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Calleja JR, Hernández EMJ, Panedas AM, Carracedo JFS, García CG, Alonso MPB, Tejedor MTC, Alonso JEF. Study on the Association between Cesarean Section Birth and Asthma Risk in the Pediatric Population of the Health Area of Palencia between 1993 and 2020. Allergol Immunopathol (Madr) 2024; 52:68-72. [PMID: 38970267 DOI: 10.15586/aei.v52i4.1084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/14/2024] [Indexed: 07/08/2024]
Abstract
INTRODUCTION AND OBJECTIVES Both asthma prevalence and the percentage of cesarean sections have increased in parallel in recent years. Research studies suggest an increased risk of developing atopic diseases and asthma after cesarean section birth compared to vaginal delivery. The main objective of this study is to analyze the risk of asthma admission after cesarean section birth compared to vaginal delivery in the pediatric population. POPULATION AND METHODS Retrospective observational analytical case-control study from 1993 to 2020. The cases include all admitted patients to our health area hospital, for patients aged 7 to 16 diagnosed with asthma. For each case, a control without a diagnosis of asthma is selected with the same age, and that has also caused an episode of admission. RESULTS A total of 290 admission episodes with a diagnosis of asthma were obtained, caused by 155 patients. Out of these, 145 cases with documented delivery types were selected. For cases, 155 controls were selected. The historical proportion of cesarean sections in the asthmatic group is 18.6%, compared to 14.2% in the non-asthmatic group. There is a statistically non-significant difference of 4.4% more cesarean sections in the asthmatic group compared to the control group. DISCUSSION We have not demonstrated a statistically significant association between being born by cesarean section and an increased risk of asthma admission. Based on this finding, we cannot conclude that there is an association between being born by cesarean section and a higher risk of suffering from asthma, unlike what has been postulated in other research studies.
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Plaza Moral V, Alobid I, Álvarez Rodríguez C, Blanco Aparicio M, Ferreira J, García G, Gómez-Outes A, Garín Escrivá N, Gómez Ruiz F, Hidalgo Requena A, Korta Murua J, Molina París J, Pellegrini Belinchón FJ, Plaza Zamora J, Praena Crespo M, Quirce Gancedo S, Sanz Ortega J, Soto Campos JG. GEMA 5.3. Spanish Guideline on the Management of Asthma. OPEN RESPIRATORY ARCHIVES 2023; 5:100277. [PMID: 37886027 PMCID: PMC10598226 DOI: 10.1016/j.opresp.2023.100277] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Abstract
The Spanish Guideline on the Management of Asthma, better known by its acronym in Spanish GEMA, has been available for more than 20 years. Twenty-one scientific societies or related groups both from Spain and internationally have participated in the preparation and development of the updated edition of GEMA, which in fact has been currently positioned as the reference guide on asthma in the Spanish language worldwide. Its objective is to prevent and improve the clinical situation of people with asthma by increasing the knowledge of healthcare professionals involved in their care. Its purpose is to convert scientific evidence into simple and easy-to-follow practical recommendations. Therefore, it is not a monograph that brings together all the scientific knowledge about the disease, but rather a brief document with the essentials, designed to be applied quickly in routine clinical practice. The guidelines are necessarily multidisciplinary, developed to be useful and an indispensable tool for physicians of different specialties, as well as nurses and pharmacists. Probably the most outstanding aspects of the guide are the recommendations to: establish the diagnosis of asthma using a sequential algorithm based on objective diagnostic tests; the follow-up of patients, preferably based on the strategy of achieving and maintaining control of the disease; treatment according to the level of severity of asthma, using six steps from least to greatest need of pharmaceutical drugs, and the treatment algorithm for the indication of biologics in patients with severe uncontrolled asthma based on phenotypes. And now, in addition to that, there is a novelty for easy use and follow-up through a computer application based on the chatbot-type conversational artificial intelligence (ia-GEMA).
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Affiliation(s)
| | - Isam Alobid
- Otorrinolaringología, Hospital Clinic de Barcelona, España
| | | | | | - Jorge Ferreira
- Hospital de São Sebastião – CHEDV, Santa Maria da Feira, Portugal
| | | | - Antonio Gómez-Outes
- Farmacología clínica, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, España
| | - Noé Garín Escrivá
- Farmacia Hospitalaria, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | | | | | - Javier Korta Murua
- Neumología Pediátrica, Hospital Universitario Donostia, Donostia-San, Sebastián, España
| | - Jesús Molina París
- Medicina de familia, semFYC, Centro de Salud Francia, Fuenlabrada, Dirección Asistencial Oeste, Madrid, España
| | | | - Javier Plaza Zamora
- Farmacia comunitaria, Farmacia Dr, Javier Plaza Zamora, Mazarrón, Murcia, España
| | | | | | - José Sanz Ortega
- Alergología Pediátrica, Hospital Católico Universitario Casa de Salud, Valencia, España
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Bercedo-Sanz A, Martínez-Torres A, Varela ALS, Belinchón FJP, Aguinaga-Ontoso I, Díaz CG, García-Marcos L, Spain GG. Prevalence and time trends of symptoms of allergic rhinitis and rhinoconjunctivitis in Spanish children: Global Asthma Network (GAN) study. Allergol Immunopathol (Madr) 2023; 51:1-11. [PMID: 37695222 DOI: 10.15586/aei.v51i1.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/03/2022] [Indexed: 09/12/2023]
Abstract
INTRODUCTION The time trends of the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy previously described in the ISAAC (International Study of Asthma and Allergies in Childhood) in 2002 are unknown; or if the geographical or age differences in Spain persist. OBJECTIVE To describe the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy in different Spanish geographical areas and compare them with those of the ISAAC. METHODS Cross-sectional study of the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy, carried out in 2016-2019 on 19943 adolescents aged 13-14 years and 17215 schoolchildren aged 6-7 years from six Spanish areas (Cartagena, Bilbao, Cantabria, La Coruña, Pamplona, and Salamanca), through a questionnaire based on the Global Asthma Network (GAN) protocol. RESULTS The prevalences of recent rhinitis and rhinoconjunctivitis (last 12 months), and nasal allergy/hay fever were 35.1%, 17.6%, and 14.6% in the adolescents and 20%, 8.5%, and 8.9% in the schoolchildren, respectively, with rhinoconjunctivitis in adolescents varying from 20.9% in Bilbao to 13.4% in Cartagena; and in schoolchildren, from 9.8% in La Coruña to 6.4% in Pamplona. These prevalences of rhinoconjunctivitis and nasal allergy in adolescents were higher than those described in the ISAAC (16.3% and 13%) and similar in schoolchildren to the ISAAC (9% and 9.4%). CONCLUSIONS There has been a stabilisation of rhinitis, rhinoconjunctivitis and nasal allergy in schoolchildren that slows the previous upward trend of ISAAC; and a slight non-significant increase in rhinoconjunctivitis and nasal allergy in adolescents. The variability found in adolescents would require local research to be better understood.
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Affiliation(s)
- Alberto Bercedo-Sanz
- Centro de Salud Los Castros. Santander, Servicio Cántabro de Salud, Instituto de Investigación Sanitaria Valdecilla, IDIVAL, Cantabria, Spain;
| | - Antonela Martínez-Torres
- Unidad de Neumología y Alergia Pediátrica y Grupo de Investigación en Enfermería, Hospital Infantil Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria IMIB, Murcia, Spain
| | | | | | - Ines Aguinaga-Ontoso
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra (UPNA), Pamplona, Spain
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Navarra, Spain
| | - Carlos González Díaz
- Unidad de Alergia Infantil, Hospital Universitario Basurto, Bilbao, Vizcaya, Spain
| | - Luis García-Marcos
- Unidad de Neumología y Alergia Pediátrica Hospital Infantil Universitario Virgen de la Arrixaca, Universidad de Murcia e Instituto Murciano de Investigación Biosanitaria IMIB, Murcia, Spain
| | - Grupo Gan Spain
- Centro de Salud Los Castros. Santander, Servicio Cántabro de Salud, Instituto de Investigación Sanitaria Valdecilla, IDIVAL, Cantabria, SpainUnidad de Neumología y Alergia Pediátrica y Grupo de Investigación en Enfermería, Hospital Infantil Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria IMIB, Murcia, SpainFundación María José Jove, Servicio Galego de Saúde (SERGAS), La Coruña, SpainCentro de Salud Pizarrales, Salamanca, Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Salamanca, SpainDepartamento de Ciencias de la Salud, Universidad Pública de Navarra (UPNA), Pamplona, SpainIdiSNA, Instituto de Investigación Sanitaria de Navarra, Navarra, Spain.Unidad de Alergia Infantil, Hospital Universitario Basurto, Bilbao, Vizcaya, SpainUnidad de Neumología y Alergia Pediátrica Hospital Infantil Universitario Virgen de la Arrixaca, Universidad de Murcia e Instituto Murciano de Investigación Biosanitaria IMIB, Murcia, Spain
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Prevalencia y evolución temporal de síntomas de asma en España. Estudio Global Asthma Network (GAN). An Pediatr (Barc) 2022. [DOI: 10.1016/j.anpedi.2021.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Somoza ML, Pérez-Sánchez N, Torres-Rojas I, Martín-Pedraza L, Blanca-López N, Victorio Puche L, Abel Fernández González E, López Sánchez JD, Fernández-Sánchez J, Fernández-Caldas E, Villalba M, Ruano FJ, Cornejo-García JA, Canto G, Blanca M. Sensitisation to Pollen Allergens in Children and Adolescents of Different Ancestry Born and Living in the Same Area. J Asthma Allergy 2022; 15:1359-1367. [PMID: 36189188 PMCID: PMC9525024 DOI: 10.2147/jaa.s370279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background Allergy can start at early ages, with genetic and environmental factors contributing to its development. Aim The study aimed to describe the pattern of sensitisation and allergy in children and adolescents of Spanish versus Moroccan ancestry but born in the same rural area of Spain. Methods Participants were children and adolescents (3–19 years) of Spanish or Moroccan descent, born in Blanca, Murcia (Spain). A detailed questionnaire was completed, and skin prick tests were performed to assess reactions to the most prevalent pollen allergens (O. europaea, P. pratense, S. kali, C. arizonica, P. acerifolia, A. vulgaris and P. judaica) plus molecular components Ole e 1 and Ole e 7. The association with ancestry was verified by studying participants’ parents. Results The study included 693 participants: 48% were aged 3–9 years and 52%, 10–19 years; 80% were of Spanish descent and 20% of Moroccan descent. Sensitisation to Olea europaea, Phleum pratense, Salsola kali and Cupressus arizonica were slightly higher in the Spanish group. The only significant differences were observed in sensitisation to Ole e 1 (p=0.02). Rhinitis, conjunctivitis, and rhinitis plus asthma were significantly higher in the Spanish group (p=0.03, p=0.02, p=0.007, respectively). The sensitisation pattern differed between Spanish and Moroccan parents, and between Moroccan parents and their children, but not between Spanish parents and their children. Conclusion Both environment and ancestry may influence sensitisation and symptoms. Although the environment seems to have a stronger influence, other factors may contribute to the differences in prevalence and in the clinical entities in people of Spanish versus Moroccan descent.
