Thirteen-year-old Saumil Mehta (name changed), looks like any other school boy. Probe a little deeper in his life and a different scenario emerges. He often misses school. He loves playing football but has to stay away from dust and mud. For two years, Saumil's parents mistook his asthmatic tendencies for chronic cough. "Saumil was presented with symptoms of cough, variant of asthma two years after having started to experience problems. He would not be short of breath but would cough incessantly. There was a delay in diagnosing him with asthma, which led him to lead a compromised life," said Dr Mukul Sanklecha, paediatric pulmonologist at a privately-run Bombay Hospital.
A study conducted by civic-run KEM Hospital, over a span of three years traced vulnerability of children to asthma. Asthma is a lung disease where swelling and narrowing of the airways leads to extra secretion of mucus, causing breathing difficulty and coughing specially at night or early morning. The study revealed that while several children had reported cough and breathlessness at any point of time in their life, few had taken corrective measures. Chest physicians visited 19 schools and studied 3,497 children and noticed that seven per cent of all children had underlying asthmatic symptoms due to poor lung health.
"In each year, we visited six to seven schools and conducted the study in parts. Children between 13 to 15 years in the government-aided and the BMC-run schools of Ghatkopar, Kurla, Mulund, Dadar, Byculla and Vasai were checked," said Dr Amita Athavale, head, pulmonology department at the KEM Hospital.
In schools from Dadar and Byculla, 2,904 children were screened of which 241 children (9%) reported breathlessness signs at any given point during their lifetime. However, only 95 (3%) children reported to have taken some medication. Two to three per cent children had active asthma in these schools, but upto 7% children were marked as vulnerable cases and were put in a grey zone. In areas such as Kurla, upto 15% children were cited vulnerable.
During the study, children were asked to vigorously blow air through a portable lung function device which measures "peak flow rate," (PEFR), a measurement of air blowing capacity of an individual based on his/her height and weight. It assesses the condition and capacity of the lungs and type of medication it would require to control the asthma attacks.
"Close to 20% children had PEFR measurement below average levels. This could be due to underlying respiratory infection at that time. However, due to poor lung health they would need further referrals and follow ups to check if they are vulnerable to asthma," said Athavale.
Following the study, doctors have had detailed meetings with parent-teachers associations at the schools and requested that their children be referred for further follow-ups at the hospital. Once the kind and severity of asthma is detected, it can be controlled and managed. Inhalers help delivering medication directly to the lungs. Tablets and syrups are largely ineffective. Inflammation of the airways requires only a small quantity of asthma drug (about 25 to 100 micrograms), but when taken in the form of tablets and syrups the amount administered is very large about forty times, wherein the drug also reaches to the other organs of the body where it is not required. So misdiagnosis should be avoided," warns Dr Sanklecha.
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