Displaying publications 1 - 20 of 47 in total

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  1. Hasan SS, Capstick T, Zaidi STR, Kow CS, Merchant HA
    Respir Med, 2020 05 26;170:106045.
    PMID: 32843175 DOI: 10.1016/j.rmed.2020.106045
    The potential detrimental effects of steroids on the immune system to fight viral infections had always been a concern for patients on long term steroids in chronic conditions. A recent warning from WHO on systemic corticosteroid use amid COVID-19 raised suspicion among public and healthcare professionals regarding the safety of steroid use during the SARS-CoV-2 pandemic. The corticosteroids (inhaled and oral) are commonly prescribed in the management of asthma and COPD patients and any unsolicited changes in medications use may lead to potentially severe exacerbations and may risk patient lives. This article provides a critical review of clinical evidence and offers a detailed discussion on the safety and efficacy of corticosteroids in asthma and COPD patients, both with and without COVID-19.
    Matched MeSH terms: Asthma/epidemiology
  2. Jie Y, Isa ZM, Jie X, Ju ZL, Ismail NH
    PMID: 23625129 DOI: 10.1007/978-1-4614-6898-1_2
    In this review, our aim was to examine the influence of geographic variations on asthma prevalence and morbidity among adults, which is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity. Asthma is a complex inflammatory disease of multifactorial origin, and is influenced by both environmental and genetic factors. The disparities in asthma prevalence and morbidity among the world's geographic locations are more likely to be associated with environmental exposures than genetic differences. In writing this article, we found that the indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke in both urban and rural areas. Asthma and asthma-related symptoms occurred more frequently in urban than in rural areas, and that difference correlated with environmental risk exposures, SES, and healthcare access. Environmental risk factors to which urban adults were more frequently exposed than rural adults were dust mites,high levels of vehicle emissions, and a westernized lifestyle.Exposure to indoor biological contaminants in the urban environment is common.The main risk factors for developing asthma in urban areas are atopy and allergy to house dust mites, followed by allergens from animal dander. House dust mite exposure may potentially explain differences in diagnosis of asthma prevalence and morbidity among adults in urban vs. rural areas. In addition, the prevalence of asthma morbidity increases with urbanization. High levels of vehicle emissions,Western lifestyles and degree of urbanization itself, may affect outdoor and thereby indoor air quality. In urban areas, biomass fuels have been widely replaced by cleaner energy sources at home, such as gas and electricity, but in most developing countries, coal is still a major source of fuel for cooking and heating, particularly in winter. Moreover, exposure to ETS is common at home or at work in urban areas.There is evidence that asthma prevalence and morbidity is less common in rural than in urban areas. The possible reasons are that rural residents are exposed early in life to stables and to farm milk production, and such exposures are protective against developing asthma morbidity. Even so, asthma morbidity is disproportionately high among poor inner-city residents and in rural populations. A higher proportion of adult residents of nonmetropolitan areas were characterized as follows:aged 55 years or older, no previous college admission, low household income, no health insurance coverage, and could not see a doctor due to healthcare service availability, etc. In rural areas, biomass fuels meet more than 70% of the rural energy needs. Progress in adopting modern energy sources in rural areas has been slow. The most direct health impact comes from household energy use among the poor, who depend almost entirely on burning biomass fuels in simple cooking devices that are placed in inadequately ventilated spaces. Prospective studies are needed to assess the long-term effects of biomass smoke on lung health among adults in rural areas.Geographic differences in asthma susceptibility exist around the world. The reason for the differences in asthma prevalence in rural and urban areas may be due to the fact that populations have different lifestyles and cultures, as well as different environmental exposures and different genetic backgrounds. Identifying geographic disparities in asthma hospitalizations is critical to implementing prevention strategies,reducing morbidity, and improving healthcare financing for clinical asthma treatment. Although evidence shows that differences in the prevalence of asthma do exist between urban and rural dwellers in many parts of the world, including in developed countries, data are inadequate to evaluate the extent to which different pollutant exposures contribute to asthma morbidity and severity of asthma between urban and rural areas.
