Environmental determinants of underdiagnosis of childhood asthma
More details
Hide details
Studium Doktoranckie Wydział Lekarski w Katowicach, Śląski Uniwersytet Medyczny
Katedra Epidemiologii Wydział Lekarski w Katowicach, Śląski Uniwersytet Medyczny
Irena Smółka   

Katedra Epidemiologii Śląski Uniwersytet Medyczny, ul. Medyków 18, 40-752 Katowice, tel. +48 32 252 37 34, fax +48 32 252 37 34
Ann. Acad. Med. Siles. 2010;64:71–75
Underdiagnosis of childhood asthma is a well known problem in many countries. In Poland the estimated occurrence of this problem reaches 50% and is similar to fi ndings published in foreign literature. The causes of the problem are not unequivocally recognized and are addressed by few authors. Among potential causes there are circumstances related to organization and practice of pediatric health care, including application of standard diagnostic criteria of asthma, availability of diagnostic tests, nozologic preferences, etc. Another category of circumstances in charge of underdiagnosis of childhood asthma stems from environmental infl uences, including family-related factors. Findings published in foreign literature show that underdiagnosis is more frequent in children of low socio-economic status, in rural setting or in families burdened by stress. Evidence however is far from being complete. There is a lack of Polish data on the subject and it remains unknown to what extent underdiagnosis of childhood asthma in this country is related to the above mentioned factors. Scientifi c investigation into the problem is necessary for a number of reasons and justifi es implementation of subject-oriented epidemiological studies. Identifi cation of factors associated with an increased probability of underdiagnosis of childhood asthma should facilitate planning of proper preventive measures, above all involving screening programs addressed to selected groups of population.
Bukowczan Z., Kurzawa R., Pisiewicz K. Częstość występowania astmy oskrzelowej u dzieci w Polsce. Alerg Astma I. 1996; 1:20-24.
Brożek G. Ocena wiarygodności populacyjnego testu przesiewowego w kierunku astmy oskrzelowej wieku dziecięcego. Rozprawa na stopień doktora nauk medycznych. SUM, Katowice 2007:12-13.
Lis G. Zmiana trendu częstości występowania astmy i chorób alergicznych u dzieci w Polsce i na świecie. Alerg Astma I. 2006; 11(SI):74-76.
Grzelewska-Rzymowska I., Zagdańska R. Astma łagodna – od patogenezy do leczenia. Pediatr Med. 2006; 2:244-252.;.
Szucs T., Anderhub H., Rutishauser M. The economic burden of asthma: direct and indirect costs in Switzerland. Eur Respir J. 1999;13:281-286.
Godard P., Chanez P., Siraudin L., Nicoloyannis N. Costs of asthma are correlated with severity: a 1-yr prospective study. Eur Respir J. 2001; 19:61-67.
Gendo K., Sullivan S., Lozano P., Finkelstein J. Resource costs for asthma-related care among pediatric patients in manager care. Alerg Asthma J. 2003;19: 251-257.
Gallefoss F., Bakke P.S., Rsgaard P.K. Quality of life assessment after patient education in a randomized controlled study on asthma and chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999; 159: 812-817.
Markson S., Fiese B. Family rituals as a protective factor for children with asthma. J Pediatr Psychol. 2000; 7: 471-480.
Reichenberg K., Broberg G. Quality of life questionnaire in a Swedish sample of children 7 to 9 years old. Acta Pediatr. 2000; 89: 989–95.
Smoliński B., Sybilski A., Raciborski F. i wsp. Występowanie astmy oskrzelowej u dzieci, młodzieży i młodych dorosłych w Polsce, w świetle badań ECAP. Alerg Astma Immunol 2009;14:27-34.
Global Strategy For Asthma Management and Prevention. The GINA Report 2009, 31-36. <http://www.ginasthma. com/Guidelineitem.asp??l1=2&l2=1&intId= 1382>.
Chmielewska-Szewczyk D. Diagnostyka astmy u dzieci. Alergia 2007; 2:4-8.
Poyser A., Nelson H., Ehrlich R., i wsp. Socioeconomic deprivation and asthma prevalence and severity in young adolescents. Eur Respir J. 2002;6: 892-898.
Egbuonu L. Child health and social status. Pediatrics. 1982; 5:550-557.
El-Sharif N., Abdeen Z., Qasrawi R., Moens G., Nemery B. Asthma prevalence in children living in villages, cities and refugee camps in Palestine. Eur Respir J. 2002; 6:1026-1034.
Nathell L., Larsson K., Jensen I. Determinants of undiagnosed asthma. Allergy. 2002; 57: 687–693.
Siersted H., Boldsen J., Hansen H.S., Mostgaard G., Hyldebrandt N. Population based study of risk factors for underdiagnosis of asthma in adolescence: Odense schoolchild study. BMJ. 1998; 28: 651–655.
Taytard A., Tessier J., Gervais M., Gachie J., Douet C., Kombou L., Vergeret J., Freour P. Actual usage of medical facilities by asthmatics in two French rural settings: a preliminary study. Eur. Respir J. 1990;42: 856-860.
Tomita K., Hanaki K., Hasegawa Y., Watanabe M., Sano H., Igishi T. Underrecognition of the severity of asthma and undertreatment of asthma in a rural area of Japan. J Asthma. 2005; 42:689-96.
Kupryś-Lipińska I., Elgalal A., Kuna P. Niedodiagnozowanie i brak właściwej terapii astmy – badanie populacji ogólnej mieszkańców województwa łódzkiego (Polska). Pneumonol Alergol Pol. 2010;78:21-27.