Distribution of severity of asthma in childhood.

OBJECTIVE To estimate the distribution of asthma severity in a population-based sample of children from Salvador, Brazil. METHODS An epidemiologically oriented questionnaire (International Study of Asthma and Allergies in Childhood, ISAAC) and a questionnaire based on criteria used in clinical practice (The Global Initiative for Asthma, GINA) were administered simultaneously to 417 children aged 5 to 12 years who reported symptoms of asthma in the past 12 months. According to the ISAAC instrument, children were classified into severe and non-severe asthma, whereas GINA clinical criteria produced four categories of severity: intermittent, mild persistent, moderate persistent and severe asthma. RESULTS Ninety children reported symptoms indicative of severity according to the ISAAC questionnaire. According to GINA criteria, 143 children had intermittent asthma, 160 mild persistent, 51 moderate and 43 severe asthma. Agreement between the two instruments was 81.3% (kappa = 0.5). CONCLUSIONS Most asthmatic children in the Salvador urban area have persistent asthma. Agreement between epidemiological and clinical classifications of asthma severity was satisfactory.