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Affiliation(s)
- Maria Luisa Somoza
- Allergy Department, Infanta Leonor University Hospital, Madrid, Spain
- Correspondence: Maria Luisa Somoza, Email
| | - Natalia Pérez-Sánchez
- Allergy Department, Hospital Regional Universitario de Málaga, Málaga-IBIMA (FIMABIS), Málaga, Spain
| | | | - Laura Martín-Pedraza
- Allergy Department, Fundación para la Investigación e Innovación Biomédica (FIIB) de los Hospitales Universitarios Infanta Leonor y Sureste, Madrid, Spain
| | | | | | | | | | - Javier Fernández-Sánchez
- Allergy Department, General University Hospital of Alicante- ISABIAL, Alicante, Spain
- Clinical Medicine Department, Miguel Hernandez University, Alicante, Spain
| | - Enrique Fernández-Caldas
- R&D Department, Inmunotek Laboratories, Madrid, Spain
- Division of Allergy and Immunology, University of South Florida College of Medicine, Tampa, FL, USA
| | - Mayte Villalba
- Department of Biochemistry and Molecular Biology, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | - Gabriela Canto
- Allergy Department, Infanta Leonor University Hospital, Madrid, Spain
- School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Miguel Blanca
- Allergy Department, Fundación para la Investigación e Innovación Biomédica (FIIB) de los Hospitales Universitarios Infanta Leonor y Sureste, Madrid, Spain
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Prevalence and temporal evolution of asthma symptoms in Spain. Global Asthma Network (GAN) study. An Pediatr (Barc) 2022; 97:161-171. [PMID: 35906153 DOI: 10.1016/j.anpede.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/20/2021] [Indexed: 10/16/2022] Open
Abstract
INTRODUCTION The temporal evolution of the prevalence of asthma described in the ISAAC (International Study of Asthma and Allergies in Childhood) in 2002 is unknown, or if the geographical or age differences are maintained in Spain. OBJECTIVE To describe the prevalence of asthma symptoms in different Spanish geographic areas and compare it with that of those centers that participated in the ISAAC. METHODS Cross-sectional study of asthma prevalence, carried out in 2016-2019 with 19,943 adolescents aged 13-14 years and 17,215 schoolchildren aged 6-7 years from 6 Spanish geographical areas (Cartagena, Bilbao, Cantabria, La Coruña, Pamplona and Salamanca). Asthma symptoms were collected using a written questionnaire and video questionnaire according to the Global Asthma Network (GAN) protocol. RESULTS The prevalence of recent wheezing (last 12 months) was 15.3% at 13-14 years and 10.4% at 6-7 years, with variations in adolescents, from 19% in Bilbao to 10.2% in Cartagena; and in schoolchildren, from 11.7% in Cartagena to 7% in Pamplona. These prevalences were higher than those of the ISAAC (10.6% in adolescents and 9.9% in schoolchildren). 21.3% of adolescents and 12.4% of schoolchildren reported asthma at some time. CONCLUSIONS There is a high prevalence of asthmatic symptoms with an increase in adolescents and a stabilization in Spanish schoolchildren with respect to the ISAAC. Geographic variations in asthma prevalence are not so clearly appreciated, but areas with high prevalences maintain high numbers.
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Asthma prevalence, lung and cardiovascular function in adolescents born preterm. Sci Rep 2020; 10:19616. [PMID: 33184335 PMCID: PMC7661536 DOI: 10.1038/s41598-020-76614-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/23/2020] [Indexed: 01/06/2023] Open
Abstract
Our main objective was to study respiratory evolution and pulmonary and cardiac function in adolescents born preterm in the post-surfactant era. Observational cross-sectional study, comparing very preterm (< 32 weeks) and moderately-late preterm adolescents (≥ 32 weeks) (74 each group). We recorded respiratory symptoms, spirometry and functional echocardiogram. Very preterm adolescents required more respiratory admissions (45.9% vs. 28.4%) (p = 0.03, OR 2.1, CI95% 1.1–4.2) and had more current asthma (21.6% vs. 9.5%, p = 0.04, OR 2.3, CI95% 1.1–5.2). Preterm subjects with intrauterine growth restriction (IUGR) presented lower FEV1 (88.7 ± 13.9 vs. 95.9 ± 13.3, p = 0.027) and lower FVC (88.2 ± 13.6 vs. 95.5 ± 13.3, p = 0.025). When assessing right ventricle, very preterm showed a greater E/E’ ratio (p = 0.02) and longer myocardial performance index (MPI) (p = 0.001). Adolescents with IUGR showed less shortening fraction (p = 0.016), worse E/E′ ratio (p = 0.029) and longer MPI (p = 0.06). Regarding left ventricle, very preterm showed less E′ wave velocity (p = 0.03), greater E/E′ ratio (p = 0.005) and longer MPI (p < 0.001). Gestational age < 32 weeks is independently associated with current asthma in adolescence. Children 13–14 years old born very preterm required more respiratory admissions and had poorer diastolic and global function of both ventricles. IUGR is a risk factor for poorer lung function in preterm adolescents, regardless gestational age.
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Vlaski E, Stavrikj K, Kimovska M, Cholakovska VC, Lawson JA. Divergent trends in the prevalence of asthma-like symptoms and asthma in a developing country: three repeated surveys between 2002 and 2016. Allergol Immunopathol (Madr) 2020; 48:475-483. [PMID: 32284265 DOI: 10.1016/j.aller.2019.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/22/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION AND OBJECTIVES There have been differences in temporal trends of asthma prevalence by geographic region and economic prosperity. The aim of this study was to assess temporal trends in asthma prevalence among young adolescents in Skopje, Republic of North Macedonia as a developing country with a low asthma prevalence. SUBJECTS AND METHODS Data were obtained from three cross-sectional surveys (2002, 2006, and 2016) of adolescents (12-15 years) from randomly selected schools in Skopje. Trends in the prevalence of asthma and asthma-like symptoms were investigated descriptively and using multiple logistic regression to adjust for potential confounding factors. RESULTS The prevalence of asthma increased, although the changes were not statistically significant (2002: 1.7%; 2006: 2.0%; 2016: 2.8%; p=0.075). Statistically significant (p<0.05) reductions in wheeze prevalence over time (2002, 2006, 2016) were observed for current wheeze (8.8%, 7.2%, 5.5%), exercise-induced wheeze (14.2%, 7.9%, 1.9%), and night dry cough (16.5%, 13.5%, 9.6%). After adjustment for potential confounding factors, there was an increase in asthma likelihood by year compared to 2002 (2006: OR=1.22, 95%CI=0.67-2.22; 2016: OR=2.45, 95%CI=1.24-4.84). In the adjusted analyses, associations between year and the asthma-like symptoms confirmed the descriptive results, except for current wheeze, where statistical significance disappeared. CONCLUSIONS Divergent trends in prevalence with a decrease in asthma-like symptoms and an increase in physician-diagnosed asthma in Skopje during a period of 14 years were established. Improved asthma labelling and effective preventative treatment of symptoms may explain some of these changes, although changes in environment and lifestyle could not be ruled out.
