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Prevalence of childhood asthma over 40 years in Greece: is the changing trend a result of diagnostic fashion?
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  • Alexandros Ntzounas,
  • Ioannis Giannakopoulos,
  • Panagiotis Lampropoulos,
  • Aggeliki Vervenioti,
  • Eleana-Georgia Koliofoti,
  • Styliani Malliori,
  • Kostas Priftis,
  • Gabriel Dimitriou,
  • Michael Anthracopoulos,
  • Sotirios Fouzas
Alexandros Ntzounas
University General Hospital of Patras
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Ioannis Giannakopoulos
University General Hospital of Patras
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Panagiotis Lampropoulos
University General Hospital of Patras
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Aggeliki Vervenioti
University General Hospital of Patras
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Eleana-Georgia Koliofoti
University General Hospital of Patras
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Styliani Malliori
University General Hospital of Patras
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Kostas Priftis
General University Hospital Attikon
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Gabriel Dimitriou
University General Hospital of Patras
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Michael Anthracopoulos
University General Hospital of Patras
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Sotirios Fouzas
University General Hospital of Patras
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Abstract

Background: A series of repeated questionnaire surveys among 8- and 9-year-old schoolchildren in the city of Patras, Greece, demonstrated a continuous rise in the prevalence of wheeze/asthma from 1978 to 2003, with a plateau between 2003 and 2008. We further investigated wheeze/asthma trends within the same environment during the last decade. Methods: Two further identical cross-sectional surveys were conducted in 2013 (N=2554) and 2018 (N=2648). Physician-diagnosed wheeze and asthma were analysed separately and in relation to their occurrence (recent-onset: solely within the last two years; non-current: prior to the last two years; persistent: both before and within the last two years). In addition, in 2018, spirometry was performed in participants reporting relevant symptoms and in a random sample of healthy controls. Results: The prevalence of current wheeze/asthma declined from 6.9% in 2008 to 5.2% in 2013 and 4.3% in 2018. The persistent and non-current wheeze/asthma groups (both including children with symptoms at preschool age) followed this overall trend, while the prevalence of recent-onset wheeze/asthma remained unchanged. Persistent and non-current wheezers were also more frequently diagnosed with asthma, in contrast to those with recent-onset wheeze. Children with recent-onset wheeze/asthma and a considerable fraction of those with persistent symptoms had lower lung function. Conclusions: The prevalence of childhood wheeze/asthma has declined significantly during the last decade in Greece. Our analysis suggests that the reversing trend is most likely attributed to changing asthma perceptions among physicians and/or parents, especially in the case of preschool children with troublesome respiratory symptoms.

Peer review status:IN REVISION

20 Mar 2021Submitted to Pediatric Pulmonology
22 Mar 2021Submission Checks Completed
22 Mar 2021Assigned to Editor
24 Mar 2021Reviewer(s) Assigned
16 Apr 2021Review(s) Completed, Editorial Evaluation Pending
22 Apr 2021Editorial Decision: Revise Major
30 Apr 20211st Revision Received
03 May 2021Submission Checks Completed
03 May 2021Assigned to Editor
03 May 2021Reviewer(s) Assigned
04 Jun 2021Review(s) Completed, Editorial Evaluation Pending
07 Jun 2021Editorial Decision: Revise Minor
08 Jun 20212nd Revision Received