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Le HHTC, Ngo HKT, Hieu LS, Sly PD, Phung D, Le An P, Vinh NN, Dang TN, Thuong DTH, Thanh HN, Thai PK. Indoor air pollution is associated with respiratory symptoms in children in urban Vietnam. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 917:170556. [PMID: 38296088 DOI: 10.1016/j.scitotenv.2024.170556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/07/2024] [Accepted: 01/27/2024] [Indexed: 02/05/2024]
Abstract
Exposure to indoor air pollution (IAP) is a leading environmental risk for respiratory diseases. We investigated the relationship between respiratory symptoms and polluting indoor activities such as smoking, cooking and contact with pets among children in Ho Chi Minh City (HCMC), Vietnam. A cross-sectional survey applied a multistage sampling method in 24 randomly selected secondary schools across the city. Approximately 15,000 students completed self-administrated questionnaires on risk factors and respiratory health outcomes within the preceding 12 months. Data were analyzed using a multivariable logistic regression model with robust standard errors. Wheeze was the most common respiratory symptom (39.5 %) reported, followed by sneezing and runny nose (28.3 %). A small percentage of students self-reported asthma (8.6 %). Approximately 56 % of participants lived with family members who smoked. A positive association between exposure to indoor secondhand smoke and respiratory symptoms was observed, with adjusted odds ratios (aOR) of 1.41 (95 % CI: 1.25-1.60, p < 0.001) for wheezing and 1.64 (95 % CI: 1.43-1.87, p < 0.001) for sneezing and runny nose, respectively. Using an open stove fuelled by coal, wood, or kerosene for cooking was associated with wheeze (aOR: 1.36, CI 95 %: 1.10-1.68, p = 0.01) and sneezing and runny nose (aOR: 1.36, CI 95 %: 1.09-1.69, p = 0.01). In the present study, IAP was associated with adverse health outcomes, as evidenced by an increase in respiratory symptoms reported within the previous 12 months.
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Affiliation(s)
- Hong H T C Le
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Australia
| | - Hieu K T Ngo
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam
| | - Le Sy Hieu
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam
| | - Peter D Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Australia
| | - Dung Phung
- School of Public Health, The University of Queensland, Australia
| | - Pham Le An
- Centre for the Training of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam; Science and Technology Department, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
| | - Nguyen Nhu Vinh
- Centre for the Training of Family Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Tran Ngoc Dang
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam
| | - Do Thi Hoai Thuong
- Science and Technology Department, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | - Huynh Ngoc Thanh
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Viet Nam
| | - Phong K Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Australia
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Alzahrani SJM, Alzahrani HAK, Alghamdi SMM, Alzahrani ANA. Health-Related Quality of Life of Asthmatic Patients in Al-Baha City, Saudi Arabia. Cureus 2024; 16:e53601. [PMID: 38449957 PMCID: PMC10915697 DOI: 10.7759/cureus.53601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction According to disability-adjusted life years (DALY), bronchial asthma (BA) is rated 28th among the top causes of disease burden globally and among the most significant reasons for years lived with disability. Internationally, 300 million people have asthma, and another 100 million individuals may develop it by 2025. In Al-Baha City, where environmental factors such as dust and pollen levels can exacerbate asthma symptoms, understanding and addressing the health-related quality of life of asthmatic patients is crucial. Understanding the health-related quality of life of asthmatic patients can inform public health policies and initiatives aimed at reducing environmental triggers and promoting better asthma management in the city. Objectives The study aims to assess the impact of asthma regarding physical, emotional, and social activities that affect health-related quality of life. Subjects and methods A cross-sectional study was conducted from January 2023 to May 2023 at King Fahad Hospital in Al-Baha City, Saudi Arabia. The study used a Mini Asthma Quality of Life Questionnaire that measures physical, emotional, and social activities that affect health-related quality of life. Results One hundred and fifty-one out of 185 participants responded, yielding a response rate of 81.6%. The average age of the participants was 52, with a standard deviation of 15.4 years. Participants' responses regarding symptoms related to the environment during the last two weeks indicated "all the time" experiencing feeling bothered by or having to avoid cigarette smoke (n=104, 69%) and dust (n=92, 61%) in the environment. Moreover, considering emotion-related symptoms, 54% reported they did not feel afraid of not having their asthma medication available. Similarly, 46% reported never feeling frustrated because of asthma, whereas 3.3% of the participants documented hardly ever feeling frustrated. Regarding social activity limitations, 44 individuals (29%) reported no limits in these activities, while 43 (28%) reported being completely limited. While there were limitations in work-related activities, 42 participants (28%) reported no restrictions, whereas 34 (23%) reported being completely limited. Conclusion The study findings highlight a concern about suboptimal asthma control and the need to attain more satisfactory levels of asthma management.
