid thoracoabdominal compression manoeuvres. RESULTS: Technically acceptable results were obtained in 50 wheezy children and 30 controls using tidal rapid thoracoabdominal compression, and 44 wheezy children and 29 controls with the raised volume technique. After adjustment for sex, age, body length at test and maternal smoking, significant reductions in z scores for forced expiratory volume at 0.5 s (mean difference (95% CI) -1.0 (-1.5 to -0.5)), forced expired flow after 75% forced vital capacity (FVC) has been exhaled (FEF(25)) (-0.6 (-1.0 to -0.2)) and average forced expired flow over the mid 50% of FVC (FEF(25-75)) (-0.8 (-1.2 to -0.4)) were observed in those with recurrent wheeze compared with controls. Wheezy children with risk factors for asthma (n = 15) had significantly lower z scores for FVC (-0.7 (-1.4 to -0.04)) and FEF(25-75) (-0.6 (-1.2 to -0.1)) than those without such risk factors (n = 29). CONCLUSIONS: Compared with healthy controls, airway function is reduced in young children with recurrent wheeze, particularly those at risk for subsequent asthma. These findings provide further evidence for associations between clinical risk factors and impaired respiratory function in early life.

Mastocytosis: a rare case of anaphylaxis in paediatric age and literature review.

The term "mastocytosis" denotes a heterogeneous group of disorders characterised by abnormal growth and accumulation of mast cells (MC) in one or more organ systems. Symptoms result from MC chemical mediator's release, pathologic infiltration of neoplastic MC in tissues or both. Multiple molecular, genetic and chromosomal defects seem to contribute to an autonomous growth, but somatic c-kit D816V mutation is more frequently encountered, especially in systemic disease. We present a literature review of mastocytosis and a rare case report of an 18 month-old-girl with a bullous dermatosis, respiratory distress and anaphylaxis, as clinical manifestations of mastocytosis. The developments of accepted classification systems and novel useful markers allowed a re-evaluation and updating of the classification of mastocytosis. In paediatric age cutaneous forms of disease prevail and may regress spontaneously. SM is more frequently diagnosed in adults and is a persistent (clonal) disease of bone marrow. The clinical course in these patients is variable. Today diagnostic criteria for each disease variant are reasonably well defined. There are, however, peculiarities, namely in paediatric age, that makes the diagnostic approach difficult. Systemic disease may pose differential diagnostic problems resulting from multiple organ systems involvement. Conversely, the "unexplained" appearance of those symptoms with no skin lesions should raise the suspicion of MC disease. This case is reported in order to stress the clinical severity and difficult diagnostic approach that paediatric mastocytosis may assume.

Mastocytosis: a rare case of anaphylaxis in paediatric age and literature review

The term "mastocytosis" denotes a heterogeneous group of disorders characterised by abnormal growth and accumulation of mast cells (MC) in one or more organ systems. Symptoms result from MC chemical mediator's release, pathologic infiltration of neoplastic MC in tissues or both. Multiple molecular, genetic and chromosomal defects seem to contribute to an autonomous growth, but somatic c-kit D816V mutation is more frequently encountered, especially in systemic disease. We present a literature review of mastocytosis and a rare case report of an 18 month-old-girl with a bullous dermatosis, respiratory distress and anaphylaxis, as clinical manifestations of mastocytosis. The developments of accepted classification systems and novel useful markers allowed a re-evaluation and updating of the classification of mastocytosis. In paediatric age cutaneous forms of disease prevail and may regress spontaneously. SM is more frequently diagnosed in adults and is a persistent (clonal) disease of bone marrow. The clinical course in these patients is variable. Today diagnostic criteria for each disease variant are reasonably well defined. There are, however, peculiarities, namely in paediatric age, that makes the diagnostic approach difficult. Systemic disease may pose differential diagnostic problems resulting from multiple organ systems involvement. Coversly, the "unexplained" appearance of those symptoms with no skin lesions should raise the suspicion of MC disease. This case is reported in order to stress the clinical severity and difficult diagnostic approach that paediatric mastocytosis may assume

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Barnacle allergy: allergen characterization and cross-reactivity with mites.

