Acute Bronchiolitis and Other Predictors for Early Diagnosis of Childhood Asthma

Abstract

BACKGROUND: Early onset of acute bronchiolitis is associated with early onset of childhood asthma. Unfortunately, childhood asthma tends to be frequently overlooked and not optimally managed. Family pediatricians, however, possess an exceptional opportunity to recognize the connection of these conditions and promptly identify, address, and oversee children with asthma. It is important to note that childhood asthma typically begins in the early years of life, often triggered by viral infections. AIM: We aimed to analyze the early predictors linked to childhood asthma, such as previous episodes of acute bronchiolitis and the presence of atopy, to facilitate the early identification of children with childhood asthma within primary care settings. MATERIALS AND METHODS: Retrospectively analyzed data from 1652 children from health records at the Primary Health Care Polyclinic - Pediatric Primary Health Care Practice -“Vitalino” in Veles, North Macedonia. Within this cohort, 108 children had experienced acute bronchiolitis in 2016, at an age range of 0–2 years. In 2020 and 2023, the data were analyzed to determine the existence of a connection between acute bronchiolitis and other predictors with the early onset of childhood asthma. RESULTS: This retrospective research showed that from the total number of children, 108 children aged up to 2 years suffered from acute bronchiolitis, of which the analysis in 2020 showed that 50 children had atopy, 19 allergic rhinitis, 33 children had recurrent laryngitis, 24 children recurrent otitis, 68 children with recurrent bronchial obstructions (≤3), and 39 children developed early onset of bronchial asthma. The analysis in 2023 showed that 51 children have asthma. Based on the obtained results, the prevalence of acute bronchiolitis in the Republic of North Macedonia is 6.54%. If acute bronchiolitis is considered an early manifestation of childhood asthma, then the prevalence of childhood asthma in the Republic of North Macedonia is about 6.54%. CONCLUSION: Based on the obtained results, we can conclude that early onset of acute bronchiolitis is an early manifestation of childhood asthma.  Additional predictors are early signs of atopy, frequent viral infections with broncho-obstruction, allergic rhinitis, and recurrent laryngitis.