Asthma and reactive airways disease: The experience of a private pediatric practice in rural Mississippi

Little is known of the prevalence of asthma or reactive airway disease in rural communities. We hypothesized that this condition is very common in our pediatric population in rural Mississippi. The purpose of the present study was to: (1) determine the prevalence of asthma/reactive airway disease (RAD), among patients using our clinic and (2) determine the sociodemographic risk factors associated with exacerbation of symptoms in this community. A convenient sample of 399 children less than 15 years old was included in the study. Clinic records of these patients were reviewed during a one year period beginning from June 1996 to May 1997. The number of times each patient was seen in the clinic for asthma or reactive airway disease was carefully recorded. Asthma was defined as physician-diagnosed wheezing with symptoms of cough, and/or respiratory distress on three or more occasions successfully treated with bronchodilators. The term RAD was sued if these symptoms occurred in less than three occasions. The average age of the sample was 37.6 months. During a one-year period, 11% of the sample were treated for asthma, while 31% were treated for RAD. The results of stepwise linear multivariate regression analyses of independent predictors of asthma/RAD are shown in the table below. There were no interactions between any of the variables. Variables B SE of B Beta T P Very Low Birthweight (<1500 gm) 1.19 0.39 0.15 3.07 0.002 Family History of Asthma 0.34 0.12 0.14 2.86 0.005 Age of Infant Less than 24 mos 0.32 0.12 0.13 2.67 0.008 Exposed to Maternal Smoke 0.28 0.14 0.10 2.08 0.039 Breastfed for at least 2 weeks after Birth -0.29 0.14 -0.10 2.05 0.041 Male Infant 0.25 0.12 0.10 2.02 0.044 Family History of Sinus Problems 0.22 0.12 0.09 1.84 0.066 Asthma and reactive airways disease is a very common problem in our pediatric population. Early prenatal care should be emphasized to decrease the indicence of very low birthweight infants. Breastfeeding should be encouraged during prenatal visits and smoking should be absolutely discouraged in all homes with children. It is recommended that further studies be done to determine if other reasons could help explain the high prevalence of asthma and RAD disease in our community.