Temporal trends in asthma and asthma-like symptom prevalence in Skopje, The Republic of Macedonia

Abstract

Background: There have been differences in temporal trends of asthma prevalence by geographic region. It is important to consider local patterns to plan health care. The aim of this study was to assess temporal trends in asthma prevalence among young adolescents in Skopje, Republic of Macedonia as a developing country. Methods: Data was obtained from 3 cross-sectional surveys (2002, 2006 and 2015) of adolescents (12-15 years) from randomly selected schools in Skopje. Trends in the prevalence of asthma and asthma-like symptoms were investigated descriptively and using multiple logistic regression to adjust for potential confounders. Results: The prevalence of asthma increased although the changes were not statistically significant (2002: 1.7%; 2006: 2.1%; 2015: 2.6%; p=0.13). The prevalence of ever wheeze differed by year (2002: 18.4%; 2006: 15.3%; 2015: 26.4%; p<0.001). Statistically significant (p<0.05) reductions in wheeze prevalence over time (2002, 2006 and 2015) were observed for current wheeze (8.8%, 7.2% and 5.9%), exercise-induced wheeze (14.2%, 7.9% and 2.1%), and night cough (16.5%, 13.6% and 10.2%). After adjustment for potential confounders, there was an increase in asthma likelihood by year compared to 2002 (2006: OR=1.35, 95%CI=0.74-2.44; 2015: OR=2.12, 95%CI=1.04-4.35). In the adjusted analyses, associations between year and the asthma-like symptoms confirmed the descriptive results. Conclusion: A significant decrease in asthma symptoms contrary to a slight increase in asthma diagnosis in Skopje during a period of 13 years was established. Improved diagnostics and treatment may explain some of these changes.