    Matched MeSH terms: Asthma/epidemiology
  3. Chan PW, Anuar AK, Fong MY, Debruyne JA, Ibrahim J
    Pediatr Int, 2001 Aug;43(4):350-3.
    PMID: 11472577 DOI: 10.1046/j.1442-200X.2001.01421.x
    BACKGROUND: The larva of Toxocara spp., a common animal roundworm, may infect non-compatible hosts, causing a profound immunological reaction with marked eosinophil and IgE responses, not unlike in atopy. In this study, we determined the seroprevalence of Toxocara exposure in 66 asthmatic and 58 non-asthmatic children.
    METHODS: Exposure to Toxocara was determined by examining the serum samples of the children for specific IgG antibodies to L2 Toxocara larvae, using a commercially available diagnostic kit.
    RESULTS: There was no significant difference in the mean age, sex, social class, residence type and presence of domestic pets at home between the two children groups. Children with bronchial asthma were observed to have higher Toxocara seropositivity than that of the non-asthmatic controls (21.2 vs 8.6%, P=0.047).
    CONCLUSION: The observed relationship between exposure to Toxocara infection and bronchial asthma in Malaysian children warrants further evaluation. An understanding of any possible contribution to the pathogenesis of childhood asthma provides a potential avenue for prevention.
    Study site: Paediatric Asthma clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Asthma/epidemiology*
  4. Noorhassim I, Rampal KG, Hashim JH
    Med J Malaysia, 1995 Sep;50(3):263-7.
    PMID: 8926906
    A cross sectional study was conducted among 1007 children aged 1-2 years, from padi farming area. The percentage of male children was 51.4%. The prevalence of at least one of the chronic respiratory symptoms was 12.81%, and the prevalence of chronic cough, chronic sputum, wheezing and bronchial asthma as diagnosed by doctors were 9.33%, 3.87% 5.36% and 3.38% respectively. The overall prevalence of bronchial asthma was 6.26%. The prevalence of asthma was highest among children aged 11-12 years (8.9%) and higher among males (6.95%). No significant relationship was found between the prevalence of either chronic respiratory disease symptoms of bronchial asthma, and selected environmental factors, namely exposure to cigarette smoke, use of mosquito coil and wood stove. However there was a significant relationship between prevalence of asthma in children and history of asthma among parents and grandparents.
    Study site: Two villages in Tg. Karang (Kg. Sawah Sempadan and Kg Sri Tiram Jaya), Selangor, Malaysia
    Matched MeSH terms: Asthma/epidemiology*
  5. Tay YK, Kong KH, Khoo L, Goh CL, Giam YC
    Br J Dermatol, 2002 Jan;146(1):101-6.
    PMID: 11841373
    BACKGROUND: Atopic dermatitis is a common disease that appears to be increasing in frequency during recent decades. Most of the studies are based on the Western population, and there are few data in the Asian population.

    OBJECTIVES: To determine the prevalence and descriptive epidemiology of atopic dermatitis among school children in the general community in Singapore.

    METHODS: This is a questionnaire study of 12 323 students done over a 1-year period, comprising 7 year olds (4605), 12 year olds (3940) and 16 year olds (3778) from 19 primary and 17 secondary schools randomly selected in Singapore. All children had a complete cutaneous examination. The diagnosis of atopic dermatitis was based on the U.K. Working Party diagnostic criteria. The questionnaire was translated into Chinese and both the English and Chinese versions were issued simultaneously to the students.

