Epidemiology of asthma
- Augusto A Litonjua, MD
Augusto A Litonjua, MD
- Professor of Medicine and Pediatrics
- Golisano Children's Hospital of University of Rochester Medical Center
- Scott T Weiss, MD, MS
Scott T Weiss, MD, MS
- Professor of Medicine
- Harvard Medical School
Accurate assessment of the prevalence of asthma has been hindered by varying definitions of asthma and methods of data collection, each combining to make data comparison across studies difficult. Following a brief discussion about the definition of asthma and the identification of affected individuals, studies of asthma prevalence are reviewed. The definition, diagnosis, and treatment of asthma are discussed in detail elsewhere. (See "Diagnosis of asthma in adolescents and adults" and "An overview of asthma management".)
Essential to any study of prevalence are the definition of the disease being studied and the methods available to identify affected individuals. Although many definitions and methods of data collection have been used and reported, herein we discuss the most common.
Definition — A definition of asthma that incorporates both a positive test of airway hyperresponsiveness and symptoms was proposed and tested for epidemiologic purposes . The study defined "current asthma" as bronchial hyperresponsiveness (BHR) in the presence of wheezing in the 12 months prior to the study. According to this definition:
●"Current asthma" identified a group of children with more severe BHR, greater peak flow variability, more symptoms, more atopy, and more medication use than children with BHR alone or wheeze alone
●Children who only had wheeze did not differ from the normal group except in reporting symptoms and in more associated use of asthma medications
Subscribers log in hereLiterature review current through: Sep 2017. | This topic last updated: Aug 03, 2017.References
- Toelle BG, Peat JK, Salome CM, et al. Toward a definition of asthma for epidemiology. Am Rev Respir Dis 1992; 146:633.
- Enarson DA, Vedal S, Schulzer M, et al. Asthma, asthmalike symptoms, chronic bronchitis, and the degree of bronchial hyperresponsiveness in epidemiologic surveys. Am Rev Respir Dis 1987; 136:613.
- Weiss ST, Speizer FE. Epidemiology and natural history. In: Bronchial Asthma Mechanisms and Therapeutics, 3rd ed, Weiss EB, Stein M (Eds), Little, Brown, Boston 1993. p.15-25.
- Jenkins MA, Clarke JR, Carlin JB, et al. Validation of questionnaire and bronchial hyperresponsiveness against respiratory physician assessment in the diagnosis of asthma. Int J Epidemiol 1996; 25:609.
- Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet 1998; 351:1225.
- Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC). Eur Respir J 1998; 12:315.
- Lai CK, Beasley R, Crane J, et al. Global variation in the prevalence and severity of asthma symptoms: phase three of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax 2009; 64:476.
- Variations in the prevalence of respiratory symptoms, self-reported asthma attacks, and use of asthma medication in the European Community Respiratory Health Survey (ECRHS). Eur Respir J 1996; 9:687.
- Sembajwe G, Cifuentes M, Tak SW, et al. National income, self-reported wheezing and asthma diagnosis from the World Health Survey. Eur Respir J 2010; 35:279.
- Eder W, Ege MJ, von Mutius E. The asthma epidemic. N Engl J Med 2006; 355:2226.
- Masoli M, Fabian D, Holt S, et al. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy 2004; 59:469.
- Weiss KB, Wagener DK. Asthma surveillance in the United States. A review of current trends and knowledge gaps. Chest 1990; 98:179S.
- Centers for Disease Control and Prevention (CDC). Asthma--United States, 1982-1992. MMWR Morb Mortal Wkly Rep 1995; 43:952.
- Mannino DM, Homa DM, Akinbami LJ, et al. Surveillance for asthma--United States, 1980-1999. MMWR Surveill Summ 2002; 51:1.
- Moorman JE, Rudd RA, Johnson CA, et al. National surveillance for asthma--United States, 1980-2004. MMWR Surveill Summ 2007; 56:1.
- Centers for Disease Control and Prevention (CDC). Vital signs: asthma prevalence, disease characteristics, and self-management education: United States, 2001--2009. MMWR Morb Mortal Wkly Rep 2011; 60:547.
- Akinbami LJ, Simon AE, Rossen LM. Changing Trends in Asthma Prevalence Among Children. Pediatrics 2016; 137.
- Maio S, Baldacci S, Carrozzi L, et al. Respiratory symptoms/diseases prevalence is still increasing: a 25-yr population study. Respir Med 2016; 110:58.
- Backman H, Räisänen P, Hedman L, et al. Increased prevalence of allergic asthma from 1996 to 2006 and further to 2016-results from three population surveys. Clin Exp Allergy 2017.
- de Korte-de Boer D, Mommers M, Gielkens-Sijstermans CM, et al. Stabilizing prevalence trends of eczema, asthma and rhinoconjunctivitis in Dutch schoolchildren (2001-2010). Allergy 2015; 70:1669.
- Kim BK, Kim JY, Kang MK, et al. Allergies are still on the rise? A 6-year nationwide population-based study in Korea. Allergol Int 2016; 65:186.
- Weiss KB, Gergen PJ, Crain EF. Inner-city asthma. The epidemiology of an emerging US public health concern. Chest 1992; 101:362S.
- Masoli M, Fabian D, Holt S, Beasley R. Global burden of asthma. http://www.ginasthma.org/local/uploads/files/GINABurdenSummary_1.pdf (Accessed on March 12, 2013).
- Kemp T, Pearce N. The decline in asthma hospitalisations in persons aged 0-34 years in New Zealand. Aust N Z J Med 1997; 27:578.
- Wijesinghe M, Weatherall M, Perrin K, et al. International trends in asthma mortality rates in the 5- to 34-year age group: a call for closer surveillance. Chest 2009; 135:1045.
- Centers for Disease Control and Prevention (CDC). Asthma mortality and hospitalization among children and young adults--United States, 1980-1993. MMWR Morb Mortal Wkly Rep 1996; 45:350.
- Centers for Disease Control and Prevention (CDC). Asthma mortality -- Illinois, 1979-1994. MMWR Morb Mortal Wkly Rep 1997; 46:877.
- Weiss KB, Gergen PJ, Wagener DK. Breathing better or wheezing worse? The changing epidemiology of asthma morbidity and mortality. Annu Rev Public Health 1993; 14:491.
- Baïz N, Annesi-Maesano I. Is the asthma epidemic still ascending? Clin Chest Med 2012; 33:419.