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Affiliation(s)
- E Vlaski
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Republic of North Macedonia.
| | - K Stavrikj
- Department of Immunology, University Children's Clinic, Skopje, Republic of North Macedonia
| | - M Kimovska
- Intensive Care Unit, University Children's Clinic, Skopje, Republic of North Macedonia
| | - V C Cholakovska
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Republic of North Macedonia
| | - J A Lawson
- Department of Medicine and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
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Frontela-Saseta C, González-Bermúdez CA, García-Marcos L. Diet: A Specific Part of the Western Lifestyle Pack in the Asthma Epidemic. J Clin Med 2020; 9:E2063. [PMID: 32630168 PMCID: PMC7408793 DOI: 10.3390/jcm9072063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/22/2020] [Accepted: 06/27/2020] [Indexed: 01/04/2023] Open
Abstract
The Western lifestyle is a complex concept that includes the diet as the main axis of different factors which contribute to a detrimental effect on health, lower life expectancy and low quality-of-life. This type of diet is characterized by being high in calories, mainly provided by saturated fats, and rich in sugars that can lead to changes in immune cells and their responsiveness, by different mechanisms that have yet to be totally clarified. Inflammatory processes are perpetuated through different pathways, in which adipose tissue is a major factor. High fat stores in overweight and obesity accumulate energy but the endocrine function is also producing and releasing different bioactive compounds, adipokines, known to be pro-inflammatory and which play an important role in the pathogenesis of asthma. This review therefore explores the latest evidence regarding the adverse effect of the Western diet on adipose tissue inflammation and its causative effect on the asthma epidemic.
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Affiliation(s)
- Carmen Frontela-Saseta
- Department of Food Science and Nutrition, Faculty of Veterinary Sciences, Regional Campus of International Excellence “Campus Mare Nostrum”, 30100 Murcia, Spain
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, 30003 Murcia, Spain; (C.A.G.-B.); (L.G.-M.)
| | - Carlos A. González-Bermúdez
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, 30003 Murcia, Spain; (C.A.G.-B.); (L.G.-M.)
| | - Luis García-Marcos
- Biomedical Research Institute of Murcia (IMIB-Arrixaca), University of Murcia, 30003 Murcia, Spain; (C.A.G.-B.); (L.G.-M.)
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Victorio Puche L, Somoza M, López-Sánchez J, Garrido-Arandia M, Díaz-Perales A, Blanca M. Peach Tree Pollen and Prunus persica 9 Sensitisation and Allergy in Children and Adolescents. Int Arch Allergy Immunol 2019; 180:212-220. [DOI: 10.1159/000502352] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/26/2019] [Indexed: 11/19/2022] Open
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López Blázquez M, Pérez Moreno J, Vigil Vázquez S, Rodríguez Fernández R. Impact of Passive Smoking on Lung Function and Asthma Severity in Children. Arch Bronconeumol 2017; 54:436-437. [PMID: 29203052 DOI: 10.1016/j.arbres.2017.10.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 10/15/2017] [Accepted: 10/16/2017] [Indexed: 12/23/2022]
Affiliation(s)
- María López Blázquez
- Servicio de Pediatría y sus Áreas Específicas, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - Jimena Pérez Moreno
- Servicio de Pediatría y sus Áreas Específicas, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Sara Vigil Vázquez
- Servicio de Pediatría y sus Áreas Específicas, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Rosa Rodríguez Fernández
- Servicio de Pediatría y sus Áreas Específicas, Hospital General Universitario Gregorio Marañón, Madrid, España
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Asthma education taught by physical education teachers at grade schools: A randomised cluster trial. Allergol Immunopathol (Madr) 2017; 45:375-386. [PMID: 28318759 DOI: 10.1016/j.aller.2016.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 10/31/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Assess whether the Asthma, Sport and Health (ASAH) programme taught by teachers improves asthmatics' quality of life, asthma knowledge, and reduces school absenteeism. DESIGN Randomised cluster trial parallel group. PARTICIPANTS 2293 students (203 asthmatic) in the Intervention School group (IS) and 2214 in the Comparison School (CS) (224 asthmatic) belonging to primary school. INTERVENTION Implementation of the educational programme "Asthma, Sport and Health" at grade schools, taught by physical education teachers. MAIN OUTCOME Quality of life according to the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). SECONDARY OUTCOMES Asthma knowledge, asthma control, school absenteeism. RESULTS After implementing the programme in the IS group, global quality of life improved significantly (p<0.001) as did their domains, symptoms (p<0.001), emotional function (p<0.001) and activity limitations (p<0.01), while in the CS group improvement was seen in global life quality (p<0.01) without any significant changes in the domains for emotional function and activity limitations. Asthma knowledge only increased in IS, among asthmatic students from 16.51 (CI 95% 16.04-16.98) to 18.16 (CI 95% 17.69-18.62) (p<0.001) and students without asthma from 15.49 (CI95% 15.36-15.63) to 17.50 (CI95% 17.36-17.64) (p<0.001). The multiple regression analysis showed that quality of life and its domains depend on asthma knowledge and above all, having well-controlled asthma. We found no decrease in school absenteeism. CONCLUSIONS The ASAH programme improved certain quality of life aspects regarding asthma (emotional function and limitation of activities) and asthma knowledge, but it failed to reduce school absenteeism NCT01607749.
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Cisneros C, Díaz-Campos RM, Marina N, Melero C, Padilla A, Pascual S, Pinedo C, Trisán A. Accreditation of specialized asthma units for adults in Spain: an applicable experience for the management of difficult-to-control asthma. J Asthma Allergy 2017; 10:163-169. [PMID: 28533690 PMCID: PMC5431694 DOI: 10.2147/jaa.s131506] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This paper, developed by consensus of staff physicians of accredited asthma units for the management of severe asthma, presents information on the process and requirements for already-existing asthma units to achieve official accreditation by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). Three levels of specialized asthma care have been established based on available resources, which include specialized units for highly complex asthma, specialized asthma units, and basic asthma units. Regardless of the level of accreditation obtained, the distinction of “excellence” could be granted when more requirements in the areas of provision of care, technical and human resources, training in asthma, and teaching and research activities were met at each level. The Spanish experience in the process of accreditation of specialized asthma units, particularly for the care of patients with difficult-to-control asthma, may be applicable to other health care settings.
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Affiliation(s)
| | | | - Núria Marina
- Asthma Unit, Laboratorio de Exploración Funcional, Department of Pneumology, Hospital Universitario Cruces, BioCruces, Barakaldo, Bizkaia
| | - Carlos Melero
- Service of Pneumology, Hospital Universitario 12 de Octubre, Madrid
| | | | | | - Celia Pinedo
- Service of Pneumology, Hospital Clínico San Carlos
| | - Andrea Trisán
- Service of Pneumology, Hospital Universitario Puerta de Hierro, Madrid, Spain
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Vennera MDC, Valero A, Uría E, Forné C, Picado C. Cost-Effectiveness Analysis of Omalizumab for the Treatment of Severe Persistent Asthma in Real Clinical Practice in Spain. Clin Drug Investig 2016; 36:567-78. [PMID: 27142072 DOI: 10.1007/s40261-016-0402-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND OBJECTIVE Omalizumab is a humanized monoclonal antibody that targets circulating immunoglobulin E molecules to treat severe uncontrolled asthma. The aim of this study was to determine the cost effectiveness of omalizumab compared with standard treatment for the control of severe persistent asthma according to data from patients treated in a specialized asthma unit. METHODS This was an observational, retrospective, single-center study in the setting of the Pulmonology and Respiratory Allergy Service, Thorax Institute, Hospital Clínic de Barcelona, Barcelona, Spain. Data were collected by review of medical records of 86 uncontrolled severe persistent asthma patients treated with omalizumab from January 2005 to April 2014. Effectiveness was assessed by the reduction in asthma exacerbations and 3-point increases in the Asthma Control Test (ACT) score. The economic evaluation was performed from the societal perspective, including direct health costs (resource use and drug treatments) and indirect costs (disease impact on labor productivity) in 2016 Euros. The time horizon was 12 months before and after the initiation of treatment with omalizumab. Results were expressed using the incremental cost-effectiveness ratio (ICER). RESULTS Taking into account only direct costs, the ICERs were €1487.46 (95 % confidence interval [CI] 1241.21-1778.34) per exacerbation avoided and €5425.13 (95 % CI 4539.30-6551.03) per 3-point increase in the ACT. When indirect costs were included, the ICERs were €1130.93 (95 % CI 909.08-1392.86) per exacerbation avoided, and €4124.79 (95 % CI 3281.69-5186.73) per 3-point increase in the ACT. CONCLUSIONS The results of this study confirm the effectiveness of the addition of omalizumab to standard therapy in patients with uncontrolled severe persistent asthma.
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Affiliation(s)
- María Del Carmen Vennera
- Department of Pneumology and Respiratory Allergy, Hospital Clinic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain.
