Cough in the pediatric populationINTRODUCTIONCough is the most common symptom seen by general practitioners and persistent cough is one of the most common problems referred to pediatricians and respiratory physicians. Although most of these consultations are probably for an acute cough (cough lasting less than 2 weeks), a significant number of consultations concern chronic cough. This article focuses on chronic cough defined as cough present for more than 4 weeks.1PREVALENCEAccording to published data, the prevalence of chronic cough in children of primary school age (6-12 years) is 5-10%. . 2 Prevalence is expected to be higher among preschool children. Studies have found that the majority of children with chronic cough seen in clinics are young (median age 2 to 3 years). 3, 4 BURDEN OF DISEASEChronic cough is associated with significant morbidity in children and their parents. Use of over-the-counter (OTC) cough medications is indicative of cough burden. Additionally, people report an increased frequency of medical visits for cough before seeing a specialist. A study was carried out to evaluate the frequency of prior medical consultations for cough during the past year. It reported that more than 80% of children had 5 or more visits to the doctor and 53% had more than 10 visits before the children first presented to a pediatrician. 5PATHOPHYSIOLOGYThere is evidence that age has a direct correlation with the physiological areas involved and therefore influences the clinical manifestation where cough is a dominant feature. These physiological domains are as follows:1. Cough-specific physiology: Cough-specific physiological differences include age- and sex-related variations in cough sensitivity...... middle of document ...... Spirometry, if necessary4 Children should be further investigated and referred to a pulmonologist if Specific indicators of cough are present, other than asthma (see Box 1) Cough has not resolved by testing therapeutics. Evaluation by an otolaryngologist should be considered if there are coexisting symptoms or signs suggesting a cause of a child's cough in the upper respiratory tract or if a foreign body is suspected. These include the presence of stridor, snoring, obstructive sleep symptoms, laryngeal disorders causing aspiration (eg, laryngeal cleft), and persistent symptoms of rhinitis/rhinosinusitis.5. “A wait-and-see approach” is advised for children with nonspecific cough, as medications are generally not effective for nonspecific cough. If drugs are tested, re-evaluation is recommended in a few weeks, which is the response time for most drugs..