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Background: Clinical presentations of coronavirus disease 2019 (COVID‐19) among children with asthma have rarely been investigated. This study aimed to assess clinical manifestations and outcome of COVID‐19 among children with asthma, and whether the use of asthma medications was associated with outcomes of interest. Methods: The Global Asthma Network (GAN) conducted a global survey among GAN centers. Data collection was between November 2020 and April 2021. Results: Fourteen GAN centers from 10 countries provided data on 169 children with asthma infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). COVID‐19 was asymptomatic in 58 (34.3%), mild in 93 (55.0%), moderate in 14 (8.3%), and severe/critical in 4 (2.4%). Thirty‐eight (22.5%) patients had exacerbation of asthma and 21 (12.4%) were hospitalized for a median of 7 days (interquartile range 3–16). Those who had moderate or more severe COVID‐19 were significantly more likely to have exacerbation of asthma as compared to those who were asymptomatic or had mild COVID‐19 (adjusted odds ratio (adjOR) 3.97, 95% CI 1.23–12.84). Those who used inhaled bronchodilators were significantly more likely to have a change of asthma medications (adjOR 2.39, 95% CI 1.02–5.63) compared to those who did not. Children who used inhaled corticosteroids (ICS) did not differ from those who did not use ICS with regard to being symptomatic, severity of COVID‐19, asthma exacerbation, and hospitalization. Conclusions: Over dependence on inhaled bronchodilator may be inappropriate. Use of ICS may be safe and should be continued in children with asthma during the pandemic of COVID‐19. [ABSTRACT FROM AUTHOR]

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Background: A new lateral flow test (LFT) for office use provides information about sensitisation to common allergens. Concordance between LFT and skin-prick test (SPT) has not been assessed in epidemiological studies. The aim of this study is to determine LFT-SPT concordance in this field. Methods: Plasma samples (n = 270) from children aged 9–12 years previously SPT tested were used for the analysis. We selected 180 samples from children SPT positive to any of the 6 allergens which were common to SPT and LFT (cat, birch, timothy-grass, olive, pellitoryand Dermatophagoides pteronyssinus), and 90 samples from children SPT negative. The intensity of the LFT colour line which indicates a positive reaction was rated from 0 to 4. Results: Only results on cat, olive and D. pteronyssinus were analysed, as only these had an acceptable number of individuals. When atopy was defined as at least 1 wheal with a mean diameter ≥3 mm, agreement was excellent (Cohen’s κ = 0.81) when a lightly visible line was considered positive in the LFT, and dropped substantially (Cohen’s κ = 0.68) when this value of LFT was considered negative. The correlation between the SPT wheal diameter and the intensity of the LFT line was 0.71 for cat, 0.81 for olive and 0.78 for D. pteronyssinus.Conclusions: As compared to SPT, LFT is a reliable method to screen for sensitisation to cat dander, olive pollen and D. pteronyssinus in the epidemiological field among schoolchildren. There is a good correlation between the SPT wheal diameter and the intensity of the LFT line. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The idea of a united airway disease for asthma and rhinoconjunctivitis is supported by clinical and epidemiological data. However, many asthmatics do not have rhinoconjunctivitis and vice versa. The aim of this study was to investigate if the family history of a specific organ involvement is associated with the implication of the same organ in the allergic child. According to the organ involvement in either or both parents, the family history of 739 children who were skin prick positive to either Dermatophagoides pteronyssinus or D. farinae or both was defined as: asthma and rhinoconjunctivitis positive; asthma and rhinoconjunctivitis negative; asthma negative and rhinoconjunctivitis positive; and asthma positive and rhinoconjunctivitis negative. Asthma and rhinoconjunctivitis in the children were defined according to the International Study of Asthma and Allergies in Childhood questionnaire. Associations between each type of family history and the presence of asthma and/or rhinoconjunctivitis in the children were calculated and adjusted for usual confounders. Adjusted odds ratio of children having asthma, when family history included asthma, was 2.48 (1.38-4.45) when it also included rhinoconjunctivitis; and 2.13 (1.12-4.05) when it did not. However, family history of rhinoconjunctivitis was not associated with asthma in the child. Conversely, the odds ratio of children having rhinoconjunctivitis when family history included rhinoconjunctivitis was 1.84 (1.05-3.21) when it also included asthma; and 1.89 (1.23-2.89) when it did not. Family history of asthma was not associated with rhinoconjunctivitis in the child. In a population of children sensitized to mites, the organ or organs (nose and/or lung) which are implicated in parents tend to be also involved in their children [ABSTRACT FROM AUTHOR]