    RESULTS: The 1-year period prevalence of atopic dermatitis was 20.8%. Atopic dermatitis was present in 22.7% of 7 year olds, 17.9% of 12 year olds and 21.5% of 16 year olds. The overall sex ratio was equal. There were slightly more boys with atopic dermatitis among the younger children (6 and 12 year olds, 1.18 : 1 and 1.19 : 1, respectively) but more girls were affected (1.57 : 1) among the 16 year olds. Atopic dermatitis was more common among the Chinese (21.6%) and Malays (19.8%) compared with the Indians (16%) and other races (14%). The onset of the disease occurred before the age of 10 years in 49.5% of the 16 year olds. "Pure" atopic dermatitis without concomitant respiratory allergies was noted in 788 respondents (30.7%); 1775 (69.3%) suffered from a "mixed" type, with 34.3% having allergic rhinitis, 9.5% having asthma and 25.5% having both asthma and allergic rhinitis. More boys had atopic dermatitis and concomitant respiratory allergies whereas more girls were affected with "pure" atopic dermatitis alone (1.4 : 1). At least one first-degree family member with atopy was noted in 1435 children (56%): atopic dermatitis (70%), asthma (62%) and allergic rhinitis (68%). Among siblings with one parent with atopic dermatitis, 37% had either a father or a mother with atopic dermatitis. Common aggravating factors reported included exercise, heat and sweating, grass intolerance, thick clothing and stress. Pityriasis alba was noted in 25% of the study population, keratosis pilaris in 13% and ichthyosis vulgaris in 8%. Most respondents had mild to moderate atopic dermatitis that could be controlled with a fairly simple regimen of moisturizers, topical steroids, antihistamines and antibiotics.

    CONCLUSIONS: The high prevalence of atopic dermatitis in Singapore is similar to that observed in developed countries, suggesting that environmental factors may be important in determining the expression of the disease.

    Matched MeSH terms: Asthma/epidemiology
  6. Yaacob I, Omar R, Mustafa WN
    Singapore Med J, 1991 Jun;32(3):166-8.
    PMID: 1876890
    We collected data on patients above the age of 5 years with acute bronchial asthma who presented to the emergency room of Hospital Sains Universiti Sains Malaysia during the period between 1 January to 31 March 1990. Two hundred and twelve patients (57% males and 43% females) who made a total of 271 visits were recorded. This constitutes 16.3% of all adults and paediatric medical cases seen in the emergency room during this period. The majority of patients presented between 8 pm and 6 am which contrasts with the attendance pattern due to other causes. We also recorded two peak periods of presentation (between 8 pm and 12 midnight and between 6 am and 10 am). Thirty-one (11.4%) cases resulted in admission. Of the 240 cases that were successfully treated and discharged from the emergency room, there were 59 relapses (in 45 patients). Twenty-two percent of the relapses occurred within 24 hours of the last visits. We recorded lower rates of admission as well as relapses compared to all previous studies. Our finding of bimodal pattern of presentations was also not previously reported.
    Study site: Emergency department, Hospital Sains Universiti Sains Malaysia, Kelantan, Malaysia
    Matched MeSH terms: Asthma/epidemiology*
  7. Mitchell EA, Beasley R, Keil U, Montefort S, Odhiambo J, ISAAC Phase Three Study Group
    Thorax, 2012 Nov;67(11):941-9.
    PMID: 22693180 DOI: 10.1136/thoraxjnl-2011-200901
    BACKGROUND: Exposure to parental smoking is associated with wheeze in early childhood, but in 2006 the US Surgeon General stated that the evidence is insufficient to infer a causal relationship between exposure and asthma in childhood and adolescents.
    AIMS: To examine the association between maternal and paternal smoking and symptoms of asthma, eczema and rhinoconjunctivitis.
    METHODS: Parents or guardians of children aged 6-7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis and eczema, and several risk factors, including maternal smoking in the child's first year of life, current maternal smoking (and amount) and paternal smoking. Adolescents aged 13-14 years self completed the questionnaires on these symptoms and whether their parents currently smoked.
    RESULTS: In the 6-7-year age group there were 220 407 children from 75 centres in 32 countries. In the 13-14-year age group there were 350 654 adolescents from 118 centres in 53 countries. Maternal and paternal smoking was associated with an increased risk of symptoms of asthma, eczema and rhinoconjunctivitis in both age groups, although the magnitude of the OR is higher for symptoms of asthma than the other outcomes. Maternal smoking is associated with higher ORs than paternal smoking. For asthma symptoms there is a clear dose relationship (1-9 cigarettes/day, OR 1.27; 10-19 cigarettes/day, OR 1.35; and 20+ cigarettes/day, OR 1.56). When maternal smoking in the child's first year of life and current maternal smoking are considered, the main effect is due to maternal smoking in the child's first year of life. There was no interaction between maternal and paternal smoking.