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Affiliation(s)
- Saleh Jamman M Alzahrani
- Department of Internal Medicine (Pulmonology and Pulmonary Rehabilitation), King Fahad Hospital, Al-Baha, SAU
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Janus M, Reid-Westoby C, Pottruff M, Schneeweiss M, Hu G, Brownell M. Developmental health of Canadian kindergarten children with teacher-reported asthma between 2010 and 2015: A population-level cross-sectional study. Prev Med Rep 2024; 37:102525. [PMID: 38186657 PMCID: PMC10767499 DOI: 10.1016/j.pmedr.2023.102525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 01/09/2024] Open
Abstract
Asthma can impact children's quality of life. It is unclear how asthma is associated with the developmental health (i.e. a broad range of skills and abilities associated with growth and development) of young children at school entry. The goals of this cross-sectional, population-level study were to: (1) investigate the association between teacher-reported asthma and children's concurrent indicators of developmental health (developmental vulnerability); and (2) explore whether school absences and functional impairments modified this association. Participants were a Canadian population-based sample of 564 582 kindergarten children (Mage = 5.71 years, SD = 0.32, 51.3 % male) with data on the Early Development Instrument (EDI) collected between 2010 and 2015. Adjusted binary logistic regressions were conducted to address the objectives. From the sample, 958 (0.2 %) children were identified as having a diagnosis of asthma. These children were absent on average 9.4 days and 53.5 % had functional impairments (vs. 6.7 days absent and 15.9 % with functional impairments in children without asthma). After controlling for demographic characteristics, children with asthma had between 1.51 and 2.42 higher odds of being developmentally vulnerable. Only the presence of functional impairments modified this relationship and only for physical health and well-being. In this large, population-based sample of Canadian kindergarten children, few teachers reported knowledge of their students' asthma diagnosis. Among teacher-reported cases, asthma was a risk factor for developmental vulnerability in the domain of physical health and well-being only. Functional impairments may therefore be more detrimental for child development at school entry than asthma alone.
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Affiliation(s)
- Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Caroline Reid-Westoby
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada
| | - Molly Pottruff
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada
| | - Michelle Schneeweiss
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario L8P 1H6, Canada
| | - George Hu
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario L8P 1H6, Canada
| | - Marni Brownell
- Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba R3E 3P5, Canada
| | - Canadian Children's Health in Context Study Team
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario L8P 1H6, Canada
- Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba R3E 3P5, Canada
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Rogerson C, He T, Rowan C, Tu W, Mendonca E. Ten year trends in hospital encounters for pediatric asthma: an Indiana experience. J Asthma 2021; 59:2421-2430. [PMID: 34818967 DOI: 10.1080/02770903.2021.2010750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Pediatric asthma is a common cause of emergency department visits, hospital admissions, and mortality. Population incidence studies have historically used large-scale survey data. We measured these epidemiologic trends using a health information exchange. METHODS In this retrospective cohort study, we used electronic health record data from a regional health information exchange to study clinical trends in pediatric patients presenting to the hospital for asthma in the State of Indiana. Data was obtained from 2010 to 2019 and included all patients ages 2-18 years. Study participants were identified using international classification of disease codes. The measured outcomes were number of hospital encounters per year, percentage of admissions per year, and mortality rates. RESULTS Data included 50,393 unique patients and 88,772 unique encounters, with 57% male patients. Over the ten-year period, hospital encounters ranged from 5000 to 8000 per year with no change in trajectory. Between 2010 and 2012, the percent of encounters admitted to the hospital was ∼30%. This decreased to ∼20-25% for 2015-2019. Patient mortality rates increased from 1 to 3 per 1000 patient encounters in 2010-2014 to between 5 and 7 per 1000 patient encounters from 2016 to 2019. White patients had a significantly higher admission percentage compared to other racial groups, but no difference in mortality rate. CONCLUSIONS Asthma continues to be a common condition requiring hospital care for pediatric patients. Regional health information exchanges can enable public health researchers to follow asthma trends in near real time, and have potential for informing patient-level public health interventions.
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Affiliation(s)
- Colin Rogerson
- Indiana University School of Medicine, Indianapolis, IN, USA.,Regenstrief Institute Center for Biomedical Informatics, Indianapolis, IN, USA
| | - Tian He
- Department of Biostatistics, Indiana University-Purdue University, Indianapolis, IN, USA
| | - Courtney Rowan
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Wanzhu Tu
- Department of Biostatistics, Indiana University-Purdue University, Indianapolis, IN, USA
| | - Eneida Mendonca
- Indiana University School of Medicine, Indianapolis, IN, USA.,Regenstrief Institute Center for Biomedical Informatics, Indianapolis, IN, USA
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Mental Well-being and General Health in Adolescents with Asthma: The Prevention and Incidence of Asthma and Mite Allergy Birth Cohort Study. J Pediatr 2021; 233:198-205.e2. [PMID: 33548259 DOI: 10.1016/j.jpeds.2021.01.074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To assess whether adolescents with asthma experience a lower mental well-being and lower general health than their peers without asthma. STUDY DESIGN Data from the Prevention and Incidence of Asthma and Mite Allergy study were used. At the ages of 11, 14, 17, and 20 years, 2651, 2522, 2094, and 2206 participants, respectively, completed questionnaires. Their parents completed questionnaires at the ages of 11 (n = 2660), 14 (n = 2338), and 17 years (n = 1872). Asthma was defined according to the Mechanisms of the Development of Allergy criteria. Mental well-being was measured using the Mental Health Index-5 and was reported by the adolescents. General health, measured on a 4-point Likert scale, was reported by the adolescents and their parents. We estimated associations of asthma with mental well-being and perceived general health using generalized estimating equations. RESULTS At ages 11, 14, 17, and 20 years, 6.7%, 6.9%, 5.0%, and 6.6%, respectively, of the adolescents had asthma. Adolescents with asthma did not score differently on the Mental Health Index than their peers without asthma. Adolescents with asthma were less likely to experience good or excellent health than their peers without asthma (aOR, 0.37; 95% CI, 0.26-0.51 for intermittent asthma and 0.33; 95% CI, 0.25-0.41 for persistent asthma). These results remain similar across the different ages. CONCLUSIONS The mental well-being of adolescents with asthma is similar to that of their peers without asthma, although adolescents with asthma are less likely to perceive a good or excellent general health.
