Introduction. Asthma is the commonest chronic condition of children. Diagnosis of this condition remains difficult. Many surrogate markers are used, such as documenting evidence of atopy. Method. A random sample of asthmatic children and their mothers attending the Children’s Chest and Allergy Clinic at Steve Biko Academic Hospital were enrolled. Children were classified as having atopic or nonatopic asthma. Mothers completed a questionnaire to uncover atopic features. Results. Along with their mothers, 64 children with atopic asthma and 36 with nonatopic asthma were studied. The proportion of children with atopic asthma does not differ for mothers with and without a positive SPT ( ), a history of asthma ( ), symptoms suggestive of an allergic disease ( ), or who were considered to be allergic ( ). The odds ratio of a child having atopic asthma when having a mother with a doctor diagnosed history of asthma is 4.76, but the sensitivity is low (21.9%). Conclusion. The data demonstrates that all maternal allergic or asthmatic associations are poor predictors of childhood atopic asthma. Despite the increased risk of atopic asthma in a child to a mother that has a doctor diagnosis of asthma (OR 4.76 ), this is a poor predictor of atopic asthma (sensitivity 21.9%). 1. Introduction Asthma is one of the commonest childhood illnesses. Unfortunately, in some individuals, the diagnosis remains difficult, particularly in the preschool wheezer. This leads to widespread underdiagnosis, which negatively affects the quality of life of asthmatic children. In an attempt to provide insight into the wheezy infant, much research has been conducted in order to provide markers, that may help predict and aid in the diagnosis of asthma in young individuals. Despite this, the epidemiology and disease expression of asthma and other allergic diseases still remain poorly understood. In the Northern Hemisphere, the relationship between asthma and atopy has been clearly shown [1, 2]. For this reason, the presence of atopy in children is often used as a surrogate marker to assist in making the diagnosis of asthma [2]. In the developing world and particularly in the South African context, the relationship between atopy and asthma may not be as clear [3]. Since 2005 the atopic status of asthmatic children attending the Steve Biko Academic Hospital Paediatric Asthma Clinic has been investigated. Results have demonstrated that only 49% of the children with asthma had one or more positive skin prick tests to common aero-allergens [4]. This is much lower than the atopic rate of asthmatics
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