BACKGROUND: Barnacles are a type of seafood with worldwide distribution and abundant along the shores of temperate seas. They are particularly appreciated and regularly consumed in Portugal as well as in Spain, France and South America, but barnacle allergy is a rare condition of which there is only one reference in the indexed literature. The molecular allergens and possible cross-reactivity phenomena implicated (namely with mites) have not been established. OBJECTIVE: To demonstrate the IgE-mediated allergy to barnacle and to identify the proteins implicated as well as possible cross-reactivity phenomena with mites. METHODS: We report the clinical and laboratory data of five patients with documented IgE-mediated allergy to barnacle. The diagnosis was based on a suggestive clinical history combined with positive skin prick tests (SPT) to barnacle--prick to prick method. Two barnacle extracts were prepared (raw and cooked barnacle) and sodium dodecylsulphate polyacrylamide gel electrophoresis (SDS-PAGE) and IgE-immunoblotting were performed. An immunoblotting inhibition assay with Dermatophagoides pteronyssinus was also done in order to evaluate cross-reactivity. RESULTS: All patients had mite-related asthma and the allergic rhinoconjunctivitis; they all experienced mucocutaneous symptoms. All of them had positive SPT to barnacle, and the immunoblotting showed several allergenic fractions with a wide molecular weight range (19 - 94 kDa). The D. pteronyssinus extract inhibited several IgE-binding protein fractions in the barnacle extract. CONCLUSIONS: We describe five patients with IgE-mediated barnacle allergy. We also describe a group of IgE-binding+proteins between 30 and 75 kDa as the allergenic fractions of this type of Crustacea. Cross-reactivity with D. pteronyssinus was demonstrated in two cases.

In vitro methods for specific IgE detection in cow's milk allergy.

BACKGROUND: A new method for determining serum specific IgE (IMMULITE 2000 3gAllergy) has recently become available. OBJECTIVE: To evaluate the clinical performance of IMMULITE 2000 in the diagnosis of cow's milk allergy compared with that of UniCAP. Additionally, we verified the behavior of both methods at two diagnostic decision points proposed by other authors. METHODS: The study population consisted of 31 children with cow's milk allergy (group A) and a control group of 19 atopic children without food allergy (group B). A blood sample from each child was tested using both methods and the results were compared. RESULTS: In group A, the values for cow's milk IgE ranged from 0.35 kU/L (the lowest common detection limit) to above 100 kU/L. In group B, the values were less than 1.1 kU/L for IMMULITE 2000 and less than 1.6 kU/L for UniCAP. An agreement of 90% in IgE classes was obtained. Both methods demonstrated exactly the same diagnostic performance (sensitivity: 100%; specificity: 78.9%; negative predictive value: 100%; positive predictive value: 84.6%; efficiency: 90.2%). The evaluation of the two methods at the two different decision points proposed in the literature showed a better positive predictive value with UniCAP, but we obtained equivalent performance with IMMULITE 2000 by choosing higher cutoff values. CONCLUSIONS: We conclude that IMMULITE 2000 is as effective as UniCAP in the diagnosis of cow's milk allergy. Both methods can be used to obtain site-specific decision points that are population, age and disease dependent.

In vitro methods for specific IgE detection on cow's milk allergy / Métodos in Vitro para detección de IgE específica en alergia a la leche de vaca

Background: A new method for determining serum specific IgE (IMMULITE® 2000 3gAllergy) has recently become available. Objective: To evaluate the clinical performance of IMMULITE 2000 in the diagnosis of cow's milk allergy compared with that of UniCAP®. Additionally, we verified the behavior of both methods at two diagnostic decision points proposed by other authors. Methods: The study population consisted of 31 children with cow's milk allergy (group A) and a control group of 19 atopic children without food allergy (group B). A blood sample from each child was tested using both methods and the results were compared. Results: In group A, the values for cow's milk IgE ranged from 0.35 kU/L (the lowest common detection limit) to above 100 kU/L. In group B, the values were less than 1.1 kU/L for IMMULITE 2000 and less than 1.6 kU/L for UniCAP. An agreement of 90 % in IgE classes was obtained. Both methods demonstrated exactly the same diagnostic performance (sensitivity: 100 %; specificity: 78.9 %; negative predictive value: 100 %; positive predictive value: 84.6 %; efficiency: 90.2 %). The evaluation of the two methods at the two different decision points proposed in the literature showed a better positive predictive value with UniCAP, but we obtained equivalent performance with IMMULITE 2000 by choosing higher cutoff values. Conclusions: We conclude that IMMULITE 2000 is as effective as UniCAP in the diagnosis of cow's milk allergy. Both methods can be used to obtain site-specific decision points that are population, age and disease dependent

