Most children with asthma develop their symptoms before the age of 5 years
and many preschool wheezers continue to wheeze in the early school years. I
t is thus important to investigate the factors that predispose young childr
en to wheeze. The objective of this study was to investigate the relevant e
nvironmental and family influences on recent wheeze (wheeze within the last
12 months) in preschool children. A cross-sectional study was conducted in
five primary health clinics in the district of Kota Bharu from April to Oc
tober 1998. Nurses from these clinics distributed Bahasa Malaysia questionn
aires containing questions on asthma symptoms, environmental risk factors,
family's social status and family history of atopy and wheeze to preschool
children aged 1-5 years during their home visits. The respondents were pare
nt(s) or carer(s) of the children.
A total of 2,524 (87.7%) complete questionnaires were available for analysi
s of risk factors. One hundred and fifty six (6.2%) children had current wh
eeze. Significant risk factors associated with current wheeze were a family
history of asthma (O.R. = 6.36 95% C.I. = 4.45-9.09), neonatal hospital ad
mission (O.R. = 2.38, 95% C.I. = 1.51 - 3.75), and a maternal (O.R. = 2.12,
95% C.I. = 1.31-3.41) or paternal (O.R. = 1.52, 95% C.I. = 0.95-2.43) hist
ory of allergic rhinitis. Among environmental factors examined, namely, hou
sehold pets, carpeting in bedroom, use of fumigation mats, mosquito coils a
nd aerosol insect repellents, maternal and paternal smoking, and air condit
ioning, none were associated with an increased risk of wheeze. In conclusio
n, the strongest association with current wheeze was a family history of as
thma. Also significant were neonatal hospital admission and a history of al
lergic rhinitis in either the mother or father. None of the environmental f
actors studied were related to current wheeze in preschool children.