Adult Asian acute asthma admissions reassessed: Blackburn 1991–1992

AbstractTwo hundred and fifty-five admissions for acute asthma with a minimum 25% PEFR improvement in patients aged 15–44 years were studied in 1991–1992. Two hundred of these patients were in the white ethnic group (84 male; 116 female) with 33 (17·4%) being readmissions (15 male; 18 female). Fifty-five admissions (19 male; 36 female) were in the Indian subcontinent (ISC) ethnic group with 3 (5·5%; all female) readmissions. The readmission rate was significantly higher in the white ethnic group (χ2=4·83; 0·05<P<0·01). Admission rates per thousand population in 5-yr cohorts were calculated from the 1991 Census data. The admission rate was higher in the ISC ethnic group in all cohorts except females aged 15–19 years, and was significantly higher in males aged 15–19 years and 40–44 years, and in all four cohorts between 25–44 years in females. Initial PEFR and % initial PEFR/highest PEFR did not suggest increased severity of asthma in the ISC ethnic group

Miliary tuberculosis in a high prevalence area of the U.K.: Blackburn 1978–1993

AbstractThirty-nine cases of miliary tuberculosis treated between 1978–1993 in a district with a high incidence of tuberculosis are reported. Twenty-eight patients were of Indian Subcontinent (ISC) ethnic origin, 10 patients were Caucasian and one patient was Chinese. Mortality at 10% in both Caucasian (x2 4·94; 0·05>P>0·01) and ISC patients (x2 10·22; 0·001>P) were significantly lower than in a recently reported series from Edinburgh, as was the proportion of post mortem diagnoses of miliary tuberculosis (x2 6·35; 0·02>P>0·01). Both the rate of miliary tuberculosis and the average age at diagnosis in Caucasian patients were lower than in the Edinburgh series suggesting that miliary tuberculosis could be under-diagnosed in the elderly Caucasian population in the Blackburn district. The better outcome of those diagnosed in life may be partly due to heightened awareness of tuberculosis locally and partly due to treatment by a centralized tuberculosis service

Prevalence of asthma and ‘probable’ asthma in the Asian population in Blackburn, U.K.

AbstractLocal research had shown increased asthma admission rates in the Asian ethnic group in Blackburn, U.K. Patients also reported that asthma seemed to develop some years after first arrival in the U.K. A community prevalence survey of respiratory symptoms and asthma was undertaken in three practices with no special asthma interest. The questionnaire was administered by a Health Visitor and language link worker. Of the Asian patients in the practices, 96·6% were studied. The age distribution was similar to that of the local 1991 census. Of the patients, 181/1783 (10·2%) had diagnosed asthma but positive responses to individual questions suggested underdiagnosis of asthma. Asthma prevalence was higher in males up to age 20 (14·6% vs. 8·2%), and aged over 50 (16·5% vs. 10·5%), but higher in females aged 20–49 (5·6% vs. 9·2%). There were no correlations with social class or Jarman index, and no effect of country of origin or duration in the U.K. by multivariate analysis. The prevalence of diagnosed asthma at ages 5–9 and 10–14 was higher than in previous studies. Diagnosed asthma prevalence rates fell in the 20–49 age band but rose again in the over-50s. In all age groups the prevalence of asthma is probably underestimated. Asthma prevalence was not related to social factors. The data show that those born in the U.K. are more likely to describe regular symptoms and to be on regular treatment, but that for those born abroad there was an increasing rate of symptoms and medication use with increasing duration in the country. These observations confirm patient views but are explained by the age/sex distribution of those born in the U.K. compared to immigrants