    CONCLUSIONS: This study has confirmed the importance of maternal smoking, and the separate and additional effect of paternal smoking. The presence of a dose-response effect relationship with asthma symptoms suggests that the relationship is causal, however for eczema and rhinoconjunctivitis causality is less certain.
    Matched MeSH terms: Asthma/epidemiology
  8. Liam CK, Loo KL, Wong CM, Lim KH, Lee TC
    Respirology, 2002 Dec;7(4):345-50.
    PMID: 12421243 DOI: 10.1046/j.1440-1843.2002.00409.x
    OBJECTIVE: The aim of this study was to investigate the prevalence of skin prick test (SPT) reactivity to common aeroallergens among Malaysian asthmatic patients with and without rhinitis.
    METHODOLOGY: An SPT using eight aeroallergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat fur, cockroach, Acacia sp., Bermuda grass, Aspergillus fumigatus and Aspergillus niger) was performed on 206 asthmatic patients.
    RESULTS: One hundred and forty patients (68%) were reactive to at least one of the aeroallergens. Among the SPT-positive patients, a positive prick test reaction to the house dust mites, D. pteronyssinus (93.6%), and D. farinae (81.4%) was most common, followed by cat fur (20.0%), cockroach (7.9%), Bermuda grass (7.9%), Acacia sp. (7.9%), A. fumigatus (0.7%) and A. niger (0.7%). A history of rhinitis was elicited in 111 (53.9%) patients and 95 (85.3%) of these patients were SPT-positive compared with only 45 (47.4%) of 95 patients with asthma symptoms alone (P < 0.001). The presence of rhinitis and a young age of onset of asthma were independent factors for positive SPT reaction to at least one of the aeroallergens.
    CONCLUSIONS: The prevalence of SPT reactivity to common aeroallergens is high among Malaysian asthmatics, particularly in those with an early age of onset and in those with coexisting rhinitis.
    Study site: Asthma Clinic, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
    Matched MeSH terms: Asthma/epidemiology
  9. Cyranoski D, Law YH, Ong S, Phillips N, Zastrow M
    Nature, 2018 06;558(7711):502-510.
    PMID: 29950631 DOI: 10.1038/d41586-018-05506-1
    Matched MeSH terms: Asthma/epidemiology
  10. Quah BS, Mazidah AR, Simpson H
    Asian Pac J Allergy Immunol, 2000 Jun;18(2):73-9.
    PMID: 10928618
    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. It is thus important to investigate the factors that predispose young children to wheeze. The objective of this study was to investigate the relevant environmental 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 October 1998. Nurses from these clinics distributed Bahasa Malaysia questionnaires 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 parent(s) or carer(s) of the children. A total of 2,524 (87.7%) complete questionnaires were available for analysis of risk factors. One hundred and fifty six (6.2%) children had current wheeze. 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 admission (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) history of allergic rhinitis. Among environmental factors examined, namely, household pets, carpeting in bedroom, use of fumigation mats, mosquito coils and aerosol insect repellents, maternal and paternal smoking, and air conditioning, none were associated with an increased risk of wheeze. In conclusion, the strongest association with current wheeze was a family history of asthma. Also significant were neonatal hospital admission and a history of allergic rhinitis in either the mother or father. None of the environmental factors studied were related to current wheeze in preschool children.
    Study site: Klinik Kesihatan, Kelantan, Malaysia
    Matched MeSH terms: Asthma/epidemiology
  11. Norbäck D, Hashim JH, Hashim Z, Cai GH, Sooria V, Ismail SA, et al.
    Sci Total Environ, 2017 Jan 15;577:148-154.
