PURPOSE: Children in minority communities have high prevalence of asthma. It is not clear if difference in socio-economic status within a ethnic community influence their risk for asthma.
METHODS: Pilot study done at Mission Day School (private elementary school with upper middle class families) and at New Salem Baptist Church (urban inner city, low income neighborhood) in Columbus, OH. All children at both centers were African Americans. Asthma risk screening was done using 4 validated questions which are part of “Easy Breathing Survey”. These four questions were episodes of wheezing, night time cough, exercise/activity related cough or wheezing or shortness of breath and prolonged colds. When surveyed at priamry care offices, positive response to any of the 4 questions had 94% sensitivity for asthma and specificity [%(95%Cl)] of each question was 83%, 66%, 81% and 86% respectively.
RESULTS: Questionnaire was sent to 105 families at both places. Fifty four families at school and 53 families at church completed the survey. Comparing data from school and church revealed median age of 7 and 9 years, M:F 28:26 and 27:26, family history of asthma 24 and 27, known asthma triggers in 16 and 18 children respectively. Nine (16%) children at both sites had previous diagnosis of asthma and among them, 8 of 9 at school and all nine at church still had positive responses to survey and majority of these children had more then one positive response suggestive of less then adequate asthma control. Additional 27 children at school and 26 at church responded positively to questions on survey though none of them had a previous diagnosis of asthma. Sixteen of 27 (57%) at school and 18 of 26 (69%)at church had more then one positive responses suggesting increased risk for asthma. Among those with positive responses, about one third at both sites had required acute care for asthma like symptoms within last one year. None of the children with negative survey required acute care for asthma like symptoms in last one year.
CONCLUSIONS: Many children in African American communities are at high risk for developing asthma irrespective of their socio-economic status. In known asthmatics, asthma control is less then adequate irrespective of their socio-economic status. More than half of children at both sites might be at high risk for undiagnosed asthma.
CLINICAL IMPLICATIONS: Risk of undiagnosed asthma in African American children is high and is independecnt of socio-economic status.
DISCLOSURE: The following authors have nothing to disclose: Shahid Sheikh, Kevin Morris, Karen McCoy
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