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Objetivo: Analizar las variaciones geograficas en la prevalencia de sintomas relacionados con el asma en ninos y adolescentes espanoles. Poblacion y metodos: Durante los anos 2001 y 2002, el International Study of Asthma and Allergies in Childhood (ISAAC) fase III estudio a 28.445 ninos de 6-7 anos de 10 areas (A Coruna, Asturias, Barcelona, Bilbao, Cartagena, Castellon, Madrid, Pamplona, San Sebastian y Valencia) y 31.257 adolescentes de 13-14 anos de 11 areas (las anteriores mas Valladolid) espanolas. Los sintomas de asma se recogieron en un cuestionario escrito completado por los padres de los ninos o por los propios adolescentes. Las variaciones geograficas de las prevalencias de los sintomas se analizaron con un modelo de regresion logistica y su correspondencia por edad mediante correlacion lineal. Resultados: La prevalencia de sibilancias recientes (ultimos 12 meses) vario entre el 7,1 y el 12,9% a los 6-7 anos, y entre el 7,1 y el 15,3% a los 13-14 anos. El riesgo mas elevado (odds ratio [OR] respecto al area de menor prevalencia) de presentar sibilancias recientes correspondio a los ninos de A Coruna (OR = 1,96; intervalo de confianza [IC] del 95%, 1,65-2,33) y Bilbao (OR = 1,83; IC del 95%, 1,54-2,18) y los adolescentes de A Coruna (OR = 2,38; IC del 95%, 2,04-2,79) y Asturias (OR = 2,37; IC del 95%, 2,03-2,77). Se comprobo una fuerte correlacion por edad en las prevalencias de sibilancias recientes de cada area geografica (r = 0,72). Conclusiones: En Espana existen, desde edades tempranas, variaciones geograficas notables en la prevalencia de sintomas de asma. Estos son mas frecuentes en los ninos y adolescentes que habitan en la fachada atlantica del pais.

Objective TO analyze geographic variations in the prevalence of symptoms related to asthma in Spanish children and adolescents. Population and methods In 2001 and 2002, the Spanish arm of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3 collected information on 28 445 children in the age bracket of 6-7 years in 10 metropolitan areas (A Coruna, Asturias, Barcelona, Bilbao, Cartagena, Castellon, Madrid, Pamplona, San Sebastian, and Valencia) and on 31 257 adolescents in the bracket 13-14 years in 11 areas (the previously named areas plus Valladolid). An asthma symptom questionnaire was filled in by parents or the adolescents themselves. Differences in symptoms between geographic areas were analyzed by fitting a logistic regression model. The relationship between symptoms and age was analyzed by linear correlation. Results The prevalence of recent wheezing (last 12 months) ranged from 7.1% to 12.9% among 6-7-year-olds and from 7.1% to 15.3% among the 13-14-year-olds. The greatest risk of recent wheezing was observed for children in A Coruna (odds ratio [OR] =1.96 in comparison with the area of lowest prevalence; 95% confidence interval [CI], 1.65-2.33) and Bilbao (OR=1.83; 95% CI, 1.54-2.18) and for adolescents in A Coruna (OR=2.38; 95% CI, 2.04-2.79) and Asturias (OR=2.37; 95% CI, 2.03-2.77). A strong correlation (r=0.72) was observed between the prevalence of recent wheezing and age in each of the geographic areas. Conclusions Considerable geographic variation in the prevalence of asthma symptoms can be seen in Spain even among young children. Symptoms are more frequent in children and adolescents who live on the Spain's northern Atlantic coast.