    PMID: 27802882 DOI: 10.1016/j.scitotenv.2016.10.148
    Few health studies exist on dampness and mould in schools in the tropics. We studied associations between fraction of exhaled nitric oxide (FeNO), respiratory symptoms and airway infections among students and dampness and fungal DNA in schools in Malaysia. A total of 368 randomly selected students from 32 classrooms in 8 secondary schools in Penang, Malaysia, participated (58% participation rate). Information on current respiratory symptoms and the home environment was collected by a standardised questionnaire. FeNO was measured by NIOX MINO (50ml/min). The classrooms were inspected and dust was collected by vacuuming on special filters and was analysed for five fungal DNA sequences by quantitative PCR. Linear mixed models and 3-level multiple logistic regression (school, classroom, student) were applied adjusting for demographic data and the home environment. Totally 10.3% reported doctor's diagnosed asthma, 15.1% current wheeze, 12.4% current asthma, 37.3% daytime breathlessness, 10.2% nocturnal breathlessness, 38.9% airway infections and 15.5% had pollen or furry pet allergy. The geometric mean of FeNO was 19.9ppb and 45% had elevated FeNO (>20ppb). Boys had higher levels of FeNO. Chinese had less daytime breathlessness than Malay (OR=0.30: p<0.001). Indoor carbon dioxide levels were low (380-720ppm). Dampness was observed in 18% of the classrooms and was associated with respiratory infections (OR=3.70; 95% CI 1.14-12.1) and FeNO (p=0.04). Aspergillus versicolor DNA was detected in 67% of the classrooms. Higher numbers of Aspergillus versicolor DNA in classroom dust were associated with wheeze (p=0.006), current asthma (p=0.002), respiratory infections (p=0.005) and elevated FeNO levels (p=0.02). In conclusion, respiratory symptoms were common among the students and the high FeNO levels indicate ongoing airway inflammation. Building dampness and the mould Aspergillus versicolor in schools in Malaysia can be risk factors for impaired respiratory health among the students.
    Matched MeSH terms: Asthma/epidemiology*
  12. Omar AH
    Acta Paediatr Jpn, 1990 Apr;32(2):183-7.
    PMID: 2116069
    In a cross-sectional study of 7 to 12-year-old primary school children in Kuala Lumpur, the prevalence of chronic cough and/or phlegm, persistent wheeze, and doctor-diagnosed asthma were 8.0%, 8.0% and 8.7%, respectively. The prevalence of asthma (defined as persistent wheeze and/or doctor-diagnosed asthma) was 13.8%. 4.3% experienced at least one episode of chest illness that resulted in inactivity for at least 3 days in the previous year. The mean age of commencement of symptoms in the doctor-diagnosed asthma group was 2.75 years. The prevalence of chronic cough and/or phlegm and persistent wheeze were highest among Indian children (p less than 0.05). More Malays had been diagnosed as having asthma than the other ethnic groups but the differences were not statistically significant. The patients' fathers' low levels of education were associated with chronic cough and/or phlegm (p less than 0.05) but not with other complaints. Asthma was significantly more common among boys than girls. No age differences were noted. Further analysis showed that persistent wheeze and doctor-diagnosed asthma were associated with increased likelihood of other respiratory illnesses or doctor-diagnosed allergy before the age of 2 years.
    Matched MeSH terms: Asthma/epidemiology*
  13. Lim FL, Hashim Z, Than LTL, Md Said S, Hashim JH, Norbäck D
    Int J Tuberc Lung Dis, 2019 11 01;23(11):1171-1177.
