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Sample Topic: Asthma

Asthma : Last revised in December 2013


Prognosis

  • Male children are more likely to grow out of asthma in the transition to adulthood [SIGN and BTS, 2011].
  • The earlier the onset of asthma, the better the prognosis; most children who present under 2 years of age become asymptomatic by mid-childhood (6–11 years of age) [SIGN and BTS, 2011].
  • However, early-onset asthma in atopic children may be associated with a worse prognosis [Warner, Personal Communication, 2006].
  • The Melbourne Epidemiological Study of Childhood Asthma was a 1964–1999 longitudinal study that suggested that in most children with asthma, significant wheezing continued into adult life, and the more severe or frequent the symptoms in childhood, the more likely that symptoms continued [Phelan et al, 2002; Horak et al, 2003]:
    • This study recruited children at age 7 years and followed them up through adolescence to adulthood. The proportion of people with no recent asthma increased steadily from 20% at age 14 years to 40% at age 42 years.
    • Episodic asthma in childhood tends to resolve in adolescence and early adulthood.
    • The study concluded that the pattern of asthma during childhood predicts outcome in later life, although this is not entirely reliable.
    • Of note, changes in disease prevalence, environmental factors, and treatment strategies over the study may affect the interpretation of longitudinal data [Robertson, 2002].