Correlation between parents and child's version of the child health survey for asthma questionnaire.

Background: The American Academy of Pediatrics Children's Health Survey for Asthma (CHSA) is a widely used instrument to assess various aspects of health and well-being in relation to asthma. There is a parent and a child version of this questionnaire and little is known about the concordance between these versions. Method: In a cross-sectional study conducted in 13 facilities, hospitals and outpatient clinics covering all areas of Kosovo, children with asthma aged 7-16 years were enrolled. Information about asthma diagnosis was obtained from the treating physician. Children and parents answered the CHSA, parent or child version (CHSA-C) as well as a number of questions about environmental conditions, health insurance and socio-demographic characteristics. Results: The survey included 161 Kosovar children with asthma and their caregivers. Although there were significant differences between parents and child versions regarding physical health, child activity and emotional health, with parents rating physical and emotional health higher and child activity lower, there were significant correlations (R > 0.7) for physical and child activity scales but only a low one (R = 0.25) for emotional health. Inspection of concordance for single items revealed very high correlations (>0.9) for all disease events, but a significant underestimation of the number of wheezing episodes by parents. Good agreement was found for statements about disease severity. Conclusions: The high correlation between information about children's health obtained from parents and children underlines the usefulness of parents as source of information on child's asthma. Impact of the disease on emotional health is, however, underestimated by parents.

The role of Human Development Index in the epidemiology of asthma in adolescents in Kosovo: A cross-sectional multicentre Global Asthma Network (GAN) study.

BACKGROUND: Very limited information is available on the prevalence and risk factors of asthma in adolescents in Kosovo, and no study has previously addressed the role of Human Development Index (HDI) on asthma in the region. The present study addresses these two issues. METHODS: Following the Global Asthma Network (GAN) methodology, a cross-sectional survey, through standardised self-completed questionnaires, was conducted in the following six centres of Kosovo: Ferizaj, Gjakova, Gjilan, Peja, Prishtina and Prizren. Current asthma symptoms (CAS) and severe current asthma symptoms (sCAS) were defined according to the GAN standards. Environmental questionnaire inquired about gender, exercise, screening time, siblings, truck traffic, use of paracetamol, pet ownership, and smoking habits. Height and weight were also measured. Multivariate logistic regression analyses were performed in each centre along with meta-analyses to summarise the overall effects of each factor in the centres as a whole. Meta-regression of the prevalence rates was calculated using HDI as a moderator. RESULTS: Participation rate was high (80.0-99.9%). Prevalence of CAS ranged from 4.6% to 11.3%, and sCAS from 1.7% to 4.5%. Factors associated with CAS were exercise, computer time, paracetamol use and dog ownership. sCAS was associated with paracetamol use and physical exercise. HDI explained 46% and 80% of prevalence variability of CAS and sCAS between centres, respectively. CONCLUSIONS: Prevalence of CAS and sCAS in Kosovo varies highly between centres. This variability is explained partly by HDI. Individual risk factors are common, with some determined in other studies conducted in other regions.

The role of Human Development Index in the epidemiology of asthma in adolescents in Kosovo: A cross-sectional multicentre Global Asthma Network (GAN) study

Background: Very limited information is available on the prevalence and risk factors of asthma in adolescents in Kosovo, and no study has previously addressed the role of Human Development Index (HDI) on asthma in the region. The present study addresses these two issues. Methods: Following the Global Asthma Network (GAN) methodology, a cross-sectional survey, through standardised self-completed questionnaires, was conducted in the following six centres of Kosovo: Ferizaj, Gjakova, Gjilan, Peja, Prishtina and Prizren. Current asthma symptoms (CAS) and severe current asthma symptoms (sCAS) were defined according to the GAN standards. Environmental questionnaire inquired about gender, exercise, screening time, siblings, truck traffic, use of paracetamol, pet ownership, and smoking habits. Height and weight were also measured. Multivariate logistic regression analyses were performed in each centre along with meta-analyses to summarise the overall effects of each factor in the centres as a whole. Meta-regression of the prevalence rates was calculated using HDI as a moderator. Results: Participation rate was high (80.0–99.9%). Prevalence of CAS ranged from 4.6% to 11.3%, and sCAS from 1.7% to 4.5%. Factors associated with CAS were exercise, computer time, paracetamol use and dog ownership. sCAS was associated with paracetamol use and physical exercise. HDI explained 46% and 80% of prevalence variability of CAS and sCAS between centres, respectively. Conclusions: Prevalence of CAS and sCAS in Kosovo varies highly between centres. This variability is explained partly by HDI. Individual risk factors are common, with some determined in other studies conducted in other regions (AU)

Atopic Dermatitis Much More Than Skin Disease.

