City kids with asthma may need more check-ups

Last Updated: 2007-11-08 11:00:52 -0400 (Reuters Health)

By Amy Norton

NEW YORK (Reuters Health) - Young inner-city children with asthma may need more frequent check-ups with the doctor to keep the condition under control, research suggests.

Researchers at Johns Hopkins University in Baltimore found that in a group of urban, minority preschoolers with asthma, symptoms often went from mild to severe within just a few months. This rapid shift suggests that children may need to see the doctor at least every three months to ensure their asthma treatment is optimal, the researchers report in the journal Pediatrics.

"Waiting three months or more is likely too long," Dr. Gregory B. Diette, the senior researcher on the study, told Reuters Health.

He and his colleagues based their findings on 150 inner-city Baltimore children ages 2 to 6 who were being treated for asthma.

Minority children in urban areas are at elevated risk of developing asthma and of having poor asthma control. Children with asthma usually have significant allergies, which trigger the airway inflammation that cause asthma symptoms. It's thought that a combination of problems -- greater exposure to air pollution and certain allergy triggers, like cockroach droppings, along with poorer access to healthcare -- contributes to the asthma problem in inner cities.

Diette and his colleagues found that of the children in their study, nearly half of those who initially had the mildest cases of asthma developed worsening symptoms within three months.

The changes were significant enough, Diette said, that the children needed a change in treatment such as new medication or a new dose.

Long gaps between doctor visits could allow children's asthma flare-ups to go unchecked, according to Diette and his colleagues. They suggest that even when a child's asthma appears to be under control, there be no more than a three-month time window between check-ups.

However, this recommendation is, for now, only relevant to inner-city minority children -- those children at greatest risk of poor asthma control.

"I don't think we can expand the data more generally yet," Diette said.

SOURCE: Pediatrics, November 2007.