Paediatric asthma is the most common chronic respiratory disease in the developed world, with the highest prevalence found in English-speaking countries such as the US, the UK, and Australia.[4] The increasing prevalence previously reported appears to have plateaued or even declined, with a more recent US childhood prevalence of 8.5% reported.[5][6][7] In developing countries, the trend in the prevalence of asthma symptoms is mixed but generally increasing.[7] In mainland China, the prevalence of childhood asthma is low (2.1%) but has been increasing rapidly since 1998.[8] There is a variable sex effect, with a higher prevalence in prepubertal males and postpubertal females.[9][10] The exact aetiology remains unclear but may be hormone related.[11] Ethnic prevalence variability also exists; in the US, the highest rates have been found in black people.[12] There may be some under-reporting of its prevalence in ethnic minority populations.[13]

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