WHEEZE IN PRESCHOOL-CHILDREN AND ITS RELATION WITH DOCTOR DIAGNOSED ASTHMA

Objective - To describe the characteristics of wheeze and its relation with doctor diagnosed asthma in children aged 5 years and under. Desi gn - Questionnaire survey of population based random sample of childre n registered on Leicestershire Health Authority's child health index f or immunisation; questionnaire completed by parents. Subjects - 1650 w hite children born in 1985 to 1989 who were surveyed in 1990.Main outc ome measures - Age distribution, severity, precipitants, seasonal char acteristics, and diurnal variation of wheeze, family history of asthma /atopy, and their association(s) with doctor diagnosed asthma. Results - There were 1422 replies (86.2%). Two hundred and twenty two (15.6%) were reported to have wheezed and of these 121 (8.6%) had formally be en diagnosed as having asthma. More than 80% of the former had recurre nces of wheeze and 40% (72) had three or more episodes in the precedin g 12 months. Age, number of episodes per year, the severity of shortne ss of breath with attacks, and precipitants other than colds were the major factors determining the probability that a wheezy child will be diagnosed as having asthma. The data also suggest that despite the str ong association of symptom based criteria with the label asthma, asthm a was not diagnosed by these same severity criteria in one quarter of cases. Conclusions - Clinical and physiological follow up studies of c hildren identified as asthmatic by the above criteria during the presc hool years should validate or refute the predictive value of these mea sures of wheeze severity.