OPP6 CLINICAL PREDICTORS TO RECURRENT WHEEZING IN YOUNG CHILDREN: A CASE-CONTROL STUDY

Nordiyana Azmi1, Amanil ‘Ula Hassan2
1Pediatric Department, Hospital Tuanku Fauziah, Perlis, Malaysia
2Pediatric Department, Hospital Sultanah Bahiyah, Kedah, Malaysia

INTRODUCTION:

Wheezing disorder is a prevalent affliction among children, predominantly target the younger one. Certain children endure recurrent disruptive symptoms, necessitating frequent hospital admissions. 

OBJECTIVES:

The study aimed to identify potential risk factors for recurrent wheezing in Malaysian children under three years old.

METHODOLOGY:

A case-control study utilized data from two state hospitals in Northern Peninsular Malaysia from January 2021 till December 2022, involving children under three with wheezing episodes. “Cases” were defined as patients with recurrent wheezing (three or more episodes in year). “Controls” were selected among those who were admitted for wheezing less than three time in a year. Logistic regression analysis was performed to determine the degree of associations. 

RESULTS:

A total of 217 patients were included in the study. Out of these, 83 (38.2%) had recurrent wheezing, mostly are male (67.7%), Malay (97.2%), with a mean age of 13.1 ± 8.80 months. Positive virus isolation correlated significantly with recurrent wheezing (p=0.003). Multivariate analyses determined that younger age of wheezing onset (aOR: 0.94, 95% CI: 0.90,0.99), higher eosinophilic count (aOR: 5.99, 95% CI: 1.84, 19.46), history of intensive unit admission (aOR: 10.00, 95% CI: 4.12, 24.24), and cigarette smoke exposure (aOR: 3.69, 95% CI: 1.73, 7.86) were significantly associated with recurrent wheezing in children under 3 years old. Respiratory viruses were isolated in 43 children, predominantly Respiratory Syncytial Virus (51.1%). Eighteen cases underwent CT thorax, half of which were reported as normal.

CONCLUSIONS:

Early identification of high-risk children for recurrent wheezing is crucial to provide better treatment and to prevent severe episodic wheezing attacks.