None of the epidemiological studies indicating that obesity is a risk factor for asthma in schoolchildren have used the percent body fat (PBF) to define obesity. The present study compares the definition of obesity using body mass index (BMI), PBF and the raw sum of the thickness of four skinfolds (SFT) to evaluate this condition as a risk factor for asthma. All classes of children of the target ages of 6–8 years of all schools in four municipalities of Murcia (Spain) were surveyed. Participation rate was 70.2% and the number of children included in the study was 931. Height, weight and SFT (biceps, triceps, subscapular and suprailiac) were measured according to standard procedures. Current active asthma was defined from several questions of the International Study of Asthma and Allergies in Childhood questionnaire. Obesity was defined using two standard cut-off points for BMI and PBF, and the 85th percentile for BMI, PBF and SFT. The highest quartile of each type of measurement was also compared with the lowest. A multiple logistic regression analysis was made for the various obesity definitions, adjusting for age, asthma in the mother and father and gender. The adjusted odds ratios of having asthma among obese children were different for boys and girls and varied across the different obesity definitions. For the standard cut-off points of BMI they were 1.19 [95% confidence interval (CI) 0.41–3.43] for girls and 2.00 (95% CI 0.97–4.10) for boys; however, for PBF (boys 25%, girls 30%) the corresponding figures were 1.54 (95% CI 0.63–3.73) and 1.20 (95% CI 0.66–2.21). BMI, PBF and SFT showed more consistency between each other when using the other cut-off points. BMI, PBF (except standard cut-off points) and SFT produce relatively comparable results when analysing the interaction between obesity and asthma. [ABSTRACT FROM AUTHOR]

Background: There are no internationally validated questionnaires to investigate the prevalence of infant wheezing. This study was undertaken to validate a questionnaire for the International Study on the Prevalence of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). Material and Methods: Construct and criterion validity were tested for the question ‘Has your baby had wheezing or whistling in the chest during his/her first 12 months of life?’. Construct validity (i.e. the ability of parents and doctors to refer to the same symptoms with the same words) was tested in a sample of 50 wheezing and 50 non-wheezy infants 12–15 months of age in each of 10 centres from 6 different Spanish- or Portuguese-speaking countries. Criterion validity (i.e. the ability of parents to correctly detect the symptom in the general population) was evaluated in 2 samples (Santiago, Chile and Cartagena, Spain) of 50 wheezing and 50 non-wheezing infants (according to parents) of the same age, randomly selected from the general population, who were later blindly diagnosed by a paediatric pulmonologist. Results: Construct validity was very high (κ test: 0.98–1) in all centres. According to Youden’s index, criterion validity was good both in Cartagena (75.5%) and in Santiago (67.0%). Adding questions about asthma medication did not improve diagnosis accuracy. Conclusions: The EISL questionnaire significantly distinguished wheezy infants from healthy ones. This questionnaire has a strong validity and can be employed in large international multicentre studies on wheezing during infancy. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The use of the population attributable fraction (PAF) of asthma owing to atopy has not been widely used in epidemiological studies on childhood asthma, especially to compare regions of the same country. The present study includes 1039 children from Cartagena, Spain (Mediterranean coast) and 663 from Madrid (centre of Spanish plateau) using the ISAAC phase II methodology (questionnaire and prick test to the most common allergens). While there were no differences in asthma symptoms between school children (aged 10–11 yr) from Madrid and Cartagena, atopy to any allergen was significantly higher in those from Madrid (40.9% vs. 29.3%, respectively, p < 0.0001). However, children from Madrid were mainly positive to pollen allergy whereas those from Cartagena were positive for mite allergy. PAF of all the different asthma symptoms owing to atopy (any positive skin test) and PAF of current wheezing owing to a more severe atopy (three positive wheals) were higher in children from Cartagena than those from Madrid (45.5% vs. 28.6% and 14.2% vs. 6.2%, respectively). Per cent of previous year wheezing attributable to atopy to specific allergens varied among those cities and was higher for D. pteronissinus, D. farinae, cat, and olive tree in children from Cartagena, and – conversely – higher for mixed grasses, mixed trees and Alternaria in those from Madrid. All of these differences remained significant even after adjusting for risk factors. PAF for asthma owing to atopy could be very different within the same country, probably depending on the allergen supply which may depend on environmental factors such as the climate. [ABSTRACT FROM AUTHOR]

