Coexistence of asthmatic and non-respiratory allergic symptoms in children of Batumi Region, Georgia: occurrence and association with known diagnosis of asthma

Objectives: Our recent studies showed that in children in the Batumi region, Georgia, underdiagnosis of asthma is 65%, and that not all children with known asthma had a history of allergic disorders. So, we decided to assess the association of known diagnosis of paediatric asthma with asthma-like symptoms and non-respiratory allergic symptoms and diseases using questionnaire-derived data provided by respiratory health survey.

Methods: Subjects of the cross-sectional population-based study were 3,239 urban and 2,113 rural children aged 5-17 years whose respiratory status was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. For children with a known diagnosis of asthma, the occurrence of respiratory symptoms suggestive of asthmatic tendency and of allergic symptoms and diseases was measured and statistical association of known asthma with the respiratory and allergic symptoms was expressed as odds ratios (OR) and their 95% confidence intervals (95% CI).

Results: Respiratory and all allergic symptoms and diseases, except for eczema, were statistically significantly (p < 0.05) more prevalent in children with asthma than in children without asthma. Based on the distribution of asthma vis-à-vis asthmatic tendency without or with allergic symptoms and allergic diseases the following odds ratios expressing likelihood of asthma were obtained: for asthmatic tendency: OR = 18.09 (95% CI: 11.82-27.68), for any allergic symptom: OR = 6.85 (95% CI: 4.69-10.02), for any allergic disease: OR = 10.75 (95% CI: 7.36-15.70), for asthmatic tendency with coexisting any allergic symptom: OR = 18.94 (95% CI: 12.96-27.68), for asthmatic tendency with coexisting any allergic disease: OR = 25.65 (95% CI: 17.47-37.67), and for asthmatic tendency with coexisting any allergic symptom and allergic disease: OR = 27.02 (95% CI: 18.18-40.15).

Conclusions: The findings support the view that in epidemiological setting questionnaire-based studies on asthma seems to more readily identify cases in children with more severe clinical presentation of the disease and with coexisting allergic disorders, perhaps reflecting diagnostic practices of consulting paediatricians.