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Putranti DP, Pulo EO, Arita C, Wicaksana AL. Effects of yoga on pulmonary functions among asthmatic patients: A protocol synthesis. ENFERMERIA CLINICA 2021. [PMID: 32331736 DOI: 10.1016/j.enfcli.2019.12.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aimed to synthesize protocol of yoga pranayama's practice through combining yoga pranayama's steps into the new integrated formations of yoga pranayama's steps for adult asthmatic patients as a protocol. METHOD Literature review from the last 20 years publication of original trial articles on adult asthmatic subjects from 4 databases: PubMed, Science Direct, EBSCO, and Scopus was conducted. Review and non-trial articles were excluded. Articles were appraised using Joanna Bridge Institute (JBI) critical appraisal tools. RESULTS There were 4 out of 252 articles which met the criteria and being included in this study. The synthesized protocol resulting 11 pranayama steps in the new synthesized protocol. CONCLUSIONS The regular 13 yoga pranayama steps within 11 pranayama steps based on synthesized protocol takes 30-45min for each session and can be conducted 2-5 times a week for 2-6 months to be able to reveal pulmonary function outcomes.
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Affiliation(s)
- Dwi Puji Putranti
- Master of Nursing Program, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Eldad Onesiforus Pulo
- Master of Nursing Program, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Caecilia Arita
- Master of Nursing Program, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Anggi Lukman Wicaksana
- Department of Medical Surgical Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; The Sleman Health and Demographic Surveillance System, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
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Fonseca LGDA, Florêncio RB, Lima INDF, Peroni Gualdi L. Time trend of Brazilian hospital admissions and deaths due to asthma among children and teenagers, 1998-2019. PLoS One 2021; 16:e0248472. [PMID: 33720970 PMCID: PMC7959376 DOI: 10.1371/journal.pone.0248472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 02/28/2021] [Indexed: 11/26/2022] Open
Abstract
Background Asthma is one of the most prevalent non-communicable diseases worldwide. The aim of this study was to characterize the distribution of Brazilian hospital admissions due to asthma among children and teenagers between 1998 and 2019, as well as to analyze hospital admission incidence and mortality rate during the period according to the geographic region, age group and gender. Methods This is a descriptive time trend study using secondary data regarding hospital admissions and lethality registered in the Brazilian System of Hospital Information of the Brazilian Public Health System (SIH/SUS) due to asthma (ICD-10) in subjects aged from 0 to 19 years old between 1998 and 2019. The following variables were collected: number and place of hospital admissions classified by the ICD-10, absolute values and frequency by age group, gender and lethality. Statistical analysis was performed by GraphPad Prism version 5.0 software. Results The total number of hospital admissions due to asthma was 3,138,064. It was observed that children aged between 1 to 4 years, living in the Northeast region and males showed the highest number of hospitalizations. A 74.37% reduction over a 21-year period was found. The lethality rate found in the study was 0.06, with the highest rates being from the Northeast region, males and < 1-year-old. Conclusion Hospital admissions were more prevalent in young children, male gender and in the Northeast region. A decrease of hospital admissions and lethality rate was observed in all groups over time. This profile is important for implementing government strategies to lower hospital admissions and decrease costs.
