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Severity of rhinitis and wheezing is strongly associated in preschoolers: A population‐based study
Author(s) -
Pereira Ana Margarida,
MoraisAlmeida Mário,
Santos Natacha,
Nunes Carlos,
Bousquet Jean,
Fonseca João Almeida
Publication year - 2015
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12430
Subject(s) - medicine , pediatrics , asthma , population , confounding , odds ratio , respiratory sounds , cross sectional study , environmental health , pathology
Abstract Background In preschool children, no study assessed the relation between wheezing and rhinitis severity. Our aims were to estimate the prevalence of current wheezing ( CW ) in preschoolers and to study the association between CW and current rhinitis ( CR ), considering its severity/persistency. Methods This is a cross‐sectional, nationwide, population‐based study including a representative sample of 5003 Portuguese children aged 3–5 years. Data were collected by a face‐to‐face interview with caregivers using an adapted ISAAC questionnaire. CW was defined as presence of ≥1 wheezing episode in the previous 12 months. Rhinitis severity/persistency was classified according to Allergic Rhinitis and its Impact on Asthma. Results Current wheezing prevalence was 24.5% [95% CI 23.3–25.7]; 9.4% of the participants had ≥4 wheezing episodes in the previous year. Children with CR had an odds ratio ( OR ) of 4.0 [95% CI 3.4–4.5] for CW ; it was highest for children with moderate–severe persistent rhinitis (11.5 [95% CI 8.1–16.3]), even after adjusting for possible confounders. Wheezers with CR reported more wheezing treatment use (p = 0.024) than those without CR . There was a trend for a higher number of wheezing episodes with more persistent and severe nasal disease – 48.4% of children with moderate–severe persistent rhinitis had >4 wheezing episodes vs. 28.9% in moderate–severe intermittent, 20.0% in mild persistent, 10.8% in mild intermittent, and 3.6% in those without CR ; p < 0.001. Conclusions Current wheezing was present in almost 25% of preschool children and was strongly associated with rhinitis, especially moderate–severe persistent disease. Preschoolers with both CW and rhinitis seem to have a more severe phenotype, emphasizing the need for concurrent evaluation of nasal and bronchial symptoms even in small children.