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Characterization of Severe Asthma in Children Aged 6 to 15 Years in a Middle-income Developing Country
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A2041 - Characterization of Severe Asthma in Children Aged 6 to 15 Years in a Middle-income Developing Country
Author Block: E. Dueñas1, C. A. Torres-Duque2, E. Correa1, M. Suarez1, C. Vásquez1, J. Jurado1, O. Barón1, A. Pachón1; 1Research, Fundación Neumológica Colombiana, Bogota, Colombia, 2Fundacion Neumologica Colombiana, Bogota, Colombia.
Introduction and rationale. In Colombia, the prevalence of asthma in children aged 5 to 17 years is 16.8%, but the proportion of severe asthma (SA) is unknown. The aim of this study was to describe the clinical and functional characteristics of children aged 6 to 15 years with diagnosis of severe asthma in a reference institution of a middle-income developing country located at high altitude (Bogota: 2.640 m). Methods. Observational, analytical, cross-sectional study in children aged 6 to 15 years with SA diagnosed according to the joint ERS/ATS criteria. Asthma questionnaires (CASI and ACT), spirometry, skin prick tests (SPT), serum total IgE and exhaled fraction of nitric oxide (FENO) were performed. Association between variables was explored by Pearson or Spearman correlation coefficients depending on the normality of data. Results: Sixty-one children were included. Most patients were male (61.3%), median age was 10 years (Interquartile range (IQR): 8-12), median BMI: 17 kg/m2 (IQR: 16-20). CASI (mean±SD): 7.7 ±2.53; ACT: 20±4.1. Median of positive SPT: 2 (IQR: 2-3). At least one SPT was positive in 88.7% of patients and 87.9% were positive for mites. The median serum total IgE was 348 UI/mL (IQR: 154-760) and the median FENO was 22 ppb (IQR: 9-41). Prebronchodilator values were (% predicted): FVC: 109.7% (±15.5%), FEV1: 98.4% (±16.3); FEV1/FVC: 82% (±8%). SPT were correlated with the FEV1/FVC (Rho: -0.34; 95% CI: -0.55 a -0.09; P=0.008). FENO was not significantly correlated with FEV1/FVC (Rho: -0.25; 95% CI: -0.52 a 0.06; P=0.10). Neither FENO nor IgE were correlated with the CASI or the ACT. Conclusions: In our population there is a higher prevalence of the atopic phenotype defined by positive SPT and high levels of total IgE and FENO. Children with more positive SPT (high atopic phenotype) had more frequently airflow obstruction. Outstandingly, there was not obesity in this group. It is necessary to study the influence of local factors, including high altitude, related to these findings.
Author Block: E. Dueñas1, C. A. Torres-Duque2, E. Correa1, M. Suarez1, C. Vásquez1, J. Jurado1, O. Barón1, A. Pachón1; 1Research, Fundación Neumológica Colombiana, Bogota, Colombia, 2Fundacion Neumologica Colombiana, Bogota, Colombia.
Introduction and rationale. In Colombia, the prevalence of asthma in children aged 5 to 17 years is 16.8%, but the proportion of severe asthma (SA) is unknown. The aim of this study was to describe the clinical and functional characteristics of children aged 6 to 15 years with diagnosis of severe asthma in a reference institution of a middle-income developing country located at high altitude (Bogota: 2.640 m). Methods. Observational, analytical, cross-sectional study in children aged 6 to 15 years with SA diagnosed according to the joint ERS/ATS criteria. Asthma questionnaires (CASI and ACT), spirometry, skin prick tests (SPT), serum total IgE and exhaled fraction of nitric oxide (FENO) were performed. Association between variables was explored by Pearson or Spearman correlation coefficients depending on the normality of data. Results: Sixty-one children were included. Most patients were male (61.3%), median age was 10 years (Interquartile range (IQR): 8-12), median BMI: 17 kg/m2 (IQR: 16-20). CASI (mean±SD): 7.7 ±2.53; ACT: 20±4.1. Median of positive SPT: 2 (IQR: 2-3). At least one SPT was positive in 88.7% of patients and 87.9% were positive for mites. The median serum total IgE was 348 UI/mL (IQR: 154-760) and the median FENO was 22 ppb (IQR: 9-41). Prebronchodilator values were (% predicted): FVC: 109.7% (±15.5%), FEV1: 98.4% (±16.3); FEV1/FVC: 82% (±8%). SPT were correlated with the FEV1/FVC (Rho: -0.34; 95% CI: -0.55 a -0.09; P=0.008). FENO was not significantly correlated with FEV1/FVC (Rho: -0.25; 95% CI: -0.52 a 0.06; P=0.10). Neither FENO nor IgE were correlated with the CASI or the ACT. Conclusions: In our population there is a higher prevalence of the atopic phenotype defined by positive SPT and high levels of total IgE and FENO. Children with more positive SPT (high atopic phenotype) had more frequently airflow obstruction. Outstandingly, there was not obesity in this group. It is necessary to study the influence of local factors, including high altitude, related to these findings.
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