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Affiliation(s)
- Luiza Gabriela de Araújo Fonseca
- Programa de Pós Graduação em Ciências da Reabilitação, Faculdade de Ciências da Saúde do Trairi (FACISA)/Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, Rio Grande do Norte, Brazil
| | - Rêncio Bento Florêncio
- Programa de Pós Graduação em Ciências da Reabilitação, Faculdade de Ciências da Saúde do Trairi (FACISA)/Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, Rio Grande do Norte, Brazil
| | - Illia Nadinne Dantas Florentino Lima
- Programa de Pós Graduação em Ciências da Reabilitação, Faculdade de Ciências da Saúde do Trairi (FACISA)/Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, Rio Grande do Norte, Brazil
| | - Lucien Peroni Gualdi
- Programa de Pós Graduação em Ciências da Reabilitação, Faculdade de Ciências da Saúde do Trairi (FACISA)/Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, Rio Grande do Norte, Brazil
- * E-mail:
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Sreter KB, Popovic-Grle S, Lampalo M, Konjevod M, Tudor L, Nikolac Perkovic M, Jukic I, Bingulac-Popovic J, Safic Stanic H, Markeljevic J, Pivac N, Svob Strac D. Plasma Brain-Derived Neurotrophic Factor (BDNF) Concentration and BDNF/ TrkB Gene Polymorphisms in Croatian Adults with Asthma. J Pers Med 2020; 10:jpm10040189. [PMID: 33114368 PMCID: PMC7712770 DOI: 10.3390/jpm10040189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/18/2020] [Accepted: 10/22/2020] [Indexed: 12/14/2022] Open
Abstract
Brain-derived neurotrophic factor (BDNF) and its tropomyosin-related kinase B (TrkB) receptor might contribute to normal lung functioning and immune responses; however, their role in asthma remains unclear. Plasma BDNF concentrations, as well as BDNF and NTRK2 (TrkB gene) polymorphisms, were investigated in 120 asthma patients and 120 healthy individuals using enzyme-linked immunosorbent assay and polymerase chain reaction, respectively. The genotype and allele frequencies of BDNF Val66Met (rs6265) and NTRK2 rs1439050 polymorphisms did not differ between healthy individuals and asthma patients, nor between patients grouped according to severity or different asthma phenotypes. Although plasma BDNF concentrations were higher among healthy subjects carrying the BDNF Val66Met GG genotype compared to the A allele carriers, such differences were not detected in asthma patients, suggesting the influences of other factors. Plasma BDNF concentration was not affected by NTRK2 rs1439050 polymorphism. Asthma patients had higher plasma BDNF concentrations than control subjects; however, no differences were found between patients subdivided according to asthma severity, or Type-2, allergic, and eosinophilic asthma. Higher plasma BDNF levels were observed in asthma patients with aspirin sensitivity and aspirin-exacerbated respiratory disease. These results suggest that plasma BDNF may serve as a potential peripheral biomarker for asthma, particularly asthma with aspirin sensitivity.
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Affiliation(s)
- Katherina B. Sreter
- Department of Clinical Immunology, Pulmonology and Rheumatology, University Hospital Centre “Sestre Milosrdnice”, 10000 Zagreb, Croatia; (K.B.S.); (J.M.)
| | - Sanja Popovic-Grle
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (S.P.-G.); (M.L.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marina Lampalo
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (S.P.-G.); (M.L.)
| | - Marcela Konjevod
- Division of Molecular Medicine, Rudjer Boskovic Institute, 10000 Zagreb, Croatia; (M.K.); (L.T.); (M.N.P.); (N.P.)
| | - Lucija Tudor
- Division of Molecular Medicine, Rudjer Boskovic Institute, 10000 Zagreb, Croatia; (M.K.); (L.T.); (M.N.P.); (N.P.)
| | - Matea Nikolac Perkovic
- Division of Molecular Medicine, Rudjer Boskovic Institute, 10000 Zagreb, Croatia; (M.K.); (L.T.); (M.N.P.); (N.P.)
| | - Irena Jukic
- Croatian Institute of Transfusion Medicine, 10000 Zagreb, Croatia; (I.J.); (J.B.-P.); (H.S.S.)
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Jasna Bingulac-Popovic
- Croatian Institute of Transfusion Medicine, 10000 Zagreb, Croatia; (I.J.); (J.B.-P.); (H.S.S.)
| | - Hana Safic Stanic
- Croatian Institute of Transfusion Medicine, 10000 Zagreb, Croatia; (I.J.); (J.B.-P.); (H.S.S.)
| | - Jasenka Markeljevic
- Department of Clinical Immunology, Pulmonology and Rheumatology, University Hospital Centre “Sestre Milosrdnice”, 10000 Zagreb, Croatia; (K.B.S.); (J.M.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Nela Pivac
- Division of Molecular Medicine, Rudjer Boskovic Institute, 10000 Zagreb, Croatia; (M.K.); (L.T.); (M.N.P.); (N.P.)
| | - Dubravka Svob Strac
- Division of Molecular Medicine, Rudjer Boskovic Institute, 10000 Zagreb, Croatia; (M.K.); (L.T.); (M.N.P.); (N.P.)
- Correspondence: ; Tel.: +385-1-457-1365
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Aydin M, Naumova EA, Lutz S, Meyer-Bahlburg A, Arnold WH, Kreppel F, Ehrhardt A, Postberg J, Wirth S. Do Current Asthma-Preventive Measures Appropriately Face the World Health Organization's Concerns: A Study Presentation of a New Clinical, Prospective, Multicentric Pediatric Asthma Exacerbation Cohort in Germany. Front Pediatr 2020; 8:574462. [PMID: 33324591 PMCID: PMC7724104 DOI: 10.3389/fped.2020.574462] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/21/2020] [Indexed: 11/13/2022] Open
Abstract
In summer 2017, the World Health Organization published 10 facts on asthma, which is known as a major non-communicable disease of high clinical and scientific importance with currently several hundred million people-with many children among them-suffering from air passages inflammation and narrowing. Importantly, the World Health Organization sees asthma as being underdiagnosed and undertreated. Consequently, much more efforts in clinical disease management and research need to be spent on reducing the asthma-related health burden. Particularly, for young approximately 6 months aged patients presenting recurrent bronchitic respiratory symptoms, many parents anxiously ask the doctors for risk prognosis for their children's future life. Therefore, we urgently need to reevaluate if the current diagnostic and treatment measures are in concordance with our yet incomplete knowledge of pathomechanisms on exacerbation. To contribute to this increasing concern worldwide, we established a multicentric pediatric exacerbation study network, still recruiting acute exacerbated asthmatics (children >6 years) and preschool asthmatics/wheezers (children <6 years) since winter 2018 in Germany. The current study that has a currently population comprising 176 study participants aims to discover novel holistic entry points for achieving a better understanding of the poorly understood plasticity of involved molecular pathways and to define biomarkers enabling improved diagnostics and therapeutics. With this study description, we want to present the study design, population, and few ongoing experiments for novel biomarker research. Clinical Trial Registration: German Clinical Trials Register (Deutsches Register für Klinische Studien, DRKS): DRKS00015738.
