Asma e rinite alérgica em área rural endêmica para esquistossomose




Asthma and allergic diseases are chronic pathologies with an expressive growth in its prevalence in recent decades. However, some studies have demonstrated that in rural areas they are less frequent. The factors associated with lower prevalence in these areas are not already fully understood, but helminth infections, presence of large families and the poverty are believed to have a protective effect on the development of these diseases. This study aimed to examine the factors associated with the asthma and allergic rhinitis in 346 children and adolescents of a rural area, endemic for schistossomiasis, in the Jequitinhonha Valley, Minas Gerais. The presence of Schistosoma mansoni infection was evaluated by Kato-Katz method. The standard questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC) was applied to determine the prevalence of asthma and allergic rhinitis symptoms. Demographic and socioeconomic data as well as the environmental exposure to infectious agents and allergenic were obtained of complementary questionnaires. The weight and height were evaluated in 294 children and adolescents to determine the nutritional status. The prevalence of asthma evaluated by reports of wheeze in the last year was 12.7% and a percentage of 8.7% of the participants related medical diagnosis of asthma. The symptoms of allergic rhinitis in the last 12 months were reported by 12.4% and only 3.2% reported medical diagnosis of rhinitis. There was an association between allergic rhinitis and asthma in 4.9% of children and adolescents. The schistossomiasis was highly prevalent in the region with 57.2% of children and adolescents affected by this infection. The risk factors related with asthma were having an allergic mother (OR = 2.82; CI 95%: 1.01 - 5.43), having allergic rhinitis in the last 12 months (OR = 7.18; CI 95%: 2.88 - 17.82), being overweight or obese (OR = 4.37; CI 95%: 1.40 - 13.63). The asthma was also more frequent in the children and adolescents that lived in the houses that had bathroom (OR = 3.71; CI 95%: 1.21 11.38). The use of stream water was related to a lower risk of asthma (OR = 0.43; CI 95%: 0.19 - 0.96). In relation to allergic rhinitis, the presence of eczema (OR = 6.74; CI 95%: 1.77 - 25.58) and asthma (OR = 8.61; CI 95%: 3.49 - 21.22) symptoms in the last 12 months, being overweight or obese (OR = 3.11; CI 95%: 1.13 - 8.57) and having contact with chickens outside the house (OR = 2.51; CI 95%: 1.11 - 5.69) were associated with the risk for this disease. The family income between 1.1 and 2.0 minimum wages (OR = 0.30; CI 95%: 0.09 - 0.92), and up to 1.0 minimum wage (OR = 0.28; IC 95%: 0.10 - 0.84) was associated with a lower risk of allergic rhinitis. Although no relationship was observed between infection with S. mansoni and the presence of asthma and allergic rhinitis symptoms, lower prevalence of these diseases were found among individuals infected and with high intensity of infection. It suggests the importance of developing new studies in the future that compare the gradients of prevalence of the asthma and allergic rhinitis in urban and rural areas and that combine evaluations clinical, epidemiological and immunological for a better understanding of determinants factors for these diseases.


população rural decs enfermagem decs esquistossomose mansoni/epidemiologia decs masculino decs criança decs fatores socioeconômicos decs dissertações acadêmicas como assunto decs obesidade decs asma/epidemiologia decs feminino decs fatores de risco decs schistosoma mansoni/patogenicidade decs pré-escolar decs enfermagem teses adolescente decs questionários decs rinite/epidemiologia decs brasil decs humanos decs

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