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Vol. 48. Issue 1.
Pages 73-77 (January - February 2020)
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Vol. 48. Issue 1.
Pages 73-77 (January - February 2020)
Original Article
DOI: 10.1016/j.aller.2019.05.006
Prevalence of and factors associated with underdiagnosis of pediatric asthma in Batumi, Georgia
J.E. Zejdaa,
Corresponding author

Corresponding author.
, V. Beridzeb, T. Bakhtadzeb, S. Beridzeb, L. Abuladzec, N. Partenadzec, J. Lawsond
a Department of Epidemiology, School of Medicine, Medical University of Silesia, Katowice, Poland
b Faculty of Natural Sciences and Health Care, Shota Rustaveli State University, Batumi, Georgia
c Maternity and Child Health Center, Batumi, Georgia
d Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Canada
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Tables (3)
Table 1. Personal characteristics of 59 children with diagnosed asthma and 107 children with undiagnosed asthma.
Table 2. Allergic disorders diagnosed by physician in the past in 59 children with diagnosed asthma and 107 children with undiagnosed asthma.
Table 3. Social and environmental characteristics of 59 children with diagnosed asthma and 107 children with undiagnosed asthma.
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Background and objective

A recent survey in Batumi, Georgia showed a low prevalence of asthma in children (1.8%). A potential explanation is underdiagnosis of asthma. To investigate this, we conducted a follow up to the survey with the objective of estimating the level of childhood asthma underdiagnosis and to describe factors related to it.


Subjects included 437 survey participants who had a history of asthma-like symptoms and no diagnosis of asthma. All children underwent clinical examination (spirometry, skin prick tests, FeNO measurement) to identify new cases of asthma. The distribution of host and environmental factors was compared between the group with newly identified asthma and a group of 59 children with previously known asthma (diagnosed asthma).


Clinical investigation identified 107 cases of undiagnosed asthma. The corrected asthma prevalence estimate was 5.1% (95%CI: 4.4%–5.9%) suggesting that 65% of asthma cases were undiagnosed. Compared to children with diagnosed asthma, children with undiagnosed asthma were younger (8.2±1.6 vs. 9.3±2.1; p=0.0005), had less frequent history of allergic disorders (38.3% vs. 64.4%; p=0.001), and a lower prevalence of parental asthma (1.8% vs. 8.4%; p=0.04). The groups did not differ in terms of environmental characteristics except for more exposure to passive smoking in the undiagnosed asthma group (p=0.01). Multivariate analysis confirmed results of simple analyses.


In Batumi, 65% of children with asthma remain undiagnosed. Older age of a child, coexisting allergic disorders, and parental asthma seem to facilitate diagnosis. Implementation of current diagnostic guidelines should improve diagnostic accuracy of pediatric asthma in Batumi.



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