The validity of the PhadiatopTM test as compared to the skin-prick test (SPT) for diagnosing atopy in the epidemiological field has not been studied in schoolchildren. The aim of the present study was to evaluate its validity for classifying schoolchildren 9–12 yr old into atopics and non-atopics. A total of 621 children whose parents authorized both a SPT and a blood extraction from all children participating in the phase II of the International Study of Allergies in Children (ISAAC) in Cartagena (Spain) were included in the analysis. A positive SPT was that with at least a wheal having a maximum diameter of 3 mm, once the negative value had been subtracted. PhadiatopTM was performed according to the manufacturer instructions. Diagnostic tests using SPT as the gold standard were calculated for the whole group of children and also for those with asthma or rhinoconjunctivitis and for children without any of them. The results of the tests were: sensitivity 85.0% (95% CI 82.2–87.8%), specificity 85.5% (95%CI 82.7–88.3%), positive predictive value 72.7% (95%CI 69.0–76.1%), negative predictive value 92.7% (95%CI 90.6–94.7%) and accuracy 85.3% (95%CI 82.3–88.0%). The results improved among the symptomatic groups. PhadiatopTM can be used as a valid alternative to SPT in the epidemiological setting to diagnose atopy. [ABSTRACT FROM AUTHOR]

Summary: We conducted a case–control study to clarify the risk factors for human fascioliasis in the Northern Peruvian Altiplano. Cases (n =61) were individuals who were diagnosed as having chronic fascioliasis by faecal and/or serologic (Fas2-ELISA) studies. Controls (n =61) had negative serologic and coprological results for Fasciola hepatica. We identified an association between fascioliasis and four variables (40 analysed): the habit of drinking alfalfa juice (OR=4.5; 95% CI 1.8–11.1; P <0.001); familiarity with aquatic plants (OR=4.3; 95% CI 1.8–10.6; P <0.001); dog ownership (OR=5; 95% CI 1.7–15.1; P =0.002); and raising more than five sheep (OR=0.3; 95% CI 0.1–0.8; P =0.01). According to clinical presentation and laboratory studies, dizzy spells (P =0.01), history of jaundice (P =0.01), peripheral eosinophilia (P =0.005) and Ascaris lumbricoides in stools (P =0.001) were associated with fascioliasis. The principal exposure factor for F. hepatica infection was drinking alfalfa juice. In conclusion, we suggest that human fascioliasis in Peru should be suspected in patients from livestock-rearing areas, who present with recurrent episodes of jaundice and who have a history of consumption of alfalfa juice or aquatic plants, or who have eosinophilia. [Copyright &y& Elsevier]

Suboptimal immune responses to vaccination have been suggested among atopic infants. The aim of this study was to assess the influence of atopy and atopic asthma on the humoral response to Bordetella pertussis vaccination. Immunoglobulin (Ig)G and IgA specific antibodies were measured by enzyme linked-immunosorbent assay in 102, 10-yr-old atopic children (66 of them also being asthmatics) and compared with 76 non-atopic and 53 non-atopic non-asthmatic controls of similar age. The levels of antibodies and the percentage of positives to B. pertussis were comparable in all groups. Children with a very high total serum immunoglobulin (Ig)E (Percentile (Pct) > 90th) showed higher (p = 0.01) IgG pertussis antibodies than children with very low serum IgE (Pct < 10th). In conclusion, we found normal pertussis antibody levels in atopic and in atopic asthmatic children in late childhood, thus overriding any possible suboptimal response during infancy. [ABSTRACT FROM AUTHOR]