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
| | - Antonio Valero
- Department of Pneumology and Respiratory Allergy, Hospital Clinic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Estefany Uría
- Department of Health Economics and Outcome Research, Oblikue Consulting S.L., Barcelona, Spain
| | - Carles Forné
- Department of Health Economics and Outcome Research, Oblikue Consulting S.L., Barcelona, Spain
| | - César Picado
- Department of Pneumology and Respiratory Allergy, Hospital Clinic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Mirzaei M, Karimi M, Beheshti S, Mohammadi M. Prevalence of asthma among Middle Eastern children: A systematic review. Med J Islam Repub Iran 2016. [PMID: 28638816 PMCID: PMC5473014 DOI: 10.18869/mjiri.31.9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background: The prevalence of asthma and allergy has increased during the last decades, especially in children. However, little is known about it in the Middle East region. This systematic review is aimed to estimate the prevalence of asthma among the Middle Eastern children.
Methods: Local and international scientific databases including SID, Iranmedex, Medline and Science Direct were systematically searched for relevant keywords including; asthma, prevalence, children, International Study of Asthma and Allergies in Childhood (ISACC) and the names of Middle Eastern countries for the period of 1996-2011. Papers in Persian and English which met the defined criteria were included into the study. Bibliographies of the extracted articles were also searched. After extraction of data, heterogeneity between studies and publication bias were measured using Egger's-test. Effect size was pooled by the random-effect model. Since significant heterogeneity was found between studies, univariate meta-regression analyses were done to assess the association of variables with the overall results.
Results: Fifty studies in the Middle East examined the prevalence of asthma and allergy in children under the age of 18 years according to the ISAAC criteria and were included. A total number of 289,717 children were examined in the included studies and the prevalence varied from 0.7 % in Isfahan to 22.3 % in Bagdad. The total prevalence of diagnosed asthma was calculated 7.53 % (95% Cl: 6.38-8.75). Prevalence of asthma in the 13-14 years age group was 7.57% (95% Cl: 5.78-9.29) and in 6-7 years age group was 7.43% (95% Cl: 5.75-9.10). The prevalence of asthma among girls, based on random effect model, was 6.30% (95% Cl: 4.97-7.61) and among boys, it was 8.91% (95% Cl: 6.80-11.04).
Conclusion: The prevalence of asthma in the Middle East is lower than most developed countries. However, there is not enough longitudinal data to estimate the trend over time. In order to have more accurate estimates and to provide evidence for proper planning, standard epidemiologic studies should be conducted in countries of the region.
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Affiliation(s)
- Masoud Mirzaei
- Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mehran Karimi
- Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Shima Beheshti
- Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Masoud Mohammadi
- Department of Social Medicine, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Segura N, Fraj J, Cubero J, Sobrevía M, Lezaun A, Ferrer L, Sebastián A, Colás C. Mould and grass pollen allergy as risk factors for childhood asthma in Zaragoza, Spain. Allergol Immunopathol (Madr) 2016; 44:455-60. [PMID: 27255475 DOI: 10.1016/j.aller.2016.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/03/2016] [Accepted: 02/08/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Examine the prevalence of asthma and associated predictive factors in a group of 468 students. PATIENTS AND METHODS A descriptive, cross-sectional observational study in a randomly selected population of 468 children aged 10-12, in the city of Zaragoza. We used the ISAAC questionnaire on asthma completed by children under supervision of the investigators. We assessed the genetic risk (family history of asthma) and environmental risks. The risk for atopy was assessed by the presence of positive skin prick tests. RESULTS 25.3% of the children had symptoms consistent with asthma in the city of Zaragoza. Among them 33.1% reported a history of asthma in close relatives (OR=1.78, p<0.001). The history of hospitalisations for lower respiratory tract illness was strongly associated with the presence of asthma (OR=6.72, p<0.0001). Positive skin tests to Alternaria (OR=2.00, p<0.0001) and grass pollen (OR=1.76, p<0.001) were predictors of asthma. 63.6% of asthmatic children had presented clinical rhinitis in the previous 12 months, compared with 32% of non-asthmatics, and this difference was statistically significant (OR=3.89, p<0.0001). 47% of asthmatics presented with or previously had eczema, whereas only 26.9% of non-asthmatics presented with or previously had these types of lesions (p<0.0001). CONCLUSION The following are predictors of asthma: History of hospital admissions for lower respiratory tract illness, presence of rhinitis and/or eczema, positive prick test for certain aeroallergens, especially Alternaria and grass pollen, and family history of asthma.
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Moral L, Loeda C, Gómez F, Pena M, Martínez M, Cerdán J, Lillo L, Toral T. Complicated pleural infection: Analysis of two consecutive cohorts managed with a different policy. An Pediatr (Barc) 2016. [DOI: 10.1016/j.anpede.2015.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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18
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Colli Lista G, Pérez-Frías J. Exposure to pets and risk of sensitisation to house dust mite, cat and dog allergens in a pre-school children population of an Andalusian seaside town. Allergol Immunopathol (Madr) 2015; 43:617-9. [PMID: 25982577 DOI: 10.1016/j.aller.2015.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 12/19/2014] [Accepted: 01/14/2015] [Indexed: 10/23/2022]
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Moral L, Loeda C, Gómez F, Pena MA, Martínez M, Cerdán JM, Lillo L, Toral T. [Complicated pleural infection: Analysis of 2 consecutive cohorts managed with a different policy]. An Pediatr (Barc) 2015; 84:46-53. [PMID: 25882625 DOI: 10.1016/j.anpedi.2015.02.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/22/2015] [Accepted: 02/02/2015] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The treatment of complicated pleural infection (CPI) is controversial. Clinical guidelines recommend drainage, but with the lowest grade of evidence. Recent reports have observed good outcomes with antibiotics alone. We retrospectively compared the outcomes in two consecutive cohorts treated with different policies: the first treated according to pleural fluid charactersitics (2005-2009, interventional-prone, group 1) and the second according to clinical assessment (2010-2013, conservative-prone, group 2). METHODS The clinical records of all children treated for CPI in our hospital between 2005 and 2013 were thoroughly reviewed. Primary outcomes were the proportion of children drained and the length of hospital stay (LHS). RESULTS One hundred and nine patients (64 group 1 and 45 group 2) were analyzed. A chest tube was placed in 83% of patients in group 1 and 47% in group 2 (P<0.001). The mean LHS was 11.4 days for patients in group 1 and 12.3 for patients in group 2 (P=0.45); no differences were observed in other outcomes. CONCLUSION Our results add to few recent observations reporting good outcomes in many children treated with antibiotics alone and challenge the need to drain most children with CPI. Clinical trials are now needed to identify when a drainage procedure would be useful.
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Affiliation(s)
- L Moral
- Servicio de Pediatría, Hospital General Universitario de Alicante, Alicante, España.
| | - C Loeda
- Servicio de Pediatría, Hospital General Universitario de Alicante, Alicante, España
| | - F Gómez
- Servicio de Pediatría, Hospital General Universitario de Alicante, Alicante, España
| | - M A Pena
- Servicio de Farmacología Clínica, Hospital General Universitario de Alicante, Alicante, España
| | - M Martínez
- Servicio de Pediatría, Hospital General Universitario de Alicante, Alicante, España
| | - J M Cerdán
- Servicio de Pediatría, Hospital General Universitario de Alicante, Alicante, España
| | - L Lillo
- Servicio de Pediatría, Hospital General Universitario de Alicante, Alicante, España
| | - T Toral
- Servicio de Pediatría, Hospital General Universitario de Alicante, Alicante, España
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Levy AN, García A Ruiz AJ, García-Agua Soler N, Sanjuan MVH. Cost-effectiveness of omalizumab in severe persistent asthma in Spain: a real-life perspective. J Asthma 2014; 52:205-10. [PMID: 24995661 DOI: 10.3109/02770903.2014.941474] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To determine the cost-effectiveness of omalizumab compared with routine clinical practice in the treatment and control of severe persistent asthma. METHODS Cost-effectiveness analysis using pre- and post-treatment with omalizumab after 10 months of 47 patients diagnosed with uncontrolled severe persistent asthma attended by the Pneumology Service, Hospital Universitario Virgen de la Victoria, Malaga. Effectiveness was assessed by the number of emergency room (ER) visits for exacerbations and quality-adjusted life years (QALY) gained. The costs of treatment with omalizumab and ER visits were analyzed using the National Health System perspective. Results are expressed in cost per QALY gained and cost per ER visit avoided (costs €2012). RESULTS Exacerbations with ER visits decreased significantly (p < 0.001) after 10 months of omalizumab treatment compared with the previous 10 months [7.94 (6.52-9.37) vs 0.19 (0.03-0.35)]. Health utilities increased significantly (p < 0.001) during the same period [0.5967 (0.5722-0.6212) vs 0.7566 (0.7232-0.7900)], representing 0.1333 (0.1053-0.1612) QALYs gained (p < 0.001).The mean cost per patient was €1850.78 (1519.46-2182.10) in the 10 months before treatment and €5431.87 (4930.72-5933.02) after 10 months of omalizumab treatment. The incremental cost-effectiveness ratios (ICERs) were €462.08/exacerbation avoided (347.65-606.22) and €26 864.89/QALY gained (21 632.07-33 859.49). CONCLUSIONS Our results confirm that adding omalizumab to the treatment of patients with uncontrolled severe persistent asthma reduces the number of exacerbations with ER visits and increases health-related quality of life after 10 months of treatment and produces ICERs favorable to omalizumab and acceptable from the health system perspective.
