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Delay in Asthma Diagnosis and Risk of Common Respiratory Infection in Young Children
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Mir Ali, Elizabeth Krusemark, Chung I. Wi, MD, Sunghwan Sohn, PhD, Hongfang Liu, PhD, Euijung Ryu, PhD, Young J. Juhn, MD MPH
Rationale: While asthma is associated with increased risk of respiratory infections, little is known about the impact of a delay in asthma diagnosis on the risk of respiratory infections among young children.

Methods: A random sample of a birth cohort (2011-2012) was enrolled for a retrospective study.  Using predetermined asthma criteria, we defined “delayed asthma diagnosis” if the asthma index date when the criteria was first met regardless of physician diagnosis was 1 month or greater prior to a physician diagnosis of asthma. History of Streptococcal pyogenes upper respiratory infection and tympanostomy tube insertion (a proxy of recurrent and persistent otitis media) and availability of asthma medications were evaluated in relation to a delay in asthma diagnosis.

Results: Among 150 subjects, 53% were male, 95% Caucasian, and median age at the last follow-up date was 2.8 years (IQR: 2.6-3.1). Thirty-eight subjects (25%) met the criteria for asthma, of whom 29 (76%) had delayed asthma diagnosis (median delay: 1.7 year). Children who had delayed asthma diagnosis tend to have less prescription for any asthma medication compared to those who did not (median number of dispensing: 0.6 vs. 2.0 per year, p=0.10).  All subjects with tympanostomy tube insertion (n=9) and/or Streptococcal infection (n=4) had delayed asthma diagnosis.

Conclusions: A significant proportion of children have delayed asthma diagnosis, which might limit access to preventive and therapeutic interventions for asthma potentially resulting in the increased risk of common respiratory infections during early childhood. Future studies with a larger sample-size needs to replicate our findings.