Asthma underdiagnosis in children. A school-based screening in a low socioeconomic status population

Abstract

Introduction. The international recommendations of asthma management and prevention emphasize the importance of an early and correct diagnosis and the achievement of good disease control. However, these aspects remain as a major concern, especially in children with low socioeconomic status.
Objective. To describe the prevalence, underdiagnosis, severity and control of asthma in a children population from a low SES setting in Bogotá, Colombia.
Materials and methods. A cross-sectional study using the International Study of Asthma and Allergies (ISAAC) Questionnaire was carried out in children aged 7-11 years in two public schools. Those with any positive response in the questionnaire were clinically and functionally evaluated at the unit health care mobile. Prevalence and underdiagnosis of asthma, level of control, severity of disease and quality of life were assessed by validated instruments.
Results. Of 920 school children (aged 9.5 ± 1.1) screened, 186 were evaluated clinically and functionally by spirometry. Among these children, 122 were diagnosed with asthma (17.2%). Underdiagnosis was 68%. The majority of cases had moderate and severe asthma, and 90% presented with not well and very poorly controlled asthma.
Conclusions. Screening children at a school setting is a good strategy for detecting asthma and reducing underdiagnosis in communities with low SES and limited access to health care services. Asthma underdiagnosis and lack of control were high.