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Affiliation(s)
- Alberto Nahon Levy
- Servicio de Neumología, Hospital Universitario Virgen de la Victoria , Málaga , Spain and
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21
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de Miguel-Díez J, Jiménez-García R, Hernández-Barrera V, López de Andrés A, Villa-Asensi JR, Plaza V, Carrasco-Garrido P. National trends in hospital admissions for asthma exacerbations among pediatric and young adult population in Spain (2002-2010). Respir Med 2014; 108:983-91. [PMID: 24795277 DOI: 10.1016/j.rmed.2014.04.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 04/08/2014] [Accepted: 04/10/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess the changes in incidence, use of mechanical ventilation, length of stay (LOS), costs and mortality of children (0-15 years) and young adults (16-45 years) hospitalized for asthma exacerbations. METHODS We included patients hospitalized for asthma exacerbations in Spain from 2002 to 2010 (ICD9-CM codes 493.0x-493.9x). The data were collected from the National Hospital Discharge Database (entire population). We calculated the yearly age- and sex-specific incidence rates for each of the two groups. RESULTS We included a total of 12,038 pediatric patients and 2792 young adults hospitalized for asthma exacerbations. Overall crude incidence decreased from 20.5 to 18.7 admissions per 100.000 inhabitants in the pediatric group (p < 0.05), and from 4.12 to 3.68 admissions per 100.000 inhabitants among young adults, from 2002 to 2010 (p < 0.05). By contrast, we detected a significant increase in the use of non-invasive ventilation (NIV) in both groups. The average LOS decreased during the study period, from 3.71 (SD 2.28) to 3.16 (SD 2.11) days (p < 0.05) among pediatric patients and there were not changes among young adults. During the study period, the mean cost per patient decreased from 1558.53 (SD 443.63) to 1378.41 (SD 472.71) euros in the pediatric group (p < 0.05), while increased from 2183.44 (SD 783.15) to 2564.32 (SD 1933.98) euros among young adults (p < 0.05). CONCLUSION Our results suggest a decrease in the incidence of hospital admissions for asthma exacerbations with concomitant increase in use of NIV in asthmatic patients, both pediatric and young adults patients. Although LOS and mean cost have decreased among pediatric patients, they have not changed and increased, respectively, among young adults. A better management of the disease at primary care services may explain the improvement in the incidence and outcomes.
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Affiliation(s)
- Javier de Miguel-Díez
- Department of Respiratory Medicine, Hospital General Universitario Gregorio Marañón, Instituto de investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, Madrid, Spain.
| | - Rodrigo Jiménez-García
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Ana López de Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - José Ramón Villa-Asensi
- Department of Respiratory Medicine, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Vicente Plaza
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Carrasco-Garrido
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
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Abstract
Asthma has puzzled and confused physicians from the time of Hippocrates to the present day. The word “asthma” comes from a Greek word meaning “panting” (Keeney 1964), but reference to asthma can also be found in ancient Egyptian, Hebrew, and Indian medical writings (Ellul-Micallef 1976; Unger and Harris 1974). There were clear observations of patients experiencing attacks of asthma in the second century and evidence of disordered anatomy in the lung as far back as the seventeenth century (Dring et al. 1689).
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Song N, Shamssain M, Mohammed S, Zhang J, Wu J, Fu C, Hao S, Guan J, Yan X. Prevalence, severity and risk factors of asthma, rhinitis and eczema in a large group of Chinese schoolchildren. J Asthma 2013; 51:232-42. [PMID: 24303994 DOI: 10.3109/02770903.2013.867973] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is a lack of information on the prevalence, severity and risk factors of asthma, rhinitis and eczema in Chinese children. OBJECTIVE To establish baseline data for a major longitudinal study of factors affecting asthma, rhinitis and eczema in a large group of children from the industrialized city of Shijiazhuang, China. METHODS We used the International Study of Asthma and Allergies in Childhood questionnaire and studied 10 338 children, ages 6-18, from Shijiazhuang. RESULTS The prevalence of childhood asthma, rhinitis and eczema is 1.2%, 13.5% and 11.8%, respectively. Boys had higher prevalence of these conditions than girls and younger children had higher prevalence of asthma and eczema but lower prevalence of rhinitis than older children. Breastfed children had lower prevalence of asthma and rhinitis, but not eczema, than non-breastfed children. Overweight children had higher prevalence of asthma and rhinitis than those who were not overweight. Children exposed to paternal smoking had higher prevalence of rhinitis and eczema than those not exposed; children exposed to pets had higher prevalence of asthma and rhinitis than those not exposed. CONCLUSIONS The prevalence of asthma in this study group is low, but the prevalence of rhinitis is high, and could be considered a major public health problem. The prevalence of asthma, rhinitis and eczema is generally higher in boys and younger children generally have higher prevalence of asthma and eczema but lower prevalence of rhinitis. Exposure to pets is a risk factor for rhinitis, being overweight is a risk factor for asthma and rhinitis, and exposure to parental smoking is a risk factor for asthma, rhinitis and eczema in these children.
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Affiliation(s)
- Ning Song
- Department of Respiratory Medicine, the Second Hospital of Hebei Medical University , Shijiazhuang, Hebei , P.R. China
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Hygidio DDA, Silva JD, Silveira S, Schwinden BC. Avaliação do controle da asma em pacientes acompanhados em dois ambulatórios de pneumologia vinculados à Estratégia Saúde da Família em Tubarão, Santa Catarina, Brasil. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2013. [DOI: 10.5712/rbmfc9(30)737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introdução: A asma é uma doença crônica debilitante, que pode gerar restrições diretamente ligadas a um mau controle da doença. O controle da asma pode ser avaliado por instrumentos padronizados. Objetivo: Determinar o controle da asma por meio do Questionário de Controle da Asma (QCA) e do Teste de Controle da Asma (TCA) e a classificação de acordo com as Diretrizes para o Manejo da Asma, de 2012. Métodos: Estudo observacional transversal com pacientes atendidos em ambulatórios de referência vinculados à Estratégia Saúde da Família em Tubarão-SC. A população foi composta por todos os pacientes asmáticos adultos que recorreram a consultas médicas durante o período de janeiro a novembro de 2010. Os dados foram compilados em uma planilha Excel e analisados pelo programa INSTAT 3. Foi realizada análise descritiva e aplicado teste quiquadrado para verificar associação entre respostas do TCA e QCA. Resultados: Foram avaliados 49 pacientes, tendo, a maioria deles, asma intermitente ou persistente leve (51%). Na avaliação do controle da asma o TCA mostrou que 69,3% dos pacientes não estavam controlados. Em relação ao QCA, foram considerados fora do alvo 75,5% dos pacientes. Houve associação significativa entre o TCA e QCA (p<0,05). Quanto às Diretrizes para o Manejo da Asma, 2012, 57,14% dos pacientes foram considerados não controlados; 30,6% estavam parcialmente controlados; e 12,2%, controlados. Conclusão: Os asmáticos estavam, em sua maioria, não controlados. Torna-se necessário identificar os fatores ligados ao descontrole e buscar estratégias, visando melhorar os escores para redução da morbimortalidade associada à asma.
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Gonzalez-Barcala FJ, Pertega S, Sampedro M, Lastres JS, Gonzalez MASJ, Bamonde L, Garnelo L, Castro TP, Valdés-Cuadrado L, Carreira JM, Moure JD, Silvarrey AL. Impact of parental smoking on childhood asthma. J Pediatr (Rio J) 2013; 89:294-9. [PMID: 23684453 DOI: 10.1016/j.jped.2012.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 11/21/2012] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To evaluate the exposure to environmental tobacco smoke (ETS) of the childhood population in this community and its relationship with asthma symptoms. METHODS A cross-sectional study was conducted using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire on children and adolescents in this community. The symptoms "wheezing ever", "current asthma", "severe asthma", and "exercise-induced asthma" were defined by this questionnaire. Parental smoking was classified into four mutually exclusive categories: 1) no parent smokes; 2) only the mother smokes; 3) only the father smokes; and 4) both parents smoke. The odds ratio of the prevalence of asthma symptoms according to ETS exposure was calculated using logistic regression. RESULTS A total of 10,314 children and 10,453 adolescents were included. Over 51% of the children and adolescents were exposed to ETS at home. ETS is associated with a higher prevalence of asthma symptoms, particularly if the mother or both parents smoke. CONCLUSION The prevalence of ETS is still high in this community, although there has been a decreasing tendency in the last 15 years. ETS is associated with higher prevalence of asthma.
