How serious is asthma in children?
Asthma gravity is now categorized as:
• mild intermittent• mild persistent
• moderate persistent
• severe persistent
Underestimation of disease severity poses the greatest threat. Asthma is the third leading cause of hospitalization in children under 15 years. It is especially serious in children, particularly those under five years, their airways are narrower than those of adults, causing reservation with less air exchange and they do not respond as well to bronchodilators (drugs that open the air passages in the lungs).
Sadly, hospitalization and fatality rates among children and young adults with asthma are on the rise, these figures almost doubled between 1980 and 1993. African American children are more than six times the mortality rate compared with the Anglo-Americans in the age groups of 4 and under and 15-24 years.
Other factors associated with increased risk of death from asthma include previous episodes of life-threatening asthma, lack of proper medical care and continuous and significant behavioral problems. Death in children by asthma attack is fortunately still quite rare. In the United States, about 6,000 asthma deaths, about 500 children die each year, the elderly account for 90% of these deaths. Unfortunately, a study in children found that almost 40% of children with asthmatic symptoms not know they had the disorder.
Long-term outlook
Although bronchial responsiveness improvement in many children when they reach adolescence, improvement is generally not complete and asthma may arise again and remain a problem throughout adulthood. In one study, 72% of men and 86% of women had asthmatic symptoms fifteen years after initial diagnosis. However, only 19% of them were still seeing a doctor and only 32% were taking any medication maintenance.
Almost half of children with allergic asthma have sinus abnormalities and are at risk of recurrent or chronic sinusitis. Children whose disease is severe enough to require steroids are less likely to resolve asthma than others. There is now some evidence that severe asthma can cause lasting damage and possibly permanent scarring, indicating that it is very important to introduce anti-inflammatory drugs as soon as possible.
