Asthma among children attending kindergarten in Alsace, France, 1998: prevalence and health care

Asthma is one of the most frequent disease in childhood. The objectives of this survey were to study asthma and asthma related symptoms epidemiology in preschool children and to analyse their medical management. Methods. - A cross-sectional survey was conducted in 1998 in Alsace-France by school doctors, on a randomized sample of 2 765 pupils attending third year kindergarten. The first questionnaire accessed diagnosed asthma and asthma related symptoms history, and school absenteeism. The cumulative prevalence was estimated for diagnosed asthma on the period since birth and for asthma related symptoms unassociated with diagnosed asthma for the past 12 months. Parents who reported diagnosed asthma or asthma related symptoms unassociated with diagnosed asthma of their children were interviewed with a supplemental questionnaire examining clinical patterns, health care and asthma-related hospitalization. Results. - Prevalence of asthma was 6,5%. Prevalence of asthma related symptoms unassociated with a diagnosis of asthma was 7,2%. The "chesty" pupils school absenteeism was important. Most of the patients (91,3%) had a mild disease form. One third of them were not getting specific treatment. The drugs mostly prescribed were inhaled bronchodilators for acute episodes of asthma and antihistamines in prophylactic treatment. The rate of asthma-related hospitalization was 11,9%. Severe clinical pattern was statisticaly related to treatment and asthma-related hospitalization. Conclusion. - Asthma prevalence is high in children attending nursery school in Alsace. This disease is still nowadays undiagnosed, underinvestigated and undertreated. (C) 2002 Editions scientifiques et medicales Elsevier SAS. All rights reserved.