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Affiliation(s)
- Malik Aydin
- Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, Wuppertal, Germany.,Clinical Molecular Genetics and Epigenetics, Faculty of Health, Center for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Germany
| | - Ella A Naumova
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Soeren Lutz
- Children's Hospital, Helios Hospital Niederberg, Teaching Hospital of the Essen University Hospital, Velbert, Germany
| | - Almut Meyer-Bahlburg
- Department of Pediatric Rheumatology and Immunology, Children's Hospital, University Medicine Greifswald, Greifswald, Germany
| | - Wolfgang H Arnold
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Florian Kreppel
- Chair for Biochemistry and Molecular Medicine, Faculty of Health, Center for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Germany
| | - Anja Ehrhardt
- Faculty of Health, Center for Biomedical Education and Research (ZBAF), Institute of Virology and Microbiology, Witten/Herdecke University, Witten, Germany
| | - Jan Postberg
- Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, Wuppertal, Germany.,Clinical Molecular Genetics and Epigenetics, Faculty of Health, Center for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Germany
| | - Stefan Wirth
- Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten/Herdecke University, Wuppertal, Germany
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Marques GÁ, Wendt A, Wehrmeister FC. Temporal evolution of and factors associated with asthma and wheezing in schoolchildren in Brazil. J Bras Pneumol 2019; 45:e20180138. [PMID: 31271601 PMCID: PMC6715041 DOI: 10.1590/1806-3713/e20180138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 09/23/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To estimate the evolution of the prevalence of asthma and wheezing among schoolchildren in Brazil from 2012 to 2015, as well as to identify factors associated with both conditions. METHODS This was a cross-sectional study using data from the Brazilian National School-Based Adolescent Health Survey for 2012 and 2015. To characterize the evolution of the prevalence of asthma and wheezing, we used linear regression with weighted-least-squares estimation and presented the annual percent change (APC). RESULTS During the study period, there was a reduction in the prevalence of wheezing, from 23.2% in 2012 to 22.4% in 2015 (APC, -0.27). The prevalence of asthma increased from 12.4% in 2012 to 16.0% in 2015 (APC, 1.20). The increase in the prevalence of asthma was greatest in the southern region of the country (APC, 2.17). Having any history of smoking and having consumed alcohol in the last 30 days were factors that influenced the prevalence of wheezing and the prevalence of a self-reported diagnosis of asthma during the two years evaluated. CONCLUSIONS There has been an increase in the prevalence of asthma in recent years in Brazil. Our data underscore the importance of improving health strategies and policies aimed at the control of asthma.
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Affiliation(s)
- Gabriela Ávila Marques
- . Universidade Católica de Pelotas, Pelotas (RS) Brasil
- . Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas (RS) Brasil
| | - Andrea Wendt
- . Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas (RS) Brasil
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Dharmage SC, Perret JL, Custovic A. Epidemiology of Asthma in Children and Adults. Front Pediatr 2019; 7:246. [PMID: 31275909 PMCID: PMC6591438 DOI: 10.3389/fped.2019.00246] [Citation(s) in RCA: 527] [Impact Index Per Article: 105.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/29/2019] [Indexed: 11/23/2022] Open
Abstract
Asthma is a globally significant non-communicable disease with major public health consequences for both children and adults, including high morbidity, and mortality in severe cases. We have summarized the evidence on asthma trends, environmental determinants, and long-term impacts while comparing these epidemiological features across childhood asthma and adult asthma. While asthma incidence and prevalence are higher in children, morbidity, and mortality are higher in adults. Childhood asthma is more common in boys while adult asthma is more common in women, and the reversal of this sex difference in prevalence occurs around puberty suggesting sex hormones may play a role in the etiology of asthma. The global epidemic of asthma that has been observed in both children and adults is still continuing, especially in low to middle income countries, although it has subsided in some developed countries. As a heterogeneous disease, distinct asthma phenotypes, and endotypes need to be adequately characterized to develop more accurate and meaningful definitions for use in research and clinical settings. This may be facilitated by new clustering techniques such as latent class analysis, and computational phenotyping methods are being developed to retrieve information from electronic health records using natural language processing (NLP) algorithms to assist in the early diagnosis of asthma. While some important environmental determinants that trigger asthma are well-established, more work is needed to define the role of environmental exposures in the development of asthma in both children and adults. There is increasing evidence that investigation into possible gene-by-environment and environment-by-environment interactions may help to better uncover the determinants of asthma. Therefore, there is an urgent need to further investigate the interrelationship between environmental and genetic determinants to identify high risk groups and key modifiable exposures. For children, asthma may impair airway development and reduce maximally attained lung function, and these lung function deficits may persist into adulthood without additional progressive loss. Adult asthma may accelerate lung function decline and increase the risk of fixed airflow obstruction, with the effect of early onset asthma being greater than late onset asthma. Therefore, in managing asthma, our focus going forward should be firmly on improving not only short-term symptoms, but also the long-term respiratory and other health outcomes.
