Original Articles
Geographic Variation in the Prevalence of Asthma Symptoms in Spanish Children and Adolescents. International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3, Spain

https://doi.org/10.1016/S1579-2129(06)60333-9Get rights and content

Objective

TO analyze geographic variations in the prevalence of symptoms related to asthma in Spanish children and adolescents.

Population and methods

In 2001 and 2002, the Spanish arm of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3 collected information on 28 445 children in the age bracket of 6-7 years in 10 metropolitan areas (A Coruña, Asturias, Barcelona, Bilbao, Cartagena, Castellón, Madrid, Pamplona, San Sebastián, and Valencia) and on 31 257 adolescents in the bracket 13-14 years in 11 areas (the previously named areas plus Valladolid). An asthma symptom questionnaire was filled in by parents or the adolescents themselves. Differences in symptoms between geographic areas were analyzed by fitting a logistic regression model. The relationship between symptoms and age was analyzed by linear correlation.

Results

The prevalence of recent wheezing (last 12 months) ranged from 7.1% to 12.9% among 6-7-year-olds and from 7.1% to 15.3% among the 13-14-year-olds. The greatest risk of recent wheezing was observed for children in A Coruña (odds ratio [OR] =1.96 in comparison with the area of lowest prevalence; 95% confidence interval [CI], 1.65-2.33) and Bilbao (OR=1.83; 95% CI, 1.54-2.18) and for adolescents in A Coruña (OR=2.38; 95% CI, 2.04-2.79) and Asturias (OR=2.37; 95% CI, 2.03-2.77). A strong correlation (r=0.72) was observed between the prevalence of recent wheezing and age in each of the geographic areas.

Conclusions

Considerable geographic variation in the prevalence of asthma symptoms can be seen in Spain even among young children. Symptoms are more frequent in children and adolescents who live on the Spain's northern Atlantic coast.

Objetivo

Analizar las variaciones geográficas en la prevalencia de síntomas relacionados con el asma en niños y adolescentes españoles.

Población y métodos

Durante los años 2001 y 2002, el International Study of Asthma and Allergies in Childhood (ISAAC) fase III estudió a 28.445 niños de 6-7 años de 10 áreas (A Coruña, Asturias, Barcelona, Bilbao, Cartagena, Castellón, Madrid, Pamplona, San Sebastián y Valencia) y 31.257 adolescentes de 13-14 años de 11 áreas (las anteriores más Valladolid) españolas. Los síntomas de asma se recogieron en un cuestionario escrito completado por los padres de los niños o por los propios adolescentes. Las variaciones geográficas de las prevalencias de los síntomas se analizaron con un modelo de regresión logística y su correspondencia por edad mediante correlación lineal.

Resultados

La prevalencia de sibilancias recientes (últimos 12 meses) varió entre el 7,1 y el 12,9% a los 6-7 años, y entre el 7,1 y el 15,3% a los 13-14 años. El riesgo más elevado (odds ratio [OR] respecto al área de menor prevalencia) de presentar sibilancias recientes correspondió a los niños de A Coruña (OR = 1,96; interva-lo de confianza [IC] del 95%, 1,65-2,33) y Bilbao (OR = 1,83; IC del 95%, 1,54-2,18) y los adolescentes de A Coruña (OR = 2,38; IC del 95%, 2,04-2,79) y Asturias (OR = 2,37; IC del 95%, 2,03-2,77). Se comprobó una fuerte correlación por edad en las prevalencias de sibilancias recientes de cada área geográfica (r = 0,72).

Conclusiones

En España existen, desde edades tempranas, variaciones geográficas notables en la prevalencia de síntomas de asma. Éstos son más frecuentes en los niños y adolescentes que habitan en la fachada atlá ntica del país.

REFERENCES (28)

  • L García-Marcos et al.

    Stabilization of asthma prevalence among adolescents and increase among schoolchildren (ISAAC phases I and III) in Spain

    Allergy

    (2004)
  • N Pearce et al.

    Self-reported prevalence of asthma symptoms in children in Australia, England, Germany and New Zealand: an international comparison using the ISAAC protocol

    Eur Respir J

    (1993)
  • PG Burney et al.

    What symptoms predict the bronchial response to histamine? Evaluation in a community survey of the bronchial symptoms questionnaire (1984) of the International Union Against Tuberculosis and Lung Disease

    Int J Epidemiol

    (1989)
  • CK Lai et al.

    Comparison of the ISAAC video questionnaire (AVQ3.0) with the ISAAC written questionnaire for estimating asthma associated with bronchial hyperreactivity

    Clin Exp Allergy

    (1997)
  • Cited by (119)

    • Pediatric asthma: The REGAP consensus

      2021, Anales de Pediatria
    View all citing articles on Scopus

    Institutions and foundations that have helped fund this study: Public Health and Planning Authority (Dirección General de Salud Pública y Planificación), Health and Healthcare Services Council of Asturias (Consejería de Salud y Servicios Sanitarios del Principado de Asturias); Óscar Rava Foundation 2001, Barcelona; Health Department of Navarra (Departamento de Salud del Gobierno de Navarra); Rotaria Luis Vives Foundation 2002-2003, Valencia; Health Department of the Autonomous Government of Murcia (Departamento de Salud del Gobierno Autónomo de Murcia); Instituto de Salud Carlos III, Red de Centros RCESP (C03/09); AstraZeneca, España.

    View full text