PREVALENCE OF ASTHMA OR RESPIRATORY SYMPTOMS AMONG CHILDREN ATTENDINGPRIMARY-SCHOOLS IN PARIS

The objectives of this study were to determine the prevalence of chron ic respiratory symptoms and asthma in 8- to 9-year-old children in Par is, and to analyze their medical management. This cross-sectional stud y was carried out in 1994 on a randomized sample of 3,756 pupils atten ding Paris public primary schools. The response rate by parents to an initial standardized self-administered questionnaire was 94.8%. This q uestionnaire identified 601 children (17%) as having recurrent respira tory symptoms. Of these children, 555 (92.3%) agreed to participate in a follow-up survey that evaluated their medical management; these chi ldren were examined by 73 school doctors of the city of Paris. Prevale nce of parent-reported doctor-diagnosed asthma was 6.1%. In addition t o these 211 children with asthma, 344 other children had recurrent res piratory symptoms. 120 children were ''wheezers,'' and the remaining 2 24 children were ''coughers.'' Among ''chesty'' pupils not identified as asthmatics;physical education teachers reported exercise-induced co ugh or respiratory discomfort in 13.7%, and nearly 14% had a peak expi ratory flow 20% lower than the predicted values for age and height. In children identified as asthmatic, 25.3% were not under medical superv ision, 55.5% had never performed lung function tests, 63.7% did not re ceive any prophylactic treatment, and 59.7% were receiving no treatmen t. Bronchodilator prophylactic medication before exercise was used by only 7% of asthmatics, although physical training teachers noted chest discomfort on exercise in 30.4% of these pupils. These results confir m that children with asthma and participating in this study were less than optimally investigated, were underdiagnosed and undertreated, and their medical management was not optimal. In addition to its epidemio logic value, the study has helped Paris school doctors to advise paren ts to refer their children to their general practitioner when asthma w as suspected or undertreated. Pediatr Pulmonol. 1998; 26:106-112. (C) 1998 Wiley-Liss. Inc.