Asthma is a common chronic disease of childhood and a leading cause of school absenteeism. There is concern that asthma is frequently under-diagnosed and under-treated, particularly among inner-city, minority children. Generally, the diagnosis of asthma depends first on the recognition by the parent of respiratory symptoms. However, children spend 5-10 hours a day in the elementary school setting, and if screening were feasible and effective, school nurses and other personnel could take a more active role in helping families get asthma diagnoses and medical care. We screened 21,468 elementary school aged children in 60 schools in the Houston Independent School District (34% African American, 53% Hispanic, 13% other). We used a video-guided child questionnaire followed by a parent survey to parents of children who screened positive on the child screen. The parent survey achieved a 66% response rate and prevalence estimates were adjusted for non-response. Preliminary estimates of asthma prevalence were 10% (range by school of 3.7-20.3%; 15.3% in African American children and 7.7% in Hispanic children). This study was followed by a telephone survey of the parents of 481 children who had screened positive for asthma to classify them as having either persistent or intermittent asthma according to the NAEPP guidelines and to determine currently prescribed medications. 62.4% of the children were classified as persistent asthma and 7.5% of these children had been prescribed anti-inflammatory medications. The most important challenge in the screening process has been to assure appropriate post-screening medical follow-up. Supported by NHLBI Contract # N01-HR-56079.
Learning Objectives: Participants will be able to consider 1. School-based screening procedures to identify a child with asthma? 2. Methodological and logistical problems of screening endeavors. 3. Ways to ensure appropriate follow-up to screening for school aged children
Keywords: Asthma, Screening
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.