    PMID: 31718753 DOI: 10.5588/ijtld.18.0668
    OBJECTIVE: To examine the associations between endotoxin and (1,3)-β-glucan concentrations in office dust and respiratory symptoms and airway inflammation among 695 office workers in Malaysia.METHODS: Health data were collected using a questionnaire, sensitisation testing and measurement of fractional exhaled nitric oxide (FeNO). Indoor temperature, relative air humidity (RH) and carbon dioxide (CO₂) were measured in the offices and settled dust was vacuumed and analysed for endotoxin and (1,3)-β-glucan concentrations. Associations were analysed by two level multiple logistic regression.RESULTS: Overall, 9.6% of the workers had doctor-diagnosed asthma, 15.5% had wheeze, 18.4% had daytime attacks of breathlessness and 25.8% had elevated FeNO (≥25 ppb). The median levels in office dust were 11.3 EU/mg endotoxin and 62.9 ng/g (1,3)-β-glucan. After adjusting for personal and home environment factors, endotoxin concentration in dust was associated with wheeze (P = 0.02) and rhinoconjunctivitis (P = 0.007). The amount of surface dust (P = 0.04) and (1,3)-β-glucan concentration dust (P = 0.03) were associated with elevated FeNO.CONCLUSION: Endotoxin in office dust could be a risk factor for wheeze and rhinoconjunctivitis among office workers in mechanically ventilated offices in a tropical country. The amount of dust and (1,3)-β-glucan (a marker of indoor mould exposure) were associated with Th2 driven airway inflammation.
    Matched MeSH terms: Asthma/epidemiology*
  14. Lin HC, Cho SH, Ghoshal AG, Muttalif ARBA, Thanaviratananich S, Bagga S, et al.
    Medicine (Baltimore), 2016 Jul;95(27):e3854.
    PMID: 27399064 DOI: 10.1097/MD.0000000000003854
    Chronic respiratory diseases such as asthma, allergic rhinitis (AR), chronic obstructive pulmonary disease (COPD), and rhinosinusitis are becoming increasingly prevalent in the Asia-Pacific region. The Asia-Pacific Burden of Respiratory Diseases (APBORD) study was a cross-sectional, observational study which examined the disease and economic burden of AR, asthma, COPD, and rhinosinusitis across Asia-Pacific using 1 standard protocol. Here we report symptoms, healthcare resource use (HCRU), work impairment, and associated cost in Taiwan.Consecutive participants aged ≥ 18 years presenting to a physician with symptoms meeting the diagnostic criteria for a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled. Participants and their treating physician completed surveys detailing respiratory symptoms, HCRU, work productivity, and activity impairment. Costs including direct medical costs and indirect costs associated with lost work productivity were calculated.The study enrolled 1001 patients. AR was the most frequent primary diagnosis (31.2%). A quarter of patients presented with a combination of respiratory diseases, with AR and asthma being the most frequent combination (14.1%). Cough or coughing up phlegm was the primary reason for the medical visit for patients with asthma and COPD, whereas nasal symptoms (watery runny nose, blocked nose, and congestion) were the primary reasons for AR and rhinosinusitis. Specialists were the most frequently used healthcare resource by patients with AR (26.1%), asthma (26.4%), COPD (26.6%), and rhinosinusitis (47.3%). The mean annual cost per patient with a respiratory disease was US$4511 (SD 5395). The cost was almost double for employed patients (US$8047, SD 6175), with the majority attributable to lost productivity.Respiratory diseases have a significant impact on disease burden in Taiwan. Treatment strategies that prevent lost work productivity could greatly reduce the economic burden of these diseases.
    Matched MeSH terms: Asthma/epidemiology*
  15. Liam CK, Goh CT, Isahak M, Lim KH, Wong CM
    Asian Pac J Allergy Immunol, 2001 Jun;19(2):79-83.
    PMID: 11699724
    The objective of this study was to determine the relationship between asthma symptoms and the degree of airway obstruction as measured by the forced expiratory volume in one second (FEV1) and peak expiratory flow rate (PEFR) in a group of 64 asthmatic patients with clinically stable disease attending a university-based urban asthma clinic. Asthma symptoms did not correlate with the degree of airway obstruction as measured by prebronchodilator PEFR (total asthma symptom score vs PEFR: r = -0.214, p = 0.104, n = 59) and only correlated poorly with prebronchodilator FEV1 (total asthma symptom score vs FEV1: r = -0.256, p = 0.041, n = 64). These results lend support to the recommendation that airway obstruction should be measured objectively when assessing patients with chronic persistent asthma.
