Balvinder Kaur, H Ross Anderson, Jane Austin, Michael Burr, Leigh S Harkins, David P Strachan, John O Warner
Objective: To investigate variations in the prevalence of self reported symptoms, diagnosis, and treatment of asthma in 12-14 year old children.
Design: Self completion questionnaire.
Setting: Great Britain.
Subjects: All pupils aged 12-14 years in a stratified cluster sample of 93 large mixed secondary schools in 1995.
Main outcome measures: Self reported prevalence of symptoms, diagnosis, and treatment of asthma at four geographical levels.
Results: 27,507 questionnaires were completed (85.9% response rate). The national 12 month prevalence of any wheezing, speech limiting wheeze, four or more attacks of wheeze, and frequent night waking with wheeze was 33.3% (n=9,155), 8.8% (2,427), 9.6% (2,634), and 3.7% (1,023) respectively. The prevalence of ever having had a diagnosis of asthma was 20.9% (5736). In total, 19.8% (5438/27,507) of pupils reported treatment with anti-asthma drugs in the past year, but, of pupils reporting frequent nocturnal wheeze in the past year, 33.8% (342/1,012) had no diagnosis of asthma and 38.6% (395/1,023) denied receiving inhaler therapy. The 12 month prevalence of wheeze was highest in Scotland (36.7%, 1,633/4,444), but in England and Wales there was no discernible north-south or east-west gradient. Wheeze prevalence was slightly higher in non-metropolitan areas (35.0%, 6,155/17,605) than in metropolitan areas (30.3%, 3,000/9,902). The prevalence of self reported asthma diagnosis and inhaler use showed no discernible national, regional, north-south, or east-west geographical pattern but was higher in non-metropolitan areas.
Conclusion: Prevalence of self reported symptoms, diagnosis, and treatment of asthma was high among 12-14 year olds throughout Great Britain with little geographical or urban-rural variation. Underdiagnosis and undertreatment were substantial.
Department of Public Health Sciences,
St George's Hospital Medical School,
London SW17 0RE
Balvinder Kaur, clinical lecturer in public health medicine
H Ross Anderson, professor of epidemiology and public health
Leigh S Harkins, statistician
David P Strachan, reader in epidemiology
Highland Communities NHS Trust,
Child Health Department,
Royal Northern Infirmary,
Inverness IV3 5SF
Jane Austin, community paediatrician associate specialist
Centre for Applied Public Health Medicine,
Temple of Peace and Health,
Cathays Park,
Cardiff CF1 3NW
Michael Burr, senior lecturer in public health medicine
Southampton General Hospital,
Southampton S016 6YD
John O Warner, professor of child health
Correspondence to: Dr Kaur