Journal of Education and Health Promotion

Screening asymptomatic school children for early asthma by determining airway narrowing through peak expiratory flow rate measurement

Document Type : Original Article

Authors

. Bharati Mehta
. Bharti Bhandari 1
. Anish Singhal 2
. Manisha Mavai 3
. Naveen Dutt 4
. Pankaja Raghav 5

1 Department of Physiology, GIMS, Greater Noida, Uttar Pradesh

2 Department of Physiology, GMC, Nalgonda, Telangana, India

3 Department of Physiology, GMC, Bharatpur, Rajasthan

4 Departments of Physiology Pulmonary Medicine

5 CMFM, All India Institutes of Medical Sciences, Jodhpur

Abstract
BACKGROUND: Peak expiratory flow rate (PEFR) is widely used as a predictor of treatment of
asthma patients. Peak expiratory flow and forced expiratory volume in first second (FEV1
) are the
most useful parameters for the diagnosis of asthma. Spirometry is not often available in the primary
care setting, and economic factors may limit its testing. Mild airway narrowing may be present in
asymptomatic children, which can be identified by determining their PEFR. This will enable us to
initiate early treatment.
MATERIALS AND METHODS: We selected 200 asymptomatic children at the age of 10–15 years
without a history of smoking, tuberculosis, or other respiratory illness. A family history about asthmatic
symptoms was sought. PEFR values of all children were recorded, and 40 children showed PEFR
values less than 80% of their predicted values. To confirm whether the low observed values were
because of airway obstruction, their spirometry was performed.
RESULTS: Nine out of 47 (19.14%) children from asthmatic families and 31 out of 153 (20.26%) from
nonasthmatic families showed PEFR values <80% of the predicted value (P > 0.05). Considering
a decrease in the FEV1
/forced vital capacity (FVC) ratio to <80% for the diagnosis of obstructive
disease, only two out of 35 children were found to have it. Correlation between PEFR and FEV1
/
FVC ratio was not significant (r = 0.314 and P = 0.065).
CONCLUSIONS: Asymptomatic children with low PEFR values may not show abnormal lung functions
on spirometry. However, these children, particularly those having the risk of family history of asthma,
may be followed for the development of airway obstruction.

Keywords

Airway obstruction
asthma
peak expiratory flow rate
spirometry
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Journal of Education and Health Promotion
Volume 10, Issue 3
March 2020
Pages 1-5

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