International prevalence of recurrent wheezing during the first year of life: variability, treatment patterns and use of health resources

• Published in: Thorax Vol. 65; no. 11; pp. 1004 - 1009
• Main Authors: Mallol, Javier, García-Marcos, Luis, Solé, Dirceu, Brand, Paul
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Thoracic Society 01.11.2010; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Asthma; Asthma - epidemiology; Biological and medical sciences; Cardiology. Vascular system; Chronic obstructive pulmonary disease, asthma; Cross-Sectional Studies; Developing countries; Disease Progression; Drug Utilization - statistics & numerical data; epidemiology; Europe - epidemiology; Female; Health Services - utilization; Humans; Infant; infants; Latin America - epidemiology; LDCs; Male; Medical sciences; paediatric asthma; Pneumology; Prevalence; Public health; Questionnaires; Recurrence; Respiratory Sounds; Respiratory System Agents - administration & dosage; Respiratory Tract Diseases - drug therapy; Respiratory Tract Diseases - epidemiology; Respiratory Tract Infections - epidemiology; Sample size; Vaccines; Wheezing; Europe; Latin America; Netherlands; Spain; Relapse; Prevalence; Health; Use; Variability; Resource; Wheezing; Recurrent; Treatment; Anesthesia; Circulatory system; Cardiology; International
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thx.2009.115188

BackgroundRecurrent wheezing (RW) during the first year of life is a major cause of respiratory morbidity worldwide, yet there are no studies on its prevalence at an international level. A study was undertaken to determine the prevalence of RW in infants during their first year of life in affluent and non-affluent localities.MethodsThis international population-based study was performed in random samples of infants aged 12–15 months from 17 centres in Latin America and Europe. It uses a validated questionnaire answered by parents at the primary care health clinics where infants attend for growth/development monitoring and/or vaccine administration.ResultsAmong the 30 093 infants surveyed, 45.2% (95% CI 44.7% to 45.8%) had at least one episode of wheezing and 20.3% (95% CI 19.8% to 20.7%) had RW. The mean prevalence of RW in Latin American and European centres was 21.4% (95% CI 20.9% to 21.9%) and 15.0% (95% CI 14.0% to 15.9%), respectively (p<0.001). There was significant morbidity associated with RW in terms of severe episodes (59.4%), visits to the emergency department (71.1%) and hospital admissions (26.8%); 46.1% used inhaled corticosteroids.ConclusionsThe prevalence of RW in infants during the first year of life is high and varies between localities. A significant proportion of infants progress to a more severe condition which results in high use of health resources (visits to emergency department and hospitalisations). The prevalence of RW is lower and less severe in European than in Latin American centres, suggesting there is a higher risk for the disease in developing areas.