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Gonzalez-Barcala FJ, Pertega S, Sampedro M, Lastres JS, Gonzalez MASJ, Bamonde L, Garnelo L, Castro TP, Valdés-Cuadrado L, Carreira JM, Moure JD, Silvarrey AL. Impact of parental smoking on childhood asthma. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2013. [DOI: 10.1016/j.jpedp.2012.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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27
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Wong GWK, Leung TF, Ko FWS. Changing prevalence of allergic diseases in the Asia-pacific region. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2013; 5:251-7. [PMID: 24003381 PMCID: PMC3756171 DOI: 10.4168/aair.2013.5.5.251] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 11/06/2012] [Indexed: 01/15/2023]
Abstract
Asia-Pacific is one of the most densely populated regions of the world and is experiencing rapid economic changes and urbanization. Environmental pollution is a significant problem associated with the rapid modernization of many cities in South Asia. It is not surprising that the prevalences of asthma and allergies are increasing rapidly, although the underlying reasons remain largely unknown. Many studies from this region have documented the changing prevalence of allergic diseases in various parts of the world. However, the methodologies used were neither standardized nor validated, making the results difficult to evaluate. The International Study of Asthma and Allergies in Childhood (ISAAC) has provided a global epidemiology map of asthma and allergic diseases, as well as the trend of changes in the prevalence of these diseases. Allergic sensitization is extremely common in many Asian communities. However, the prevalence of allergic diseases remains relatively rare. The rapid urbanization in the region, which increases environmental pollution and can affect the rural environment, will likely increase the prevalence of asthma and allergies in Asia.
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Affiliation(s)
- Gary W K Wong
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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Ghanname I, Ahid S, Berrada G, Belaiche A, Hassar M, Cherrah Y. Trends in the use of antiasthmatic medications in Morocco (1999-2010). SPRINGERPLUS 2013; 2:82. [PMID: 23519830 PMCID: PMC3601251 DOI: 10.1186/2193-1801-2-82] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 02/19/2013] [Indexed: 11/10/2022]
Abstract
Background Asthma is a big public health problem in Morocco. The drug therapy existing in Morocco is currently insufficient because of the low purchasing power and the low health insurance coverage available to the average citizen in Morocco. In this study we evaluated the consumption of antiasthmatics in Morocco during the period 1999–2010, the classes of used drugs and the generics’ market share. Methods We used sales data from the Moroccan subsidiaries of the IMS Health “Intercontinental Marketing Service”. The consumption volume was converted to Defined Daily Doses (DDDs). Results During 1999–2010, antiasthmatics’s consumption increased from 3.91 to 14.47 DDD per 1000 inhabitants per day. In 2010, the association Beta-2-mimetic-Glucocorticosteroids were the most consumed (8.53 DDD/1000 Inhabitants/day) followed by the short-acting inhaled Beta-2-mimetic (4 DDD/1000 Inhabitants/day) and inhaled Glucocorticosteroids alone accounted for 1.13 DDD/1000 Inhabitants/day. The largest consumption share in volume was held by the short-acting inhaled Beta-2-mimetic (42%) followed by the combination Beta-2-mimetic-Glucocorticosteroids (38%). Between 1999 and 2010, the market for generic antiasthmatics increased from 1.84 to 2.18 DDD/1000 Inhabitants/day. The ratio of the monthly average cost of treatment to the minimum wage in Morocco decreased from 10.8% in 1999 to 7.11% in 2010. Conclusion Antiasthmatics’ consumption in Morocco has undergone significant changes between 1999 and 2010. However, the availability of these drugs expressed as the Average Monthly Expenditure/Guaranteed Minimum Wage ratio improved. Despite this, the use of antiasmathics in Morocco remains low.
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Affiliation(s)
- Imane Ghanname
- Department of Pharmacology and Toxicology, Faculty of Medicine and Pharmacy, Research team of Pharmacoepidemiology & Pharmacoeconomics, Rabat, Morocco
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Martín-de-Carpi J, Rodríguez A, Ramos E, Jiménez S, Martínez-Gómez MJ, Medina E. Increasing incidence of pediatric inflammatory bowel disease in Spain (1996-2009): the SPIRIT Registry. Inflamm Bowel Dis 2013; 19:73-80. [PMID: 22535573 DOI: 10.1002/ibd.22980] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Although pediatric inflammatory bowel disease (IBD) diagnosis has increased in the last decades in Spain, there are no consistent epidemiologic data. Our aim was to describe the changing pattern of pediatric IBD incidence in Spain in the last 14 years. METHODS A retrospective survey of patients diagnosed below 18 years of age in the period 1996-2009 was performed. Patients' data were obtained from the hospitals' databases. To avoid reduced accrual of cases diagnosed by adult physicians, adult IBD units in referral centers were invited to participate. Seventy-eight centers participated in our survey. Rates of incidence were calculated using age-stratified population-based epidemiologic data. Incidence rates were compared for the last 14 years (1996-2009). RESULTS In total, data from 2107 patients were obtained: 1,165 Crohn's disease (CD, 55.3%), 788 ulcerative colitis (UC, 37.4%), and 154 IBD unclassified. The sex distribution was 56.4% male, with higher predominance for CD (59.3%) as compared to UC (52.8%) and IBD unclassified (53.2%) (P = 0.012). The median age at diagnosis was 12.3 years (p25-75 9.7-14.6) with significant differences between diseases. IBD incidence increased from 0.97 to 2.8/100,000 inhabitants <18 years/year in the study period. Although this increase is more evident for CD (from 0.53 to 1.7), UC has also risen considerably (0.39 to 0.88). CONCLUSIONS This is the first attempt to calculate the current incidence of pediatric IBD in Spain. A significant increase of incidence rates in the study period was observed. In the last 14 years pediatric IBD incidence has almost tripled, with a more important CD increase.
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Affiliation(s)
- Javier Martín-de-Carpi
- Unidad para el Cuidado Integral de la Enfermedad Inflamatoria Intestinal Pediátrica, Sección de Gastroenterología, Hepatología y Nutrición Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain.
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Gonzalez-Barcala FJ, Aboal J, Carreira JM, Rodriguez-Alvarez MX, Puga A, Sanjose E, Pintos M, Valdes L. Trends of asthma mortality in Galicia from 1993 to 2007. J Asthma 2012; 49:1016-20. [PMID: 23102239 DOI: 10.3109/02770903.2012.728272] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION In the past few years, deaths due to asthma appear to decrease at least in Western countries; but there are significant variations between populations. The aim of this study is to describe the trends in deaths due to asthma between 1993 and 2007 in our community and to analyze any factors associated with this. METHODS All cases, which had asthma as a cause of death, were included in the study. The mortality data were obtained from the official death certificate from the Deaths Register. Mortality relative risk, based on the calendar year, sociodemographic variables (age and gender), seasons, and days of the week, were estimated using a Poisson generalized linear model with a log-link. RESULTS In the 15 years of the study period, a total of 1180 people had died due to asthma, mainly in winter (34.5%), women (64.5%), and advanced age (65 years or above; 84.6%). A tendency of decreased mortality in all age groups was observed during the period of the study, which was significant in both the sexes in the 35- to 64-year-old age group, and in males above 65 years. CONCLUSION Death due to asthma is changing favorably in our community, with a tendency to decrease in the past few years. Advanced age, being female, and the winter period are associated with a higher mortality rate due to asthma.
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Affiliation(s)
- F J Gonzalez-Barcala
- Department of Respiratory Diseases, University Hospital of Santiago de Compostela, Spain.
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Dennis RJ, Caraballo L, García E, Rojas MX, Rondon MA, Pérez A, Aristizabal G, Peñaranda A, Barragan AM, Ahumada V, Jimenez S. Prevalence of asthma and other allergic conditions in Colombia 2009-2010: a cross-sectional study. BMC Pulm Med 2012; 12:17. [PMID: 22551171 PMCID: PMC3488963 DOI: 10.1186/1471-2466-12-17] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 05/02/2012] [Indexed: 12/03/2022] Open
Abstract
Background While it is suggested that the prevalence of asthma in developed countries may have stabilized, this is not clear in currently developing countries. Current available information for both adults and children simultaneously on the burden and impact of allergic conditions in Colombia and in many Latin American countries is limited. The objectives of this study were to estimate the prevalence for asthma, allergic rhinitis (AR), atopic eczema (AE), and atopy in six colombian cities; to quantify costs to the patient and her/his family; and to determine levels of Immunoglobulin E (IgE) in asthmatic and healthy subjects. Methods We conducted a cross-sectional, population-based study in six cities during the academic year 2009–2010. We used a school-based design for subjects between 5–17 years old. We carried out a community-based strategy for subjects between 1–4 years old and adults between 18–59 years old. Serum samples for total and antigen-specific (IgE) levels were collected using a population-based, nested, case–control design. Results We obtained information on 5978 subjects. The largest sample of subjects was collected in Bogotá (2392). The current prevalence of asthma symptoms was 12% (95% CI, 10.5-13.7), with 43% (95% CI, 36.3-49.2) reporting having required an emergency department visit or hospitalization in the past 12 months. Physician diagnosed asthma was 7% (95% CI, 6.1-8.0). The current prevalence of AR symptoms was 32% (95% CI, 29.5-33.9), and of AE symptoms was 14% (95% CI, 12.5-15.3). We collected blood samples from 855 subjects; 60.2% of asthmatics and 40.6% of controls could be classified as atopic. Conclusions In Colombia, symptom prevalence for asthma, AR and AE, as well as levels of atopy, are substantial. Specifically for asthma, symptom severity and absence from work or study due to symptoms are important. These primary care sensitive conditions remain an unmet public health burden in developing countries such as Colombia.
