No abstract

The aim of this cross-sectional study was to compare the prevalence of asthma and its symptoms in children aged 6-7 years and 13-14 years in an urban (Amman city) area and among Bedouins in northern Jordan. The number of students included in both studied groups was 9108. This study is part of the International Study of Asthma and Allergies in Childhood (ISAAC), phase III. The response rate was 84% for urban schoolchildren compared with 68% among Bedouin schoolchildren. There was no statistical significance in prevalence of asthma diagnosed by a physician between the Amman city group and Bedouins (8.8% versus 9.5%). Wheeze induced by exercise and night cough was significantly common in schoolchildren aged 13-14 years compared with primary schoolchildren (18.5 and 25.3% versus 11.1 and 22.6%; p < 0.001). Wheezing ever and sleep disturbances were significantly more common in male subjects (27.5%, p < 0.01, and 12.2%, p < 0.001, respectively). Primary schoolchildren aged 6-7 years had significant wheezing ever (27.2%) compared with older children (25.1%; p < 0.05). Bedouin children had significant exercise-induced wheeze (16.4%) compared with children in Amman city (13.1%, p < 0.001), but the latter had significant prevalence of night cough (25%) compared with the Bedouin group (22.6%; p < 0.01). In conclusion, this study shows that asthma is moderately common in Jordan. There was no difference in prevalence of asthma diagnosed by a physician between an urbanized region and Bedouins having low socioeconomic status. Asthma was common in male children, which is similar to other reports elsewhere. There is a twofold increase in the prevalence of asthma in Jordan in the last 10 years.

Lung function abnormality is a known complication of thalassemia, but the results of studies in pulmonary function have been inconsistent. This study was conducted to describe the type of lung impairment in thalassemic children. Pulmonary function tests were conducted in 40 children with beta-thalassemia major, 23 males and 17 females. Tests included spirometry, total lung capacity (TLC), single breath diffusing capacity of the lung for carbon monoxide (DL(CO)) and arterial blood gases. Serum ferritin level was measured in all children to study its relationship to lung function impairment. A predominantly restrictive pattern was seen in 14 patients (35%). These patients had a significant reduction in RV, FVC, TLC and PEF with an FEV1/FVC ratio of more than 75%. Obstructive airway disease was found in six patients (15%), with an FEV1/FVC ratio less than 75%, increased RV and reduced FEF(25%-75%). Impairment of diffusion was found in 10 patients (25%), with DL(CO) reduced to less than 80% of the predicted value. Arterial blood gases results showed that no patient was hypoxic. No correlation was found between the severity of restrictive or obstructive disease and the serum ferritin level. There was a significant linear correlation between age and serum ferritin level (P < 0.019). Patients with thalassemia have a predominantly restrictive lung dysfunction pattern. This may be due to pulmonary parenchymal pathology, although the reason for the obstructive pattern seen in a small proportion of patients remains obscure.

A prospective study of 203 children admitted with a first febrile seizure was carried out over 18 months. Aseptic meningitis was diagnosed in nine children (4%). The mean age of the children was 19.9 months and the peak age incidence (88%) was between 6 months and 3 years. Complex seizures were seen in 16 cases (8%). There was a history of perinatal asphyxia in 16 patients (8%), positive family history of epilepsy in 3%, of first degree relatives and a history of febrile seizures in siblings in 13%. Upper respiratory tract infection was the commonest triggering factor, diagnosed in 53% of cases. The third child was the most commonly affected (22%) in the family. There was a lower incidence of both complex febrile seizures and history of seizures in siblings compared to other studies. Lumbar puncture should be considered for all children below the age of 2 years, presenting with a first febrile seizure.

The association between congenital major urinary tract anomalies (CMUTA) and spontaneous pneumothorax in term newborn infants (SPTNI) is controversial. We conducted a case-control study to test the hypothesis that SPTNI is associated with CMUTA. We compared 80 term infants with spontaneous pneumothorax to 80 healthy control infants. We recorded risk factors, clinical course, therapy, and outcome. Only 1 infant of 60 infants (1.7%) had CMUTA with SPTNI, as revealed by renal ultrasound studies. This is comparable to the 1.4% rate reported for CMUTA in healthy newborn infants by Steinhart et al. ([1988] Pediatrics 82:609-614). SPTNI were significantly more likely in males with higher birth weights and with vacuum delivery. Sixty-seven (84%) infants with SPTNI had follow-up for a mean and median of 46.4 and 39 months, respectively (range, 1-126 months), without manifesting any renal or pulmonary complications.