The change in prevalence of wheeze in seven year old children over 19 years.

OBJECT

to determine the change in prevalence of wheeze on clinical examination and history over a 19 year period.

METHODS

a survey of random samples of seven year old children at primary schools in an urban area (Hutt Valley). Outcome measures were answers to a questionnaire and auscultation of children's chest for wheeze.

RESULTS

in 1971, 1981, and 1990, the point prevalence of clinical wheeze by auscultation remained steady between 3.2% and 5.9%. However there was a significant increase in the prevalence of reported wheeze from 23% to 36% (p less than 0.001). Between 1981 and 1990 there was a 10.7% increase in the number of children who had been to their general practitioner for wheeze (p less than 0.001), a 5.3% increase in children who were on daily medication (p less than 0.001) and a 8.2% increase in the family history of asthma (p less than 0.001). There was no significant increase in the number of children who had been to hospital for wheezing. The proportion of children who were found to be wheezing on the day and whose parents did not identify a problem in their child had not changed between 1981 and 1990.

CONCLUSION

there was an increasing high level of wheeze reported in the Hutt Valley with a corresponding steady level of clinical wheeze. More educational efforts are needed by primary health care workers to improve on parental perception of wheeze because a steady third of those children who were found to be clinically wheezing were recognised by their parents to have a problem.