Burden of Illness, Primary Care Use, and Medication Utilization among US-México Border Children with Wheezing
Among high-risk, underserved populations, such as children living along the US-México border, suffering from asthma-like symptoms without an asthma diagnosis can result in a high burden of illness. We estimated the prevalence of physician-diagnosed and possible undiagnosed asthma among students with histories of wheezing in the US-México border community of El Paso, Texas, and evaluated their burden of illness, primary care use, and medication utilization.
We analyzed cross-sectional survey data collected in May 2012. The survey included validated International Study of Asthma and Allergies in Childhood (ISAAC) items. We performed bivariate and logistic regression analyses on data from 307 students who wheezed.
Forty-two percent of students had possible undiagnosed asthma and 58% had physician-diagnosed asthma based on primary caretaker reports. Children of Mexican origin were more likely to report undiagnosed vs. diagnosed asthma (p < 0.05). Children with an asthma diagnosis were more likely to report any medication use for wheezing/asthma and to experience a higher burden of illness in the last year compared to students with possible undiagnosed asthma (p < 0.05).
The burden of illness among these children was high; however, children with asthma-like symptoms were not faring worse than children with asthma symptoms and a diagnosis. Undiagnosed children were being evaluated and receiving treatment for their symptoms; however, by not receiving a diagnosis, they were eliciting an ameliorative rather than preventive treatment strategy.
KeywordsUndiagnosed asthma Asthma burden Respiratory outcomes Racial disparities
This study was jointly supported by the National Institute of Minority Health and Health Disparities (NIMHD) and the US Environmental Protection Agency [Award Number P20 MD002287-05S1].
Compliance with Ethical Standards
The Institutional Review Board (IRB) at the University of Texas at El Paso (UTEP), and then the University of Texas, School of Public Health (UTSPH) reviewed and approved the protocol for this study. Informed consent was obtained from all participants
Conflict of Interest
The authors declare that they have no conflict of interest.
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