الفهرس 
P RESCHOOL W HEEZE
Environmental factorsOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Prevalence of recurrent wheeze in the preschool age was reported to affect one third of children in the developed world, with even more frequency and severity in the developing countries. Nearly 50% of all preschool children experience at least one episode of wheezing before 6 years of age and up to 40% of these children have recurrent wheezing episodes during early life. Epidemiological studies on this subject in Egypt are lacking.
In this retrospective cohort study, we have investigated the frequency and different phenotypes of preschool wheezes (PSW) among a group of Egyptian children and their relation to different risk factors. The study was survey based, conducted on 1209 children, aged between 6 and 10 years, recruited from the Outpatients’ Clinics of Ain Shams University Hospitals from March 2019 to March 2021. Children with underlying chronic disease or suspected to be immunodeficient were excluded. The survey composed of 30 questions included sociodemographic data details of wheezing episodes before the age of 6, wheezing risk factors and comorbidities. The investigator was responsible for interviewing the parents/caregivers. Full physical examination was applied to assess anthropometric measures, signs of respiratory disease, manifestations of allergic disease like allergic rhinitis, eczema, urticaria, …etc.
In conclusion, our retrospective study revealed that preschool wheeze is a common problem in Egypt and mounts up to 24.6 % of the preschool children. with higher body mass index, living near fume sources, need for mechanical ventilation in the neonatal period, lack of breast feeding, associated allergic rhinitis, parental allergic rhinitis or asthma, and maternal bronchial asthma representing the main risk factors for wheeze. This is while, high crowding index and pet ownership were the main risk factors, and maternal and paternal bronchial asthma, and frequent episodes of wheezes per year during their preschool years were the significant predictors of asthma persistence beyond the age of 6.
This study was limited by the retrospective design, restrictions imposed by the pandemic of COVID-19 including the limited visits of children to the outpatient clinics and the performance of pulmonary function tests and allergy tests. Also, data collected were based on parents/caregivers recall rather than medical records with possibility of bias or missing data. The limited panel of allergens tested in the study is another point where only 5 allergens were tested for persistent wheezers while the rest of the allergens were tested only in selected cases. The microbiology and respiratory viruses panel testing would add more data if were done.