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Affiliation(s)
- Shyamali C Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Jennifer L Perret
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Institute for Breathing and Sleep, Melbourne, VIC, Australia
| | - Adnan Custovic
- Department of Paediatrics, Imperial College London, London, United Kingdom
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Kuschnir FC, Gurgel RQ, Solé D, Costa E, Felix MMR, de Oliveira CL, de Vasconcellos MTL, Kuschnir MCC. ERICA: prevalence of asthma in Brazilian adolescents. Rev Saude Publica 2016; 50 Suppl 1:13s. [PMID: 26910542 PMCID: PMC4767043 DOI: 10.1590/s01518-8787.2016050006682] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 10/29/2015] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To describe the prevalence of asthma and physician-diagnosed asthma in Brazilian adolescents. METHODS Cross-sectional, national, school-based study with adolescents from 12 to 17 years old, participants in the Study of Cardiovascular Risks in Adolescents (ERICA). The study stratified the sample by region and grouped according to schools and classes with representativeness to the set of cities with more than 100,000 inhabitants of the Country, macro-regions, capitals, and Federal District. A questionnaire collected data through a self-filled in method. We calculated the prevalences and their confidence intervals of 95% (95%CI) according to sex, age group, type of school and skin color. RESULTS Between 2013 and 2014, 74,589 adolescents were evaluated, 55.3% of the female sex. The total prevalence of active asthma was of 13.1% (95%CI 12.1-13.9), being higher in girls (14.8%; 95%CI 13.7-16.0) when compared to boys (11.2%; 95%CI 10.3-12.2) in all geographical strata examined. It was also higher between students of private schools (15.9%; 95%CI 14.2-17.7) when compared to public ones (12.4%; 95%CI 11.4-13.4). It was higher in the Southeast region (14.5%; 95%CI 12.9-16.1), and in the city of Sao Paulo (16.7%; 95%CI 14.7-18.7). The lowest prevalence was observed in North region (9.7%; 95%CI 9.7-10.5), and in Teresina (6.3%; 95%CI 4.9-7.7). The prevalence of physician-diagnosed asthma was of 8.7% (95%CI 8.2-9.1); higher in the North region (13.5%; 95%CI 12.7-14.2), and in Porto Alegre (19.8%; 95%CI 17.5-22.3). It was lower in the Midwest (6.9%; 95%CI 6.0-7.8), and in Cuiaba (4.8%; 95%CI 3.8-5.9). We found no significant difference in the expression of this rate between the sexes, as well as in other variables evaluated by the study. CONCLUSIONS The prevalence of asthma in Brazilian adolescents is high. Rates of active asthma and physician-diagnosed asthma vary widely in different regions and capitals evaluated by the ERICA. These results may assist in the preparation of preventive programs and policies on health and a better understanding of the factors associated with asthma in this age group.
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Affiliation(s)
- Fábio Chigres Kuschnir
- Departamento de Pediatria. Faculdade de Ciências Médicas. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
| | | | - Dirceu Solé
- Disciplina de Alergia Imunologia Clínica e Reumatologia. Departamento de Pediatria. Universidade Federal de São Paulo. São Paulo, SP, Brasil
| | - Eduardo Costa
- Departamento de Medicina Interna. Faculdade de Ciências Médicas. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
| | - Mara Morelo Rocha Felix
- Programa de Pós-Graduação em Ciências Médicas. Faculdade de Ciências Médicas. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
| | - Cecília Lacroix de Oliveira
- Departamento de Nutrição Aplicada. Instituto de Nutrição. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
| | | | - Maria Cristina Caetano Kuschnir
- Núcleo de Estudos de Saúde do Adolescente. Faculdade de Ciências Médicas. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
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Zemp E, Schikowski T, Dratva J, Schindler C, Probst-Hensch N. Asthma and the menopause: a systematic review and meta-analysis. Maturitas 2012; 73:212-7. [PMID: 22964072 DOI: 10.1016/j.maturitas.2012.08.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 08/12/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To review the available literature to determine whether the menopausal transition is associated with asthma incidence. METHODS We performed a systematic review and meta-analysis of cohort and cross-sectional studies providing a definition/assessment of menopausal status, incidence or prevalence of a defined diagnosis of asthma, and providing a measure of the association or of menopausal state and asthma or enough data for a calculation of this association. Where possible these meta-analytic estimates were also stratified by intake of menopausal hormone therapy (MHT). RESULTS Of 76 potentially relevant articles, 8 studies met the inclusion criteria and were included in the review, and 6 in the meta-analysis. There was heterogeneity across studies: four studies reported slightly increased prevalence rates of asthma in post-menopause, one large cohort yielded a lower asthma incidence and one cross-sectional study a lower prevalence in post-menopause. Overall, the meta-analysis showed no significant association between menopause and asthma rates. When stratifying by use of MHT, the association between menopause and asthma rates was increased in women reporting use of MHT (RR 1.32, 95%CI 1.01-1.74), but not in women not using MHT. CONCLUSION We found no significant association of menopause with asthma prevalence or incidence except for women reporting use of MHT. However, these findings result from a small number of studies, including only 1 large cohort with incidence rates for pre- as well as post-menopause. Further studies are needed addressing more closely subgroup analyses and a possible modification of the association of menopause and asthma by MHT.
