Prevalence estimates and risk factors for early childhood wheeze across Europe: the EuroPrevall birth cohort

Selby, Anna; Munro, Alasdair; Grimshaw, Kate; Cornelius, Victoria; Keil, Thomas; Grabenhenrich, Linus; Clausen, Michael; Dubakiene, R.; Fiocchi, Alessandro; Kowalski, Marek L.; Papadopoulos, Nikolaos G.; Reche, Marta; Sigurdardottir, Sigurveig; Sprikkelman, A. B.; Xepapadaki, Paraskevi; Mills, E. N. Clare; Beyer, Kirsten; Roberts, Graham

doi:10.1136/thoraxjnl-2016-209429

Cited by 27 publications

(29 citation statements)

References 39 publications

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“…The sample size was estimated to provide 80% power at a 5% significance level to assess the primary association between an occurrence of at least one wheezing exacerbation within 3 months of the index ED visit and the overall baseline TRACK score, adjusting for patients' sex and atopy, which are known to impact preschool wheeze severity . Based on a previous study we assumed that approximately 40% of participants would have further exacerbations .…”

Section: Methodsmentioning

confidence: 99%

Test for respiratory and asthma control in preschool kids in the emergency department as a predictor of wheezing exacerbations

Harel‐Sterling

Dai

Moraes

et al. 2020

Pediatric Pulmonology

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Objective The test for respiratory and asthma control in kids (TRACK score) is a standardized questionnaire tool validated to identify poor symptom control in children with stable preschool wheeze. This study determined if TRACK score measured within 5 days of an Emergency Department (ED) visit for acute wheezing predicts a subsequent wheezing exacerbation requiring an ED visit and/or treatment with systemic corticosteroids within 3 months. Methods This was a single‐center prospective cohort study of children aged 36 to 71 months who presented to the ED with an acute episode of wheezing and had TRACK score measured at a clinic visit within 5 days of the index ED encounter, focused on information about symptoms occurring before the onset of the current acute episode. The outcomes were the independent association of a repeat wheezing exacerbation with the overall TRACK score (primary) and with mutually uncorrelated TRACK items (secondary), adjusted for sex and atopy. Results We enrolled 102 children; median age 52.3 (44.1, 59.9) months, 59% males. Of these, 33 (32.4%) had further wheezing exacerbations. For each 10 unit decrease in TRACK, the odds of a future exacerbation was 1.38 (95% CI, 1.10‐1.75); male sex demonstrated OR, 5.13 (1.84‐14.33). A model that included TRACK items reflecting more than equal to 1 awakenings for wheezing in the past 4 weeks, receipt of more than equal to 2 courses of corticosteroids in the last year and male sex was predictive of wheezing exacerbations: OR, 6.43 (2.18‐19.00). Conclusion In preschoolers with acute wheezing episodes in the ED, we have identified the TRACK score components which, together with male sex, can be used to identify children at risk of future exacerbations requiring referral for specialized care. These results need to be confirmed and validated in other populations enrolled at multiple sites before they can be implemented in practice.

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Section: Methodsmentioning

confidence: 99%

Test for respiratory and asthma control in preschool kids in the emergency department as a predictor of wheezing exacerbations

Harel‐Sterling

Dai

Moraes

et al. 2020

Pediatric Pulmonology

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“…Selby et al ’s study published in Thorax fills this important gap 12. Although their wheeze measure used does not differentiate any of the early childhood asthma/wheeze phenotypes described to date, their findings on the substantial variation in wheeze prevalence across a number of countries and differential patterns of risk factors provide valuable insights and will inform future research.…”

mentioning

confidence: 99%

“…Lack of delineation of early transient wheeze from other wheeze phenotypes (intermediate-onset or early persistent wheeze) in the EuroPrevall analysis may have influenced the ability to find this association. Another reason Selby et al ’s analysis did not find more previously identified associations could be their approach to model construction, which was more predictive modelling in nature without consideration of potential causal pathways when variables are included in the models, which may lead to underestimates of associations 12. For example, a model including both breast feeding and any potential mediators that lie in the causal pathway between breast feeding and wheeze may mask the association.…”

mentioning

confidence: 99%

“…A further reason for lack of relationship found for common risk factors could be that the relationships may differ between sites. Estimates of associations between exposures and wheeze were pooled across centres when there is clear evidence of a protective effect or risk effect for some centres and not in others (table S6 in Selby et al 12). …”

mentioning

confidence: 99%

“…As mentioned, phenotyping early life wheeze is important because of the differing long-term prognoses and associated risk factors which likely reflect different causal mechanisms requiring differing prevention and treatment approaches 12. The holy grail of childhood wheeze is to be able to easily identify wheezing infants who will go on to have asthma from those who will have a benign resolution of their wheeze.…”

mentioning

confidence: 99%

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EuroPrevall: insights into the allergic disease epidemic

Lodge

Lowe

Dharmage

2018

Thorax

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Prevalence of asthma, allergic rhinitis and eczema in 6–7-year-old schoolchildren from Luanda, Angola

Arrais¹,

Lulua²,

Quifica³

et al. 2019

Allergologia et Immunopathologia

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Background: Epidemiological data have shown that the prevalence of asthma, rhinoconjunctivitis and eczema in children is still increasing, namely in Africa. However, there are no epidemiological studies on asthma or allergic diseases in Angolan children. Objective: To study the prevalence of asthma and other allergic diseases in Angolan children. Methods: Descriptive, observational, cross-sectional study, using the ISAAC study methodology, in the province of Luanda, Angola in 6-7-yearold children. Forty-six (8.3%) public schools were randomly selected. Data were analysed using the SPSS Statistics version 24.0 software. Results: A total of 3080 children were studied. Results showed that the prevalence of asthma (wheezing in the previous 12 months) was 15.8%, that of rhinitis (sneezing, runny or blocked nose in the previous 12 months) was 19% and that of eczema (itchy skin lesions in the previous 12 months) was 22%, without differences between sexes. Rhinitis was associated with a higher number of episodes of wheezing episodes, disturbed sleep and night cough, in children with asthma. Rhinitis, eczema, Split-type air conditioning system, antibiotic intake in the child's first year of life, frequent intake (more than once per month) of paracetamol and active maternal smoking were associated with a higher risk of having asthma, whereas electrical cooking was associated with a protective effect. Conclusion: Asthma and allergic diseases are highly prevalent in children from Luanda. A strategy for preventive and control measures should be implemented.

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Prevalence estimates and risk factors for early childhood wheeze across Europe: the EuroPrevall birth cohort

Cited by 27 publications

References 39 publications

Test for respiratory and asthma control in preschool kids in the emergency department as a predictor of wheezing exacerbations

Test for respiratory and asthma control in preschool kids in the emergency department as a predictor of wheezing exacerbations

EuroPrevall: insights into the allergic disease epidemic

Prevalence of asthma, allergic rhinitis and eczema in 6–7-year-old schoolchildren from Luanda, Angola

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