    Study site: Asthma clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Asthma/epidemiology
  16. Quah BS, Mazidah AR, Hamzah AM, Simpson H
    Asian Pac J Allergy Immunol, 2000 Mar;18(1):15-21.
    PMID: 12546053
    While many studies of the prevalence of wheeze have been conducted in schoolchildren, there have been few in pre-school children. Most children with asthma develop symptoms before the age of 5 years and many pre-school wheezers continue to wheeze in the early school years. Among the latter, those children who continue to wheeze at school age have poorer lung function than those who don't. It is thus appropriate to enquire more fully about wheeze in this age-group where its incidence is high and its relation with asthma less well defined. The objective of this study was to investigate the prevalences of wheeze, night cough and doctor diagnosed asthma in pre-school children. A cross-sectional study was conducted in five primary health clinics in the district of Kota Bharu from April to October 1998. Nurses from these clinics distributed Bahasa Malaysia questionnaires containing questions on asthma symptoms to preschool children aged 1-5 years during their home visits. The respondents were parent(s) or carer(s) of the child. The response rate was 100% and a total of 2,878 responses were analysed. The prevalence of symptoms and doctor diagnosed asthma were as follows: ever wheezed 9.4% (95% confidence interval (CI) 8.3-10.4%); current wheeze 6.2% (95% CI 5.2 to 7.0%); night cough 10.2% (95% CI 9.1 to 11.4%); and doctor diagnosed asthma 7.1% (95% CI 6.2 to 8.0%). There were no significant differences in prevalence between males and females, or among age groups. The prevalence of night cough in children with no history of wheeze was 6.9%. The cumulative and current prevalences of wheeze were similar to, and those of night cough and doctor-diagnosed asthma significantly lower than, those reported for Kelantan schoolchildren. These findings provide a baseline for assessing future symptoms trends, and perhaps also the validity of diagnosing asthma in this age group.
    Matched MeSH terms: Asthma/epidemiology*
  17. Norzila MZ, Haifa AL, Deng CT, Azizi BHO
    Med J Malaysia, 2000 Mar;55(1):33-9.
    PMID: 11072488 MyJurnal
    Objectives: (a) To examine the intra-observer reliability of the Malay language versions of two international respiratory questionnaires i.e. the International Study of Asthma and Allergy in Children (ISAAC) and the American Thoracic Society (ATS) questionnaires, and (b) using the more reliable of these questionnaires, to estimate the prevalence of asthma and allergy related symptoms in an ethnically homogenous inner city community in Kuala Lumpur.
    Methods: The study was conducted among 7 to 12 year old school children of Malay ethnic origin living in an inner city area of Kuala Lumpur. The sample consisted of 787 children attending the only primary school in the area. The Malay versions of both questionnaires were administered twice, one month apart, and were completed by parents. Agreement between the first and second responses to the same questions were assessed by Cohen’s kappa. Kappa values <0.4 were indicative of poor intra-observer reliability, 0.4-0.59 moderate reliability, 0.6-0.79 good reliability and >0.79 excellent reliability.
    Results: 77.9% and 36.3% of parents responded to the first and second administrations of the questionnaires respectively. Kappa values of >0.4 were obtained in 15/16 (93.8%) and 17/27 (63.0%) questions of the ISAAC and ATS questionnaires respectively. Excellent kappa values were obtained in 4/16 (25%) questions of the ISAAC questionnaire versus only 1/27 (3.7%) questions of the ATS questionnaire. From the ISAAC questionnaire, all questions on wheeze had good reliability while those on asthma had excellent reliability. Questions on allergic symptoms had poor to moderate reliability. In contrast, from the ATS questionnaire, questions on wheeze had moderate reliability while questions on asthma were excellent reliable. Questions on allergic symptoms had moderate to good reliability while those on cough, phlegm and bronchitis had poor reliability.
    According to the ISAAC questionnaire the prevalence of ever wheeze, wheeze in the last 12 months, ever asthma and wheeze with exercise in the last 12 months was 12.5%, 6.6%, 10.3% and 5.9% respectively. The prevalence of ever sneeze or runny nose, sneeze or runny nose in the last 12 months, watery eyes in the last 12 months and ever eczema was 15.2%, 11.1%, 4.4% and 8,5% respectively.
