{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T03:08:10Z","timestamp":1776481690474,"version":"3.51.2"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:00:00Z","timestamp":1607385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Asthma is a major cause of morbidity and mortality in children worldwide, but many cases may remain undiagnosed. Community health worker (CHW) programs have improved detection of other diseases such as childhood pneumonia, but none have been validated for detection of asthma in resource\u2010poor settings. We hypothesized that a CHW administered questionnaire would be effective in case\u2010detection of asthma in a poor Nicaraguan community.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled children aged 2\u201317 from a small semiurban Nicaraguan community. A trained CHW administered a questionnaire based on a previously validated school\u2010based screening questionnaire, which was compared to pediatric pulmonologist evaluation as a reference standard. We determined the questionnaire's sensitivity, specificity, and positive and negative likelihood ratios at different score cut\u2010points.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 199 out of 218 eligible children were enrolled. Total asthma prevalence based on physician diagnosis was 33%. Mean scores on the CHW questionnaire were 3.6 points out of 22 (<jats:italic>SD<\/jats:italic>\u2009=\u20094.3) for nonasthmatics and 11.0 points (<jats:italic>SD<\/jats:italic>\u2009=\u20095.3) for children with asthma (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Area under the curve was 0.87. Multivariable analysis showed increased association of asthma\/reactive airways disease with respiratory infection in the first 3 months of life and with family history of asthma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Prevalence of asthma in this community was high compared to previously reported national prevalence (15.2%), possibly due to increased exposure to risk factors. The questionnaire had a high area under the receiver operating characteristic curve, making it an excellent screening tool. This questionnaire could greatly increase the detection of asthma, allowing for education and referral for ongoing care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.25187","type":"journal-article","created":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T13:10:56Z","timestamp":1606396256000},"page":"1145-1154","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Community health worker case\u2010detection of asthma or reactive airways disease in a resource\u2010poor community in Nicaragua"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0587-1249","authenticated-orcid":false,"given":"Mary","family":"Crocker","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine Seattle Children's Hospital  Seattle Washington USA"},{"name":"Department of Pediatrics University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0505-7893","authenticated-orcid":false,"given":"Ceila E.","family":"Loughlin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8081-2986","authenticated-orcid":false,"given":"Charles R.","family":"Esther","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5134-3164","authenticated-orcid":false,"given":"Terry","family":"Noah","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia Picado","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"AMOS Health &amp; Hope  Managua Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Woo","sequence":"additional","affiliation":[{"name":"AMOS Health &amp; Hope  Managua Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Chanchien","family":"Paraj\u00f3n","sequence":"additional","affiliation":[{"name":"AMOS Health &amp; Hope  Managua Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Paraj\u00f3n","sequence":"additional","affiliation":[{"name":"AMOS Health &amp; Hope  Managua Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7808-2507","authenticated-orcid":false,"given":"Sylvia","family":"Becker\u2010Dreps","sequence":"additional","affiliation":[{"name":"Department of Family Medicine University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2015-207199"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24713"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.106609"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.4104\/pcrj.2012.00038"},{"issue":"6","key":"e_1_2_8_6_1","first-page":"353","article-title":"Challenges in treating pediatric asthma in developing countries","volume":"14","author":"Zar HJ","year":"2012","journal-title":"Pediatric Drugs"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2004.11.002"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00004-1"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/02770900902912638"},{"issue":"2","key":"e_1_2_8_10_1","first-page":"42","article-title":"Detection and management of pneumonia by community health workers\u2014a community intervention study in Rehri village, Pakistan","volume":"47","author":"Mehnaz A","year":"1997","journal-title":"J Pak Med Assoc"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0066030"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0152204"},{"key":"e_1_2_8_13_1","unstructured":"World Health Organization. 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