Abstract
Background: Wheeze-associated disorders are common in childhood,
associated with considerable morbidity, if not detected and treated.
Under diagnosis of asthma remains a problem, especially in
resource-limited settings. Methods: We used a validated school-based
screening questionnaire to detect children likely to have asthma.
Children with positive screening were referred to the Pulmonology
Department for clinical review and lung function testing. We compared
asthma-like symptoms, activity limitation, school absence and health
service utilization before and after in those diagnosed with, and
treated for asthma. Results: 6400 children, from a potential population
of 70,000 were screened between 2010 and 2016, with 900 (14.1%)
screening positive. Lung function data were available from 578 (64.2%)
children (5.7 to 6.5 years old). Asthma was confirmed in 549 children;
438 were treated with short acting bronchodilator alone and 111 with
inhaled corticosteroids. Asthma control improved in 58% of children,
with fewer daytime [mean 4.7 (SD1.9), vs 11.1 (0.6) days per week,
p<0.001] and nocturnal [4.3 (1.1) vs 0.89 (0.5) days per
month, p<0.001] symptoms. Activity improved and fewer school
days were lost due to asthma [12.8 (3.0) vs 1.9 (0.9) days in past 3
months, p<0.001] in over 50% of children. Emergency
department visits were reduced [1.8 (0.7) vs 0.3 (0.2) visits in past
3 months, p<0.001] in over 80% of children. Conclusions:
Asthma under diagnosis remains a problem in Argentina. Our school-based
assessment is an effective tool for detecting children with undiagnosed
asthma. Instituting effective asthma treatment in these children reduces
symptoms and improves control.