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Affiliation(s)
- E Zemp
- Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, Switzerland.
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Kuschnir FC, da Cunha ALA. Association of overweight with asthma prevalence in adolescents in Rio de Janeiro, Brazil. J Asthma 2009; 46:928-32. [PMID: 19905920 DOI: 10.3109/02770900903231566] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the relationship between asthma and overweight in adolescents. METHODS Cross-sectional study including 13-14-year-old adolescents in Rio de Janeiro, Brazil. Asthma was defined according to the International Study of Asthma and Allergies in Childhood (ISAAC). Body Mass Index (BMI) was calculated; overweight was defined as BMI > or = 85th percentile. The distribution of asthma and associated symptoms were compared according weight category using the chi(2) test for linear trend. The association between asthma and overweight, controlling for confounding variables, was studied using odds ratios (OR), confidence intervals (95% CI) and logistic regression, stratified by sex. RESULTS 2,858 (50.1% female) adolescents were studied; 458 (16.1%) were overweight and 13.3% asthmatic. Average BMI was higher among asthmatics (p = 0.01). When stratified, this difference remained only among girls (p = 0.03). Asthma prevalence increased with higher BMI (p = 0.02). Asthma was associated to overweight (OR = 1.51; 95% CI: 1.07-2.13), irrespective of sedentary lifestyle, smoking mother and presence of dog in the domicile, but only among the girls. CONCLUSIONS In Rio de Janeiro adolescents, we found a positive association between asthma and overweight, exclusively among girls. This suggests that health policies related to asthma and overweight/obesity in this age group need to take sex into consideration.
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Tantisira KG, Colvin R, Tonascia J, Strunk RC, Weiss ST, Fuhlbrigge AL. Airway responsiveness in mild to moderate childhood asthma: sex influences on the natural history. Am J Respir Crit Care Med 2008; 178:325-31. [PMID: 18420965 DOI: 10.1164/rccm.200708-1174oc] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Airway responsiveness is a prognostic marker for asthma symptoms in later life. OBJECTIVES To evaluate characteristics responsible for persistence of airway responsiveness in children with asthma. METHODS A total of 1,041 children, initially aged 5-12 years, with mild to moderate persistent asthma enrolled in the Childhood Asthma Management Program (CAMP) were studied prospectively for 8.6 +/- 1.8 years with methacholine challenges yearly. MEASUREMENTS AND MAIN RESULTS Least squares geometric mean models were fit to determine effects of sex and age on airway responsiveness (provocative concentration producing 20% decrease in FEV(1) [PC(20)]). Multiple linear regression analysis was performed to determine factors at baseline and over time, which were associated with PC(20) at end of follow-up. A total of 7,748 methacholine challenges were analyzed. PC(20) increased with age, with boys having greater increase after age 11 years than girls (P < 0.001). The divergence coincided with the mean age for Tanner stage 2. Postpubertal girls had greater airway responsiveness, even after adjustment for FEV(1) and other potential confounders. Although multivariable regression analyses noted a variety of factors that influenced airway responsivness in both sexes, a history of hay fever (beta= -0.30, P = 0.005), respiratory allergy (beta= -0.32, P = 0.006), or recent inhaled corticosteroid usage (beta= -0.18, P = 0.02) were associated with decrements in final log PC(20) only in girls. CONCLUSIONS Airway responsiveness (PC(20)) is more severe in the postpubertal female with asthma than in males. Although there are factors associated with airway responsiveness in both males and females, sex-specific factors may contribute to new insights into asthma pathogenesis.
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Affiliation(s)
- Kelan G Tantisira
- Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA.
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Lee JH, Haselkorn T, Borish L, Rasouliyan L, Chipps BE, Wenzel SE. Risk factors associated with persistent airflow limitation in severe or difficult-to-treat asthma: insights from the TENOR study. Chest 2008; 132:1882-9. [PMID: 18079222 DOI: 10.1378/chest.07-0713] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens study is among the largest to assess persistent airflow limitation and the first to evaluate a wide range of potential risk factors in high-risk patients with severe or difficult-to-treat asthma. A better understanding is needed regarding factors associated with persistent airway obstruction; this study was performed to determine demographic and clinical characteristics associated with persistent airflow limitation. METHODS Data from adult patients (>or= 18 years old) with severe or difficult-to-treat asthma were evaluated. Patients with COPD, obesity with a restrictive respiratory pattern, or a >or= 30 pack-year history of smoking were excluded. Patients with persistent airflow limitation (postbronchodilator FEV1/FVC ratio <or= 70% at two annual consecutive visits) and normal postbronchodilator FEV1/FVC ratio (75 to 85%) were compared. Multivariate analysis identified factors independently associated with persistent airflow limitation. RESULTS Of 1,017 patients, 612 patients (60%) showed evidence of persistent airflow limitation. Risk factors were as follows: older age (odds ratio [OR] per 10 years, 1.4; 95% confidence interval [CI], 1.3 to 1.6); male gender (OR, 4.5; 95% CI, 2.3 to 8.5); black ethnicity (OR, 2.2; 95% CI, 1.3 to 3.8); current or past smoking (OR, 3.9; 95% CI, 1.8 to 8.6; and OR, 1.6; 95% CI, 1.2 to 2.3, respectively); aspirin sensitivity (OR, 1.5; 95% CI, 1.0 to 2.4); and longer asthma duration (OR per 10 years, 1.6; 95% CI, 1.4 to 1.8). Protective factors were Hispanic ethnicity, higher education, family history of atopic dermatitis, pet(s) in the home, and dust sensitivity. CONCLUSIONS Persistent airflow limitation is prevalent in patients with severe or difficult-to-treat asthma and is associated with identifiable clinical and demographic characteristics.
