Impact of rhinitis on asthma severity in school-age children.

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Abstract

BACKGROUND: In a population-based sample of school-age children, we investigated factors associated with rhinitis, and differences between allergic and non-allergic rhinitis. Amongst children with asthma, we explored the association between rhinitis and asthma severity. METHODS: Children participating in a birth cohort study (n=906) were reviewed at age 8 years. Asthma was defined as at least two of the following: physician-diagnosed asthma, currently using asthma medication, and current wheeze. We measured lung function (plethysmography and spirometry), and airway hyper-reactivity (AHR; methacholine challenge. RESULTS: In the analysis adjusted for the presence of asthma, children with rhinitis had significantly higher AHR (p=0.001). Maternal smoking and absence of breastfeeding were stronger predictors of non-allergic rhinitis, whereas current wheeze and eczema were stronger predictors of allergic rhinitis. Amongst asthmatics (n=159), when compared to 76 children without rhinitis, those with rhinitis (n=83) were 2.89 fold (95% CI 1.41-5.91) more likely to experience frequent attacks of wheezing, 3.44 fold (1.19-9.94) more likely to experience severe attacks of wheezing limiting speech, 10.14 fold (1.27-81.21) more likely to have frequent visit to their doctor because of asthma, and 9 fold (1.11-72.83) more likely to miss school. Reported use of intranasal corticosteroids resulted in a numerically small, but consistent reduction in risk, rendering associations between rhinitis and asthma severity non-significant CONCLUSION: We observed differences in risk factors and severity between allergic and non-allergic rhinitis. In children with asthma, rhinitis had adverse impact on asthma severity. The use of intranasal corticosteroids resulted in a small but consistent reduction in the risk. This article is protected by copyright. All rights reserved.

Keyword(s)

asthma severity; childhood asthma; childhood rhinitis

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