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Int J Med Sci 2009; 6(6):348-357. doi:10.7150/ijms.6.348 This issue Cite

Research Paper

Why are some children with early onset of asthma getting better over the years? - Diagnostic failure or salutogenetic factors

Eduardo Roel¹, Olle Zetterström², Erik Trell¹, Tomas Faresjö^{1 ✉}

1. Department of Medical and Health Sciences/Community Medicine, Faculty of Health Sciences, Linköping University, SE-581 83 Linköping, Sweden.
2. Department of Clinical and Experimental Medicine /Allergy Centre, Faculty of Health Sciences, Linköping University, SE-581 83 Linköping, Sweden.

✉ Correspondence to: Tomas Faresjö, Assoc Prof., Department of Medical and Health Sciences / Community Medicine, Faculty of Health Sciences, Linköping University, SE-581 83 Linköping, Sweden. Telephone: +46 13 22 20 00; Fax: +46 13 22 40 20; E-mail: Tomas.Faresjose More

Abstract

Among children earlier having been identified with a hospital or primary care diagnosis of asthma at least once between 0-7 years of age, almost 40 % of their parents reported in the ISAAC-questionnaire as never having had asthma (NA). These are further analysed and compared with the persisting asthma cases (A) in this study. All these children's medical records were scrutinized concerning their asthma diagnose retrospectively.

The aim of this study was to analyse possible factors related to the outcome in an Asthma diagnosis reassessment by parental questionnaire at the age of ten of the children earlier having been identified with a hospital or primary health care diagnosis of asthma at least once between 0-7 years of age in a total birth-year cohort in a defined Swedish geographical area.

A multiple logistic analysis revealed four significant and independent factors associated to the improvement/non-report of asthma at the age of ten. These factors were; not having any past experiences of allergic symptoms (p<0.0001), only having one or two visits at the hospital for asthma diagnosis in the 0-7 interval (p=0.001), not living in a flat but a villa at the age of ten (p=0.029) and no previous perception of mist or mould damage in the house (p=0.052).

In the early postnatal stage, obstructive and bronchospastic symptoms typical of asthma may be unspecific, and those cases not continuing to persisting disease tend to have identifiable salutogenetic factors of constitutional rather than environmental nature, namely, an overall reduced allergic predisposition.

Keywords: asthma diagnosis, childhood asthma, diagnose setting, follow-up, salutogenetic factors.

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