Article Text
Abstract
Background Clinical experience suggests that childhood asthma phenotype in developing countries may be different from developed countries where majority of asthma is atopic.
Objective To study the phenotypic expression of bronchial asthma in Indian children with special reference to symptoms, features of atopy, family history, and exacerbating/relieving factors.
Methods The study was conducted with Ethics clearance and children were enrolled with written informed parental consent. Childhood asthma phenotype (CAP) cohort comprises 600 consecutively enrolled children (<12y) with asthma defined by NAEPR-III Guidelines. Enrolled children underwent a standard questionnaire to elicit demographic features, presenting symptoms, atopic features, and parental perception of exacerbating/relieving factors. Older children (>8y) underwent spirometry. Classification of severity, treatment plan, follow-up protocol and monitoring of response were as per GINA Guideline.
Results The mean age of enrolled children was 73.4 months (range 3–144) and mean age of symptom onset was 45.0 months (range3.0–75.0). The age distribution was: <12 months (20, 3.3%),12–60 months (228,38.0%), 60–144 months (352, 58.7%). The male:female ratio was 2.7. Severity classification was: Mild intermittent-12.0%, Mild persistent-18.0%, Moderatepersistent-63%, Severe persistent-7%. Table 1 summarises the symptom profile and Table 2 shows parental perception of exacerbating/relieving factors.
Symptom profile of children in the CAP cohort
Parental perception of exacerbating and relieving factors in the CAP report
Conclusion These observations suggest that childhood asthma phenotype in a developing country setting is distinct from developed countries.