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One Third Of Schoolchildren With Asthma Are Undiagnosed

(Population based study of risk factors for underdiagnosis of asthma in adolescence: Odense schoolchild study)

According to Siersted et al in this week's BMJ, one third of young people with asthma are not diagnosed, a phenomenon which is particularly prevalent in girls. In a Danish study of nearly 500 schoolchildren aged 12 -15 years, the authors found that asthma that had gone undiagnosed was usually linked to one or more of five factors.

A low level of physical activity is relatively unlikely to provoke the types of symptoms of asthma induced by exercise and so may form as part of a ëself-treatment' in childhood asthma. Low activity promotes weight gain, which in turn may lead to misinterpretation of asthma symptoms as due to lack of physical fitness.

Family problems may obscure a child's symptoms and parents who smoke may be disinclined to get a doctor's advice about symptoms related to smoke in the family. If a child has no history of allergic rhinitis then this can also lead to a diagnosis of asthma being overlooked.

Siersted et al conclude that as two thirds of those with undiagnosed asthma do not report their symptoms to a doctor, then there could be a good case for an asthma campaign targeting those families with children in the risk categories.

Contact:

Dr Hans Siersted, Senior Registrar, Section of Respiratory Diseases, Department of Medicine C, Odense Hospital, DK-5000 Odense C, Denmark hc.siersted@winsloew.ou.dk

The Siersted paper is accompanied by three commentaries:-

(Commentary: Risk factors for underdiagnosis of asthma in adolescence)
Contact:
John Rees, Consultant Physician, United Medical and Dental Schools of Guy's and St Thomas's Hospitals, London

(Commentary: Identifying the correct risks in diagnosis)
Contact:
Stephen Evans, Visiting Professor of Medical Statistics, London School of Hygiene and Tropical Medicine, London
s.evans@qmw.ac.uk

(Commentary: Improving the diagnostic rate in asthma: a community issue)
Contact:
Hans Siersted, As above.

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