Background and Objective: Although the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire has been used in many countries and has been validated previously, it has not been used in Australian Indigenous communities. We endeavoured to assess its performance when administered in Aboriginal and Torres Strait Islander communities.
Methods: In a cross-sectional study, we assessed the ISAAC's questionnaire when administered face-to-face in Indigenous communities in the Torres Strait region, Australia.
Results: Comparing responses to the questionnaire with clinical assessment of 260 Indigenous children by a pediatric respiratory physician, sensitivity (87%) was high, but specificity (51%) and positive predictive value (33%) were low. Using a logistic regression model, we determined which questions were most useful in predicting a clinical diagnosis of asthma. Using a predictive equation, asthma was detected with 79% sensitivity and 77% specificity, and the calculated weighted estimate of asthma prevalence in the region was 16.3%.
Conclusion: Our findings reveal that although the ISAAC questionnaire is a reasonably sensitive tool for both epidemiologic and clinical studies of asthma in Indigenous communities, its value is enhanced when used in conjunction with a predictive model. We have also shown that asthma is prevalent in the Torres Strait region.
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- Asthma and atopy in four rural Australian Aboriginal communities.Med J Aust. 1996; 165: 192-196
- High prevalence of asthma in five remote indigenous communities in Australia.Eur Respir J. 2001; 17: 1089-1096
- Validation of questionnaire and bronchial hyperresponsiveness against respiratory physician assessment in the diagnosis of asthma.Int J Epidemiol. 1996; 25: 609-616
- The St George's Respiratory Questionnaire.Respir Med. 1991; 85: 25-31
- Questionnaire of the ECSC on respiratory symptoms.Eur Repir J. 1989; 2: 1021-1022
- International study of asthma and allergies in childhood (ISAAC): rationale and methods.EurRespir J. 1995; 8: 483-491
- Self-reported prevalence of asthma symptoms in children in Australia, England, Germany and New Zealand: an international comparison using the ISAAC protocol.Eur Respir J. 1993; 6: 1455-1461
- Epidemiological study of wheeze, doctor diagnosed asthma, and cough in preschool children in Leicestershire.BMJ. 1993; 306: 1386-1390
- What do parents of wheezy children understand by “wheeze”?.Arch Dis Child. 2000; 82: 327-332
- Survey of respiratory sounds in infants.Arch Dis Child. 2001; 84: 35-39
- Parents' interpretations of children's respiratory symptoms on video.Arch Dis Child. 2001; 84: 31-34
- Asthma management in indigenous children of a remote community using an indigenous health model.J Paediatr Child Health. 2000; 36: 249-251
- Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC.Lancet. 1998; 351: 1225-1232
- Asthma: classification, clinical patterns and natural history.Baillieres Clin Paediatr. 1995; 3: 307-318
- Asthma and wheezing in the first six years of life. The Group Health Medical Associates.N Engl J Med. 1995; 332: 133-138
- Applied regression analysis and other multivariate methods. 2nd ed. Duxbury Press, Belmont, CA1988
- Index for rating diagnostic tests.Cancer. 1950; 3: 32-35
- Essentials of medical statistics.Blackwell Scientific Publications, Oxford1992
- Modern epidemiology. 2nd ed. Lippicott-Raven Publishers, Philadelphia1998 (p. 354)
- Prevalence of respiratory symptoms among 7 and 11 year old schoolchildren and association with asthma.Arch Dis Child. 1989; 64: 1118-1125
- Reproducibility of childhood respiratory symptom questions.Eur Respir J. 1992; 5: 930-935
- The natural history of respiratory symptoms in preschool children.Am J Respir Crit Care Med. 1995; 52: 1872-1878
- Night cough counts and diary card scores in asthma.Arch Dis Child. 1985; 60: 473-474
- Poor agreement between reported and recorded nocturnal cough in asthma.Pediatr Pulmonol. 1993; 15: 209-211
- Cough—but is it asthma?.Arch Dis Child. 1994; 70: 1-2
- State of the art: cough, cough receptors, and asthma in children.Pediatr Pulmonol. 1999; 28: 59-70
- Asthma morbidity in Australia: an epidemiological study.Med J Aust. 1992; 156: 827-831
- Comparison of the ISAAC video questionnaire (AVQ3.0) with the ISAAC written questionnaire for estimating asthma associated with bronchial hyperreactivity.Clin Exp Allergy. 1997; 27: 540-545
- Underdiagnosis and under treatment of asthma in childhood.BMJ. 1983; 286: 1253-1256
- Role of bronchial responsiveness testing in asthma prevalence surveys.Thorax. 2000; 55: 352-354
- Bronchial responsiveness and its measurements.in: Silverman M. Childhood asthma and other wheezing disorders. Chapman & Hall, London1995: 142-174
- Wheezing phenotypes in childhood.Thorax. 1997; 52 ([editorial comment]): 936-937
- Characteristics associated with rapid decline in forced expiratory volume.Ann Epidemiol. 1996; 6: 217-227
Chang AB, Masel JP, Masters B. Post-infectious bronchiolitis obliterans: clinical, radiological and pulmonary function sequelae. 1998; 28(1):23–9.
- Asthma epidemiology: principles and methods. Oxford University Press, New York1998
- The Macquarie Dictionary. 4th ed. The Macquarie Library Pty Ltd., North Ryde, North Ryde, NSW2001
© 2003 Elsevier Inc. Published by Elsevier Inc. All rights reserved.