Asthma after childhood pneumonia: six year follow up study. Issue 7248 (3rd June 2000)

• Record Type: Journal Article
• Authors: Clark, Christopher E; Coote, Jacqueline M; Silver, David A T; Halpin, David M G
• Is Part Of: BMJ. Volume 320:Issue 7248(2000)
• Page Start: 1514
• Page End: 1516
• Publication Date: 2000-06-03
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Periodicals; 610
• DOI: 10.1136/bmj.320.7248.1514
• Languages: English
• ISSNs: 0007-1447

Abstract

Abstract: Objective: To establish the long term cumulative prevalenceof asthma in children admitted to hospital with pneumonia and to examine the hypothesis that some children admitted to hospital with pneumonia may be presenting with undiagnosed asthma. Design: Prospective study of a cohort of children previously admitted to hospital with pneumonia, followed up by postal questionnaires totheir general practitioners and the children or their parents. Setting: General practices in southwest England. Participants: 78 children admitted to the Royal Devon and Exeter Hospital between 1989 and 1991 with a diagnosis of pneumonia confirmed on independent review of x ray films. Main outcome measures: Any diagnosis of asthma, use of any treatment for asthma, and asthma symptom scores. Results: On the basis of a 100% response rate from general practitioners and 86% from patients or parents, the cumulative prevalence of asthma was 45%. A diagnosis of asthma was associated with a family history of asthma (odds ratio 11.23; 95% confidence interval 2.57 to 56.36; P=0.0002). Mean symptom scores were higher for all children with asthma (mean score 2.4; χ 2 =14.88; P=0.0001)and for children with asthma not being treated (mean 1.4; χ 2 =6.2; P=0.01)than for those without asthma (mean 0.2) Conclusions: A considerable proportion of children presenting to a district general hospital with pneumonia either already have unrecognised asthma or subsequently develop asthma. The high cumulative prevalence of asthma suggests that careful follow up of such children is worth while. Asthma is undertreated in these children; a structured symptom questionnaire may help to identify and reduce morbidity due to undertreatment.