    Conclusions: The translated ISAAC questionnaire was more reliable than the translated ATS questionnaire. Asthma and related symptoms were common among Malay school children in inner city Kuala Lumpur.
    Matched MeSH terms: Asthma/epidemiology*
  18. Zainal N, Rahardja A, Faris Irfan CY, Nasir A, Wan Pauzi WI, Mohamad Ikram I, et al.
    Singapore Med J, 2016 Dec;57(12):690-693.
    PMID: 26805669 DOI: 10.11622/smedj.2016019
    INTRODUCTION: This study aimed to determine the prevalence of asthma-like symptoms among schoolchildren with low birth weight (LBW), and to compare the lung function of these children with that of children with normal birth weight.

    METHODS: This was a comparative cross-sectional study. We recruited children aged 8-11 years from eight primary schools in Kota Bharu, Kelantan, Malaysia. The children were divided into two groups: those with LBW (< 2,500 g) and those with normal birth weight (≥ 2,500 g). Parents of the enrolled children were asked to complete a translated version of the International Study of Asthma and Allergies in Childhood questionnaire. Lung function tests, done using a MicroLoop Spirometer, were performed for the children in both groups by a single investigator who was blinded to the children's birth weight.

    RESULTS: The prevalence of 'ever wheezed' among the children with LBW was 12.9%. This value was significantly higher than that of the children with normal birth weight (7.8%). Forced vital capacity (FVC), forced expiratory volume in one second, and forced expiratory flow when 50% and 75% of the FVC had been exhaled were significantly lower among the children with LBW as compared to the children with normal birth weight.

    CONCLUSION: LBW is associated with an increased prevalence of asthma-like symptoms and impaired lung function indices later in life. Children born with LBW may need additional follow-up so that future respiratory problems can be detected early.

    Matched MeSH terms: Asthma/epidemiology*
  19. Quah BS, Razak AR, Hassan MH
    Acta Paediatr Jpn, 1997 Jun;39(3):329-35.
    PMID: 9241894
    The prevalence and severity of asthma, rhinitis and eczema in Kelantanese schoolchildren were determined as part of an international study of the epidemiology of asthma and allergic diseases. The international study of asthma and allergies in childhood (ISAAC) written questionnaire was administered to 7055 schoolchildren from February 1995 to August 1995. The respondents were parents or guardians of 5- to 7-year-old children (n = 3939), and schoolchildren aged 12-14 years (n = 3116). The ISAAC video questionnaire (AVQ3.0) was shown to children aged 12-14 years after the written questionnaire. The overall prevalences of 'ever wheezed' and 'wheezing in last 12 months' were 9.4 and 6.0% respectively. The prevalence of 'ever diagnosed with asthma' was 9.4%. Both 'ever wheezed' and 'wheezing in the last 12 months' were significantly higher in 12- to 14-year-old children than in 5- to 7-year-old children, with P values of 0.0006 and 0.014 respectively. No gender differences in the prevalences were observed. For the complete study group, 4.7% of children had sleep disturbed by wheezing but only 1.1% had a severe attack limiting speech in the preceding 12 months. Sleep disturbance was more common in the 12- to 14-year-old children than in 5- to 7-year-old children (P = 0.006). There was no difference between the age groups for severe attacks limiting speech. The overall prevalence of rhinitis and eczema symptoms were 27 and 12%, respectively. The prevalence of rhinitis in the 12-14 year age group (38.2%) was significantly higher (P < 0.0001) than in the 5-7 year age group (18.2%). The prevalence of eczema in the 5-7 year age group (13.7%) was significantly higher (P = < 0.0001) than in the 12-14 year age group (9.9%). These prevalence data are comparable with previous reports in Malaysian children, but are considerably lower than those reported for most developed countries.
    Matched MeSH terms: Asthma/epidemiology*
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