Simple predictors to differentiate acute asthma from ARI in children: implications for refining case management in the ARI Control Programme.

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dc.contributor.authorSachdev, H Pen_US
dc.contributor.authorVasanthi, Ben_US
dc.contributor.authorSatyanarayana, Len_US
dc.contributor.authorPuri, R Ken_US
dc.date.accessioned1994-10-01en_US
dc.date.accessioned2009-05-27T05:49:51Z
dc.date.available1994-10-01en_US
dc.date.available2009-05-27T05:49:51Z
dc.date.issued1994-10-01en_US
dc.description.abstractThere is a considerable overlap in the clinical presentation of acute asthma and ARI. According to the current ARI Control Programme recommendations, a child with cough and rapid breathing is overtreated for ARI (pneumonia) with antibiotics and undertreated for asthma with bronchodilators. The present study, therefore, evaluated simple predictors to differentiate these two conditions to refine the recommended case management. In a case control comparison, children between 6 to 60 months age who presented with cough and rapid breathing due to acute asthma (n = 100) and ARI (n = 100) were evaluated. Only 34% of asthmatics had an audible wheeze. Significant independent predictors on multiple logistic regression analysis were number of earlier similar attacks and fever (or temperature). The best predictor for asthma was two or more earlier similar episodes (sensitivity 84%, specificity 84%) followed by temperature < 37.6 degrees C (sensitivity 73% and specificity 84%). Absence of fever, audible wheeze and a family history of asthma had excellent specificities (98-100%) but low sensitivities (20-34%). It is concluded that simple clinical predictors can differentiate acute asthma and ARI. The recommended case management can, therefore, be refined by either: (i) Prescribing bronchodilators and no antibiotics with two or more earlier similar episodes of cough and rapid breathing; or (ii) To further minimize undertreatment for pneumonia, prescribing bronchodilators as above, but denying antibiotics in such cases only if there is audible wheeze or family history of asthma or no fever.en_US
dc.description.affiliationDepartment of Pediatrics, Maulana Azad Medical College, New Delhi.en_US
dc.identifier.citationSachdev HP, Vasanthi B, Satyanarayana L, Puri RK. Simple predictors to differentiate acute asthma from ARI in children: implications for refining case management in the ARI Control Programme. Indian Pediatrics. 1994 Oct; 31(10): 1251-9en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/13394
dc.language.isoengen_US
dc.source.urihttps://indianpediatrics.neten_US
dc.subject.meshAcute Diseaseen_US
dc.subject.meshAmpicillin --administration & dosageen_US
dc.subject.meshAsthma --diagnosisen_US
dc.subject.meshBronchodilator Agents --administration & dosageen_US
dc.subject.meshCase-Control Studiesen_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshCough --physiopathologyen_US
dc.subject.meshDiagnosis, Differentialen_US
dc.subject.meshFever --physiopathologyen_US
dc.subject.meshForecastingen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshLogistic Modelsen_US
dc.subject.meshPneumonia, Bacterial --diagnosisen_US
dc.subject.meshRespiration --physiologyen_US
dc.subject.meshRespiratory Sounds --physiopathologyen_US
dc.subject.meshRespiratory Tract Infections --diagnosisen_US
dc.subject.meshSensitivity and Specificityen_US
dc.titleSimple predictors to differentiate acute asthma from ARI in children: implications for refining case management in the ARI Control Programme.en_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
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