Introducción: Un nuevo método para la detección de IgE sérica específica, IMMULITE 2000® 3gAllergy se ha introducido recientemente. Objetivo: En este estudio evaluamos el rendimiento clínico de IMMULITE 2000 en el diagnóstico de alergia a la leche de vaca en comparación con el UniCAP®. Adicionalmente, verificamos el comportamiento de ambos métodos en los dos valores considerados como diagnósticos propuestos por otros autores. Métodos: La población estudiada consistió en 31 niños con alergia a la leche de vaca (grupo A) y un grupo control de 19 niños atópicos sin alergia alimentaria (grupo B). Se analizó una muestra de sangre de cada niño con ambos métodos y se compararon los resultados. Resultados: En el grupo A, la amplitud de valores obtenidos osciló de 0,35 kU/l (el límite común de detección más bajo) al valor superior de 100 kU/l. En el grupo B, los valores fueron menores de 1,1 kU/j para IMMULITE 2000® y menor de 1,6 ku/l para UniCAP®. Obtuvimos el 90% de concordancia en las clases de IgE. Ambos métodos demostraron exactamente el mismo rendimiento diagnóstico —sensibilidad: 100%; especificidad: 78,9%; valor predictivo negativo: 100%; valor predictivo positivo: 84,6%; eficiencia: 90,2 %—. La evaluación de los dos métodos en los dos diferentes valores diagnósticos propuestos en la bibliografía mostró un mejor valor predictivo positivo con UniCAP®, pero nosotros obtuvimos un rendimiento equivalente con IMMULITE 2000®, debido a la elección de un valor diagnóstico mas elevado. Conclusiones: Concluimos que IMMULIT es tan adecuado como UNIC en el diagnóstico de CMA. Cualquiera de los dos métodos puede utilizarse para obtener grados de decisión diagnósticos que dependen de la población, edad y enfermedad

Prevalence of asthma in a Portuguese countryside town: repercussions on absenteeism and self-concept.

BACKGROUND: Childhood asthma represents an increasing health problem and is the leading cause of hospital admission and absenteeism in children with chronic disease. It also compromises quality of life, eventually contributing to disturbances in self-concept. Self-concept is a recent and global perspective of "the self" and relates to skills, self-image and self-esteem. Little information is available on this topic and there are no data from Portuguese countryside towns. OBJECTIVE: The aim of this study was to determine the prevalence of asthma among all school children in the 5th and 6th grades in a Portuguese countryside town and to establish its possible correlation with absenteeism and self-concept. METHODS: In April 2002, two questionnaires were administered in the presence of the researcher to a group of 950 children attending different schools. The children completed the internationally renowned questionnaires: ISAAC and the Self-Concept Scale by Susan Harter. RESULTS: Our sample (n = 818) had a mean age of 11 years (10-15 years) and a male-to-female ratio of 1/1. The cumulative prevalence of asthma was 11.9 % and that of active asthma was 8.8 %; 63.9 % of asthmatics were male and 36.1 % were female. The mean age of asthmatics was 11.34 years and 74 % had active symptoms. Comparison of this group of 97 asthmatic children with the remaining children revealed a statistically significant correlation between the presence of asthma and school absenteeism (global: p = 0.04; gymnastics: 0.05). Regarding the Self-Concept Scale a statistically significant association was found between the presence of asthma and school achievement (p = 0.027), physical appearance (p = 0.015), behavior (p < 0.000) and self-esteem (p < 0.000). No statistically significant correlations were found in social acceptance (p = 0.289) or athletic competence (p = 0.085). Asthmatic boys had higher self-concept scores than girls, except in the domain of behavior. CONCLUSIONS: Twelve percent of the population studied was asthmatic. In asthmatic children, absenteeism was higher and self-concept was lower for almost all domains, except social acceptance and athletic achievement, probably due to overprotection.