Asma no adolescente prevalência, gravidade e fatores de risco associados em São José do Rio Preto - SP.

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Asthma is a serious public health problem worldwide, due to its frequency, morbidity and increasing prevalence, especially in childhood. Comparative studies on asthma prevalence among distinct regions and periods of time reveal differences which are essential to monitor the secular trend of asthma occurrence and suggest hypotheses about its causes. With simple and standardized methodology, the International Study of Asthma and Allergies in Childhood (ISAAC) provided such comparisons, maximizing the results of epidemiological studies on asthma. OBJECTIVES: To estimate the prevalence, symptoms related, and severity of asthma in schoolchildren aged 13 and 14 years of public and private schools at São José do Rio Preto and identify risk factors associated with asthma and severe asthma. METHODS: Initially, in cross-sectional study, 4 498 adolescents selected by conglomerate sampling, answered the written questionnaire of ISAAC. Subsequently, were selected from previous population, 555 students for a case-control study, in the proportion of one case to two controls. The ISAAC complementary questionnaires on potential risk factors for asthma was answered by parents of students and after formal consent were submitted to skin prick test for investigation of atopy. The association between variables of response and predictors was assessed by univariate analysis (Chi-square or Fischer) and multivariate analysis (logistic regression). RESULTS: Were found the following prevalence of asthma: 35.0% of cumulative; 16.0% of current; 9.5% of medical diagnosis; 13.2% of wheezing following exercise; 31.7% of nocturnal cough; 5.6 % of severe asthma (defined by positive responses to two or more of the following questions: four or more attacks per year, nocturnal awakening at some time in weeks, difficulty in speaking and wheezing following exercise). The risk factors associated with asthma were: paternal asthma, sensitization to Der p, to cockroach, current eczema, current smoking mother and during the 1st year of life; carpet in the bedroom, studying in the northern region, prematurity, current rhinitis and diet Abstract | xiv without raw vegetables. Not use wool blanket and have a few brothers (until 2) were indirectly associated with asthma. The risk factors associated with severe asthma were: severe eczema, severe rhinitis, prematurity, carpet in bedroom, paternal asthma, sensitization to Der p, studying in the northern region, current rhinitis, and exposure at home to cat allergens and condary tobacco smoke. Absence of allergy in parents showed as a protective factor for severe asthma. CONCLUSIONS: The results of this study put São José do Rio Preto in the intermediate range of current asthma prevalence (10 to 19%), above the world average levels and below the national rates. Asthma was more prevalent in regions of less favored social classes and the physician diagnosis of the disease was more common in children of higher socioeconomic level. The prevalence of symptoms that define severe asthma was below the reported by other centers around the world. There was significant interaction between genetic risk factors as the presence of paternal asthma, comorbidities such as rhinitis and eczema and environmental factors as allergy to dust mites and cockroaches, exposure at home to cat allergens and tobacco smoke, prematurity and low socioeconomic level in genesis of asthma and severe asthma in adolescents.

ASSUNTO(S)

adolescente prevalence adolescents alergologia e imunologia clinica risk factors prevalência Índice de gravidade de doença asthma asma indice de severidad de la enfermedad severity of illness index fatores de risco

ACESSO AO ARTIGO

Documentos Relacionados