INTRODUCTION: The importance of managing Atopic Dermatitis (AD) lies not only in their proper treatment, but primarily in their early detection and in the correct determination of the cause of the disease. AD is a common pruritic, chronic, relapsing, inflammatory skin disease occurring primarily, in childhood. The clinical picture of AD varies substantially depending on the age of the patient. AIM: We presented three cases of AD which fond them interesting from a lot of reasons. RESULTS: Case three is mono sensitizated against house dust mite, only (inhalants), also to milk and white egg, with symptoms of very Severe form of AD. So, we put him in hypoallergenic diet (hypoallergenic milk and diet without egg) and also started with SLIT against house dust mites. After 3 year of treatment the changes during the skin completely disappeared. This boy we have treated four years before, very successfully. The use of immunotherapy is still a matter of debate in the various guidelines for the treatment of this very complicated disease. Immunotherapy can be expressed only in the well-chosen group, sensitized patients in aeroallergens. Especially in monosensitized patients we expect satisfactory achievement (our third case, today after a treatment we achieved absolute success). But we must not forget that this therapy lasts three to five years, so patients may feel tired and physically exhausted (as in our second case). CONCLUSION: While in cases where we are dealing with polysentisizited patients and extremely sensitive (our first case), we should be very careful. Except the possibility that the patient may respond to us with undesirable reaction, we should also be very careful with the selection of the vaccine and initial dose of application. In these patients, we are looking forward for the biological therapy.

The Prevalence of Self-reported Respiratory Symptoms, Asthma and use of Asthma Medication Among Young Adolescents from Southeast Kosovo.

INTRODUCTION: Asthma is a chronic inflammatory airway disease characterized by episodes of airway narrowing leading to manifestations of symptoms such as wheeze, shortness of breath, chest tightness and cough, that may resolve spontaneously or following treatment. AIM: The aim of this paper was to present the collected data related to the prevalence of self-reported respiratory symptoms, asthma, and use of asthma medication among school children aged 13-14 years from the city of Gjilan, a municipality located in southeast Kosovo. METHODS: This was a cross-sectional study realized during the year 2018 as a part of the Project of Global Asthma Network (GAN) Phase I. The study elaborated randomly selected sample of 1200 school children from the city of Gjilan, in the southeast of Kosovo. The mean age was 13.4±0.51 with median IQR=13 (13-14). About 618 (51.5%) were male and 582 (48.5%) were female with the relation between the genders of 1:1.1. The percentage difference between the genders was not statistically significant (Difference test: Difference 3% [(-0.99-6.99) CI 95%]; Chi-square=2.159; df=1 p=0.1417). The prevalence of wheezing/ whistling in the chest EVER and the last 12 months was 12.7% vs. 6.4% respectively with no significant association between gender and symptoms (p>0.05) (Table 1). About 1132 (94.3%) had no attacks of wheezing in the last 12 MONTHS, 59 (4.9%) had 1-3 attacks, 7 (0.6%) had 4-12 attacks and 2 (0.2%) had>12 attacks. The analysis did not indicate a significant association between gender and the frequency of wheezing attacks (none / 1-3 / ≥ 4) for Pearson Chi-square: 2.5501; df=2; p=0.2801. CONCLUSION: This study has found moderately low asthma prevalence among adolescents in the southeast region of Kosovo, with no significant association between genders. Although, should be considered as an urgent need the proper examination, because asthma seems to be under-diagnosed and also untreated. It's possible that doctors in our country hesitate to diagnose asthma or the parents themselves and the children deny it.