Intraregional differences in asthma prevalence and risk factors for asthma among adolescents in Split-Dalmatia County, Croatia

Abstract

SummaryBackgroundOur aim was to assess the differences in intraregional prevalence of asthma in adolescents in Split-Dalmatia County to determine asthma risk factors in our population and estimate the specificity and sensitivity of the questionnaire used.Material/MethodsWe conducted the study using the European Community Respiratory Health Survey II short questionnaire supplemented by some questions from the International Study of Asthma in Childhood questionnaire. The participants suspected to have asthma were invited for examination by an asthma specialist who established the final diagnosis of asthma according to the medical history, physical examination, skin-prick tests, and peak flow measurements.ResultsA total of 4027 students (51.2% male) participated in the study. According to the prevalence of wheezing during the last 12 months, asthma prevalence was estimated at 9.7%. The total prevalence of asthma confirmed by an asthma specialist in the selected population was 5.60% (95% CI, 4.93–6.36%); 6.18% in Split (95% CI, 5.37–7.09), 5.63% in Imotski (95% CI, 3.48–8.58), and 2.90% in Sinj (95% CI, 1.67–4.68) (P=0.0028). We found sensitization to aeroallergens and peanuts, and active smoking to be independent risk factors for asthma.ConclusionsSplit-Dalmatia County has moderate asthma prevalence, with a significant intraregional difference. Asthma prevalence estimated by a questionnaire (9.7%) overestimates the prevalence of asthma confirmed by an asthma specialist (5.6%) in adolescents in Croatia. Our data confirmed the need of a more complex questionnaire to evaluate the accurate prevalence of current asthma or the need for subsequent clinical evaluation of the questionnaire obtained data. Allergic sensitization to aeroallergens and active smoking were important risk factors for asthma.

Allergic Diseases and Atopy among Schoolchildren in Eastern Croatia

“…They included different age groups of children: 6-7 years, 10-11 years, 12-14 and 14-16 years. In comparison to the research conducted in Zagreb ( 15 ), Primorje-Gorski Kotar County ( 11 ) and Međimurje County ( 13 ), we recorded a higher prevalence of current wheezing (Brod-Posavina County 7.9%) as compared with Zagreb (6.02%) and Međimurje County (5.11%), but lower than in Primorje-Gorski Kotar County (6-7 age group 9.7% and 13-14 age group 8.4%) and Split-Dalmatia County (9.7%) ( 12 ). The prevalence of rhinoconjunctivitis was higher in Zagreb (12.13%), than in this (Brod-Posavina County 9.9%) and other Croatian studies (Međmurje County 7.14% and Primorje-Gorski Kotar County – 6-7 age group 5.6% and 13-14 age group 6.7%).…”

Prevalence of Asthma Bronchiale in the Czech Republic and its Economic Burden

“…It is an insufficiently defined syndrome characterized by several phenotypes most probably with different etiology (Gudelj et al, 2012). The biggest problem is the fact that we still do not know the optimal standard for exact diagnosis and its relevant evaluation in epidemiological studies, so exact registration is difficult (Gudelj et al, 2012).…”

“…Despite the fact that in recent years there is considerable attention focused on diagnostic of all allergic diseases including AB, a full and precise diagnosis is still often unsatisfactory, with subsequent problems starting treatment at the earliest start of this disease (Bedouch et al, 2012;Doz et al, 2013;Pakhale et al, 2011;Petru, 2008;Pohunek et al, 2009;Zhang et al, 2015). Problems in evidence of AB, leading to disproportional evidence of AB in individual regions, are also significant (Gudelj et al, 2012;Hansen et al, 2012). An exact and early diagnosis can significantly reduce progression of clinical manifestation of AB and thus strongly lower financial burden (Bahadori et al, 2009;Litonjua and Weiss, 2007;Edwards et al, 2011;Doz et al, 2013;Pohunek et al, 2009).…”

“…Prevalence of AB is constantly increasing, even if this trend is different in individual countries (Accordini et al, 2013;Bahadori et al, 2009;Litonjua and Weiss, 2007;D'Amato et al, 2015;Doz et al, 2013;Gudelj et al, 2012;Kim et al, 2013;Wong et al, 2013;Zalewska et al, 2013). Numerous inductors are considered to be responsible for an increase in AB prevalence, among others it is urbanization and environmental pollution, but also more precise diagnostic and registration (Anderson et al, 2012;Bonds and Midoro-Horiuti, 2013;Daghri-Al et al, 2013;D'Amato et al, 2015;Lamnisos et al, 2013;Patel et al, 2012).…”

Attitudes of Croatian pulmonologists concerning obstacles to earlier, more appropriate use of biologics in severe asthma: Survey results

“…The number of patients with SA in Croatia was estimated based on the local epidemiology data for asthma (estimated prevalence of 3%) [7][8][9][10] and the Dutch report on SA [11]. In the Dutch study, authors suggested the prevalence of SA in the range of 0.9% (when the most stringent criteria applied: adherence >80%, adequate inhaler use, optimal treatment of contributory factors) and 3.6% of the total asthma population.…”