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Affiliation(s)
- June H Lee
- Genentech, Inc., 1 DNA Way, MS 453B, South San Francisco, CA 94080, USA.
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Kuschnir FC, Cunha AJLAD, Braga DDAC, Silveira HHND, Barroso MH, Aires ST. Asma em escolares de 13 e 14 anos do Município de Nova Iguaçu, Rio de Janeiro, Brasil: estimativas de prevalência, gravidade e diferenças de gênero. CAD SAUDE PUBLICA 2007; 23:919-26. [PMID: 17435889 DOI: 10.1590/s0102-311x2007000400019] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2005] [Accepted: 11/28/2006] [Indexed: 11/21/2022] Open
Abstract
O objetivo deste estudo foi descrever a prevalência, a gravidade e os sintomas associados à asma e sua relação com o gênero em escolares de 13 e 14 anos do Município de Nova Iguaçu, Rio de Janeiro, Brasil. Trata-se de estudo transversal, no qual se utilizou o questionário escrito auto-aplicável para asma do International Study of Asthma and Allergies in Childhood (ISAAC). Participaram 3.033 escolares de 37 escolas públicas e privadas selecionadas aleatoriamente. A prevalência de sibilância alguma vez na vida foi de 26% e nos últimos 12 meses (asma atual) de 11,7%, sendo essas taxas maiores entre as meninas (razão de prevalência - RP = 1,46; IC95%: 1,31-1,62 e RP =1,72; IC95%: 1,35-2,21, respectivamente). Sintomas associados à gravidade da doença, como distúrbio do sono e limitação da fala por sibilos, também se associaram positivamente com o gênero feminino (RP = 2,57; IC95%:1,77-3,73 e RP = 2,07; IC95%:1,25-3,43). A prevalência da asma mostrou-se menor quando comparada com as de outras cidades brasileiras, porém ainda é alta entre adolescentes de Nova Iguaçu, sendo mais freqüente e mais grave no gênero feminino. Outros estudos são necessários para explicar tais diferenças.
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Affiliation(s)
- Fábio Chigres Kuschnir
- Programa Saúde na Escola, Secretaria de Defesa Civil do Estado do Rio de Janeiro, Rua Alvaro Ramos 405, Rio de Janeiro, RJ 22280-110, Brazil.
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Kuschnir FC, Alves da Cunha AJL. Environmental and socio-demographic factors associated to asthma in adolescents in Rio de Janeiro, Brazil. Pediatr Allergy Immunol 2007; 18:142-8. [PMID: 17338787 DOI: 10.1111/j.1399-3038.2006.00477.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although asthma is of frequent occurrence, little is known about the factors associated with this disease in Brazil. We studied the association between asthma, environmental and socio-demographic factors in adolescents in Nova lguacu, Rio de Janeiro State. Cross-sectional study using the questionnaires about asthma and environmental factors from the International Study of Asthma and Allergies in Childhood (ISAAC). We performed bivariate analyses between asthma and the factors studied using prevalence ratio (PR), confidence intervals of 95% (95% Cl) and Chi-squared test. Factors associated to asthma in a bivariate analysis were studied using logistic regression and odds ratio (OR). We included 3,033 students, aged 13-14 yrs, selected from 37 schools. The prevalence of asthma was 13.1%. Being female (OR = 1.40; 95%Cl:1.11-1.77), the presence of a mother who smokes (OR = 1.32; 95%Cl:1.04-1.66), a cat in the domicile (OR = 1.32; 95%Cl:1.04-1.69), being the firstborn (OR = 1.34; 95%Cl:1.07-1.68), frequent use of paracetamol (OR = 1.45; 95%Cl: 1.15-1.84), the presence of rhinitis (OR = 5.15; 95%:3.89-6.82) and eczema (OR = 2.35; 95%Cl:1.73-3.19) were independently associated to asthma. Environmental and socio-demographic factors were associated to asthma in adolescents in Rio de Janeiro, irrespective of the presence of others allergic diseases. Interventions acting on these factors may decrease the occurrence of asthma in this population.
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Gold DR. Less childhood obesity--less persistence of wheeze in teenage girls and boys? Am J Respir Crit Care Med 2004; 170:8-9. [PMID: 15220121 DOI: 10.1164/rccm.2404003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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