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Affiliation(s)
- Rodolfo J Dennis
- Research Department, Fundación Cardioinfantil - Instituto de Cardiología, Carrera 13 B N° 163-85, Torre A, tercer piso, Bogota, Colombia.
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[Impact of an asthma educational intervention programme on teachers]. An Pediatr (Barc) 2012; 77:236-46. [PMID: 22498020 DOI: 10.1016/j.anpedi.2012.02.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 02/18/2012] [Accepted: 02/20/2012] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Our objective was to measure the impact of an educational intervention program on teacher's knowledge about asthma and its management. MATERIAL AND METHOD Before and after quasi-experimental study, with control group, of an educational intervention, which had as its aim to improve the teacher's knowledge of asthma and its management, was conducted in some schools of San Sebastian (Gipuzkoa), Spain. The Newcastle Asthma knowledge Questionnaire (NAKQ) was used as a measuring tool, and an adaptation of the asthma, sport and health program was used as an educational intervention. The Wilcoxon signed rank test was used to compare the total score of the questionnaire before and after the intervention, and the McNemar test was performed to compare the percentages of correct answers to each item. The Mann-Whitney U test was also performed to compare the baseline score and the score at three months between the intervention group and control group. The size of the effect and the standardised mean response were studied. RESULTS A total of 138 teachers from 6 schools, which were chosen at random (study group), and 43 teachers in the control group participated in the study. In the study group, the mean score of the NAKQ before the educational intervention was 16.1±3.4 points, with a median of 16 (range 7 to 23). After the intervention the mean score increased to 22.3±4.1, with a median of 23 (range, 6 to 29). The mean difference in the overall score of the NAKQ was 7.0±4.2 points, with a median of 8 (range, -2 to17). Furthermore, the size of the effect was 2.0 (> 0.8) and the standardised mean response was 1.7. After 3 months of the intervention the mean score of the NAKQ was 21.4±3.0 points, with a median of 22 (range, 12 to 29) which was significantly higher than the score obtained before the intervention (P<.001) and slightly lower than the score obtained immediately after the intervention, assuming a size of the effect of 1.6 and a standardised mean response of 1.2. In the control group, the level of knowledge did not change modified and was lower than the level of the intervention group (P<.001). CONCLUSIONS An educational intervention program conducted among teachers significantly increases their knowledge of asthma. Moreover, the increase reduces slightly but maintains its higher level for at least 3 months. In spite of the fact that some aspects of knowledge improved with the educational intervention, they were not optimal.
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Abstract
There has been a global epidemic of asthma during the past half-century. More recently, the prevalence has leveled off or declined in many Western countries, whereas the prevalence in less affluent nations is still increasing. The reasons for this and the different geographical patterns of asthma prevalence remain unclear. This paper provides an epidemiologic perspective on whether allergen exposure and allergies can explain these trends. In particular, the paper discusses 1) geographical and temporal trends in asthma and the role of allergens and allergy, 2) the importance of nonallergic mechanisms, 3) nonallergenic exposures that may modify the risk of allergies and asthma, and 4) new and emerging risk and protective factors. Although allergy and asthma are closely related, allergen exposure and allergy alone cannot explain current time trends and geographical patterns of asthma. Population-based studies focusing on recently identified risk and protective factors may provide further insight.
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Nieto A, Mazon A, Martin-Mateos MA, Plaza AM, Garde J, Alonso E, Martorell A, Boquete M, Lorente F, Ibero M, Bone J, Pamies R, Garcia JM, Echeverria L, Nevot S, Martinez-Cañavate A, Fernandez-Benitez M, Garcia-Marcos L. Pediatric allergy and immunology in Spain. Pediatr Allergy Immunol 2011; 22:742-50. [PMID: 21950680 DOI: 10.1111/j.1399-3038.2011.01211.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The data of the ISAAC project in Spain show a prevalence of childhood asthma ranging from 7.1% to 15.3%, with regional differences; a higher prevalence, 22.6% to 35.8%, is described for rhinitis, and atopic dermatitis is found in 4.1% to 7.6% of children. The prevalence of food allergy is 3%. All children in Spain have the right to be visited in the National Health System. The medical care at the primary level is provided by pediatricians, who have obtained their titles through a 4-yr medical residency training program. The education on pediatric allergy during that period is not compulsory and thus very variable. There are currently 112 certified European pediatric allergists in Spain, who have obtained the accreditation of the European Union of Medical Specialist for proven skills and experience in pediatric allergy. Future specialists in pediatric allergy should obtain their titles through a specific education program to be developed in one of the four accredited training units on pediatric allergy, after obtaining the title on pediatrics. The Spanish Society of Pediatric Allergy and Clinical Immunology (SEICAP) gathers over 350 pediatric allergists and pediatricians working in this field. SEICAP has a growing activity including yearly congresses, continued education courses, elaboration of technical clinical documents and protocols, education of patients, and collaboration with other scientific societies and associations of patients. The official journal of SEICAP is Allergologia et Immunophatologia, published every 2 months since 1972. The web site of SEICAP, http://www.seicap.es, open since 2004, offers information for professionals and extensive information on pediatric allergic and immunologic disorders for the lay public; the web site is receiving 750 daily visits during 2011. The pediatric allergy units are very active in clinical work, procedures as immunotherapy or induction of oral tolerance in food allergy, contribution to scientific literature, and collaboration in international projects.
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Affiliation(s)
- Antonio Nieto
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe, Valencia, Spain
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López-Silvarrey-Varela A, Pértega-Díaz S, Rueda-Esteban S, Sánchez-Lastres JM, San-José-González MA, Sampedro-Campos M, Pérez-Castro T, Garnelo-Suárez L, Bamonde-Rodríguez L, López-Silvarrey-Varela J, González-Barcala J. Prevalence and Geographic Variations in Asthma Symptoms in Children and Adolescents in Galicia (Spain). ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.arbr.2011.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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de Sousa JC, Santo ME, Colaço T, Almada-Lobo F, Yaphe J. Asthma in an urban population in Portugal: a prevalence study. BMC Public Health 2011; 11:347. [PMID: 21595928 PMCID: PMC3121634 DOI: 10.1186/1471-2458-11-347] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 05/19/2011] [Indexed: 11/16/2022] Open
Abstract
Background The prevalence and incidence of asthma are believed to be increasing but research on the true incidence, prevalence and mortality from asthma has met methodological obstacles since it has been difficult to define and diagnose asthma in epidemiological terms. New and widely accepted diagnostic criteria for asthma present opportunities for progress in this field. Studies conducted in Portugal have estimated the disease prevalence between 3% and 15%. Available epidemiological data present a significant variability due to methodological obstacles. Aim To estimate the true prevalence of asthma by gender and age groups in the population of the area covered by one urban Health Centre in Portugal. Method An observational study was conducted between February and July 2009 at the Horizonte Family Health Unit in Matosinhos, Portugal. A random sample of 590 patients, stratified by age and gender was obtained from the practice database of registered patients. Data was collected using a patient questionnaire based on respiratory symptoms and the physician's best knowledge of the patient's asthma status. The prevalence of asthma was calculated by age and gender. Results Data were obtained from 576 patients (97.6% response rate). The mean age for patients with asthma was 27.0 years (95% CI: 20.95 to 33.16). This was lower than the mean age for non-asthmatics but the difference was not statistically significant. Asthma was diagnosed in 59 persons giving a prevalence of 10.24% (95% CI: 8.16 to 12.32). There was no statistically significant difference in the prevalence of asthma by gender. Conclusion The prevalence of asthma found in the present study was higher than that found in some studies, though lower than that found in other studies. Further studies in other regions of Portugal are required to confirm these findings.
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Affiliation(s)
- Jaime Correia de Sousa
- Life and Health Sciences Research Institute, ICVS, School of Health Sciences, University of Minho, Portugal and Horizonte Family Health Unit, Matosinhos, Porto, Portugal.
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Arnedo-Pena A, García-Marcos L, Fernández-Espinar JF, Bercedo-Sanz A, Aguinaga-Ontoso I, González-Díaz C, Carvajal-Urueña I, Busquet-Monge R, Suárez-Varela MM, de Andoin NG, Batlles-Garrido J, Blanco-Quirós A, Varela ALS, García-Hernández G. Sunny hours and variations in the prevalence of asthma in schoolchildren according to the International Study of Asthma and Allergies (ISAAC) Phase III in Spain. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2011; 55:423-434. [PMID: 20803035 DOI: 10.1007/s00484-010-0353-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Revised: 07/01/2010] [Accepted: 07/30/2010] [Indexed: 05/29/2023]
Abstract
The objective of this study was to estimate the relationship between the prevalence of asthma in schoolchildren aged 6-7 years and 13-14 years and the mean annual sunny hours (MASH) in Spain, and to explore predictive models for asthma prevalence. The prevalence of asthma was obtained from the International Study of Asthma and Allergies (ISAAC) Phase III 2002-2003, and climate and socio-economic variables from official sources. Nine centres were studied and a further four centres, two of which are in ISAAC, to test the predictive models. Logistic regression was used to estimate adjusted prevalence rates of asthma for each centre, and multiple regression models to study the effects of MASH and other meteorological and socio-economic variables. The adjusted prevalence rate of asthma decreased 0.6% [95% confidence interval (CI) 0.4-0.8%] for the 6-7 years group and 1.1% (95% CI 0.8-1.3%) for the 13-14 years group with an increase in the MASH of 100 h. Relative humidity was negatively associated with asthma in the older age group, and gross province product per capita (GPP) was positively associated with asthma in the younger age group. The predictive models, which included MASH, gender, relative humidity, and GPP, anticipated prevalence rates of asthma without significant differences between the levels observed and those expected in 9 of the 11 measurements carried out. The results indicate that sunny hours have a protective effect on the prevalence of asthma in schoolchildren.