García-Marcos L, Castro-Rodríguez JA, Montaner AE, Garde JG, Bernabé JJM, Belinchón JP for the Spanish Pediatric Asthma Study Group. The use of spirometers and peak flow meters in the diagnosis and management of asthma among Spanish pediatricians. Results from the TRAP study. Pediatr Allergy Immunol 2004: 15: 365–371. © 2004 Blackwell Munksgaard The objective of this study was to determine the level of adherence of pediatricians in Spain to the Spanish National Guidelines for Asthma Treatment with regard to the use of a peak flow meter (PEFR) or a spirometer in the diagnosis and management of asthma in childhood and to analyze sources of variations in these practices. A prospective survey (consisting of demographic and asthma knowledge sections) was conducted over a 2-wk time interval of 3000 pediatricians throughout the country. At least one part of the questionnaire was completed and returned by 2773 individuals (92.4%), with 2347 (78.2%) answering both sections; results are for this population. Around 62% of the pediatricians reported having a peak flow meter or a spirometer in their office; however, only 33% and 48% of them used the devices for the diagnosis and treatment of asthma, respectively. There was a significant association between being older (36–55 yr old) and using PEFR or spirometry for the diagnosis (OR: 1.35, 95% CI 1.11–1.66) and the management (OR 1.47, 95% CI 1.22–1.77) of asthma. Males used a peak flow meter or a spirometer more often than females for the diagnosis (37.8% vs. 30.9%, p = 0.001) and management of asthma (52.0% vs. 45.6%, p = 0.008). Pediatricians with formal pediatric residence training used these devices more for the diagnosis (OR: 1.39, 95% CI 1.09–1.75) and management (OR: 1.58, 95% CI 1.27–1.96) than those without. Working in a hospital was also related with more peak flow meter or spirometer use than working in health centers (OR: 2.08, 95% CI 1.71–2.54 for diagnosis; OR: 1.83, 95% CI 1.50–2.22 for management). About one-third of the Spanish pediatricians surveyed use spirometers and/or peak flow meters for diagnosing asthma and about half use one of these devices occasionally for managing the disease. Independent factors favoring their use are: age 36–55 yr, male gender, working in a hospital setting, and having been trained in a formal pediatric residence program. [ABSTRACT FROM AUTHOR]

The article presents an update on data of the study related to prevalence and severity of asthma symptoms in the phase three of the International Study of Asthma and Allergies in Childhood (ISAAC) by D. Sole and others published in the journal. Topics discussed include prevalence of asthma and eczema in adolescents in Brazil; standardization of asthma therapy as a factor for reducing asthma morbidity and mortality; and increase in prevalence except asthma that show declining trend.

The aim of this study was to evaluate the relative contribution of several risk factors to the prevalence of allergic respiratory symptoms, and the positivity of the bronchodilator test with fenoterol, and to establish the relative importance of these factors on the variability of FVC, FEV1, PEF, MEF25, MEF50 and MEF75. A total of 340 11‐year‐old children attending school in polluted and non‐polluted areas of the city of Cartagena, Spain, were studied. The polluted area had had an annual mean of 75 μg/m3 of SO2 over the last 10 years and the non‐polluted area had < 20 μg/m3 during this period. A questionnaire about allergic respiratory symptoms was completed by the parents. Specific questions about parental smoking habits and socio‐economic level were included. Each child’s performance in spirometry before and after administration of 0.2 mg of inhaled fenoterol was evaluated. The only significant predictive variables in the logistic regression (for suffering any symptom or a positive bronchodilator response) were male sex for nasal symptoms (RR 1.37; p = 0.04) and housing near heavy traffic for eye symptoms (RR 1.45; p = 0.01). Living in the polluted area reduced the risk of a positive bronchodilator response (RR 0.61; p = 0.004). Maternal smoking, even though not statistically significant, tended to increased the risk of suffering any symptom (RR 1.26; p = 0.07) or of having a positive bronchodilator response (RR 1.23; p = 0.1). None of the risk factors studied was of significant importance in explaining the variability of spirometry results. Although none of the risk factors were specifically determinant to the symptom questions, bronchodilator test or spirometric measurements, having a mother who smokes seems more important than living in a polluted area if statistically non‐significant trends are considered. [ABSTRACT FROM AUTHOR]

Current diagnostics for tuberculosis (TB) only manage to confirm a small proportion of children with TB and require respiratory samples, which are difficult to obtain. There is a need for non-invasive biomarker-based tests as an alternative to sputum testing. Fujifilm SILVAMP TB lipoarabinomannan (FujiLAM), a lateral-flow test to detect lipoarabinomannan in urine, is a novel non-sputum-based point-of-care diagnostic reported to have increased sensitivity for the diagnosis of TB among human immunodeficiency virus (HIV)-infected adults. We evaluate the performance of FujiLAM in children with presumptive TB. Fifty-nine children attending a paediatric hospital in Haiti with compatible signs and symptoms of TB were examined using Xpert MTB/RIF, smear microscopy and X-rays, and classified according to the certainty of diagnosis into bacteriologically confirmed TB (n = 5), unconfirmed TB (bacteriologically negative, n = 50) and unlikely TB (n = 4). Healthy children (n = 20) were enrolled as controls. FujiLAM sensitivity and specificity were 60% and 95% among children with confirmed TB. FujiLAM's high specificity and its characteristics as a point-of-care indicate the test has a good potential for the diagnosis of TB in children. [ABSTRACT FROM AUTHOR]