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Gonzalez-Barcala FJ, Aboal J, Valdes L, Carreira JM, Alvarez-Dobaño JM, Puga A, Garcia-Sanz MT, Takkouche B. Trends in adult asthma hospitalization: gender-age effect. Multidiscip Respir Med 2011; 6:82-6. [PMID: 22958944 PMCID: PMC3497863 DOI: 10.1186/2049-6958-6-2-82] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Accepted: 09/06/2010] [Indexed: 11/17/2022] Open
Abstract
Background Hospital admissions due to asthma are a reliable source of information on the morbidity of the disease which, after the increase observed in the last quarter of the last century, shows a declining trend in the last few years. The aim of this study was to look at hospital admission trends due to asthma in our community and analyze some of its associated factors. Methods Retrospective analysis of all hospital admissions involving adults aged 15 years and older with asthma as the primary or secondary diagnosis (if the first diagnosis was respiratory failure or respiratory infection) in Public Health Service hospitals in the Galician region of Spain between the years 1995-2009 (total 24,766 admissions). Results The majority of patients admitted were female (71%), over 60 years of age (64%), and admission occurred predominantly in the winter months. The hospitalization rate due to asthma tripled over the period studied, this being mainly accounted for by women aged over 60 years. Mean hospital stay was 9.2 days, longer in older patients or those admitted over the weekend. Conclusions A significant increase in hospital admissions due to asthma over the last few years has been observed in our community, mainly involving older women. The mean stay seems long, increasing with patients' age and admission over the weekend.
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Pegas PN, Alves CA, Scotto MG, Evtyugina MG, Pio CA, Freitas MC. [Risk factors and prevalence of asthma and rhinitis among primary school children in Lisbon]. REVISTA PORTUGUESA DE PNEUMOLOGIA 2011; 17:109-16. [PMID: 21549669 DOI: 10.1016/j.rppneu.2011.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 08/02/2010] [Indexed: 10/18/2022] Open
Abstract
AIMS A cross-sectional study was carried out with the objective of identifying nutrition habits and housing conditions as risk factors for respiratory problems in schoolchildren in Lisbon. MATERIAL AND METHODS Between October and December 2008, parents of 900 students of the basic schools of Lisbon were invited to answer a questionnaire of the International Study of Asthma and Allergies in Childhood Program (ISAAC). The response rate was 40%. Logistic regression was used in the analysis of results. RESULTS The prevalence of asthma, allergic rhinitis and wheeze was 5.6%, 43.0% and 43.3%, respectively. Risk factors independently associated with asthma were wheezing attacks, and dry cough at night not related to common cold in the last 12 months. Wheezing crises were found to affect children daily activities. Risk factors for wheeze were hay fever and the presence of a pet at home. A risk factor for rhinitis was cough at night. The frequent consumption of egg was also associated with increased risk of rhinitis. CONCLUSION Contrarily to asthma, the prevalence of allergic rhinitis and wheeze increased in comparison with previous ISAAC studies. Wheezing attacks were associated with asthma and hay fever was identified as a risk factor of manifesting wheezing symptoms. Having pets at home was pointed out as a significant risk factor for rhinitis, but not smoking exposure, mould, plush toys, diet (except egg consumption), breastfeeding or other conditions.
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Affiliation(s)
- P N Pegas
- Centro de Estudos do Ambiente e do Mar, Departamento de Ambiente e Ordenamento, Universidade de Aveiro, Aveiro, Portugal.
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Hung WT, Su SL, Shiu LY, Chang TC. Rapid identification of allergenic and pathogenic molds in environmental air by an oligonucleotide array. BMC Infect Dis 2011; 11:91. [PMID: 21486490 PMCID: PMC3100263 DOI: 10.1186/1471-2334-11-91] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Accepted: 04/13/2011] [Indexed: 11/10/2022] Open
Abstract
Background Airborne fungi play an important role in causing allergy and infections in susceptible people. Identification of these fungi, based on morphological characteristics, is time-consuming, expertise-demanding, and could be inaccurate. Methods We developed an oligonucleotide array that could accurately identify 21 important airborne fungi (13 genera) that may cause adverse health problems. The method consisted of PCR amplification of the internal transcribed spacer (ITS) regions, hybridization of the PCR products to a panel of oligonucleotide probes immobilized on a nylon membrane, and detection of the hybridization signals with alkaline phosphatase-conjugated antibodies. Results A collection of 72 target and 66 nontarget reference strains were analyzed by the array. Both the sensitivity and specificity of the array were 100%, and the detection limit was 10 pg of genomic DNA per assay. Furthermore, 70 fungal isolates recovered from air samples were identified by the array and the identification results were confirmed by sequencing of the ITS and D1/D2 domain of the large-subunit RNA gene. The sensitivity and specificity of the array for identification of the air isolates was 100% (26/26) and 97.7% (43/44), respectively. Conclusions Identification of airborne fungi by the array was cheap and accurate. The current array may contribute to decipher the relationship between airborne fungi and adverse health effect.
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Affiliation(s)
- Wen-Tsung Hung
- Environmental Analysis Laboratory, Environmental Protection Administration, Zhongli, Taiwan
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Prevalence and geographic variations in asthma symptoms in children and adolescents in Galicia (Spain). Arch Bronconeumol 2011; 47:274-82. [PMID: 21440354 DOI: 10.1016/j.arbres.2011.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 01/09/2011] [Accepted: 01/12/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To determine the prevalence and geographic variations of the symptoms associated with asthma in Galician children and adolescents. POPULATION AND METHODS A cross-sectional epidemiological study following ISAAC (International Study of Asthma and Allergies in Childhood) methodology, and using a written questionnaire distributed in schools. The study sample included 10,371 6-7 year-old children and 10,372 13-14 year-old adolescents, all of them from Galician Health Areas. A logistic regression model was used to analyse geographic variations. RESULTS In the 6-7 year-old group, wheezing in the last 12 months varied from 11.4% (Santiago) to 15.7% (Vigo) and in the adolescents varied from 8.8% (Ourense) to 18.8% (Vigo). The distribution by gender showed a predominant significance in 6-7 year-old males (P<.001), and near to be statistically significant in 13-14 year-old females (P=.08). The risk (odds ratio [OR]) of wheezing in the last 12 months in the area with highest prevalence in comparison with the area of lowest prevalence was 1.45 (95% Confidence Interval [CI], 1.12-1.88) for children and 2.39 (95% CI, 1.82-3.13) for adolescents. The estimated prevalence of asthma in the Autonomous Community of Galicia was 13.6% in younger children and 12.2% in adolescents. CONCLUSIONS The prevalence of wheezing in the last 12 months in the different areas of Galicia is considerably higher than the rest of Spanish ISAAC cities in the 6-7 years group and very similar in the 13-14 years group, except in Vigo where it is considerably higher. We found a clearly defined geographic pattern in the adolescent group, with higher prevalences in coastal areas than in the interior.
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Montefort S, Ellul P, Montefort M, Caruana S, Agius Muscat H. A decrease in the prevalence and improved control of allergic conditions in 13- to 15-yr-old Maltese children (ISAAC). Pediatr Allergy Immunol 2011; 22:e107-11. [PMID: 20961337 DOI: 10.1111/j.1399-3038.2010.01058.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The International Study of Asthma and Allergies in Childhood (ISAAC) has produced a reliable global map of childhood allergies through the use of a validated standardized questionnaire. Phase 1 of the study was carried out in the Maltese Islands in 1995 and repeated in 2002 in phase 3. To investigate the trends in prevalence and severity of childhood allergies in Maltese schoolchildren, in this article, we compare the data obtained from 4184 children, 13- to 15-yr-olds (88.7% response rate) in phase 1, to that of phase 3 when 4139 (90% response rate) children participated. The cumulative (27.9% vs. 27.4%: p=0.6) and current (16% vs. 14.6% p=0.08) prevalence rates of wheezing remained quite static but wheezers were more likely to be diagnosed with asthma in 2002 (11.1% vs. 14.1% p<0.0001). Along the 7 yrs, these asthmatics were better controlled with less wheezing attacks (p<0.01), less disturbed nights (p<0.05) and less acute severe episodes (p<0.05). Nasal problems were present in 52.7% of participants in 1995 and in 50.4% in 2002 (p<0.05), and 47.4% vs. 42.8% (p<0.0001) persisted with these symptoms and associated itchy eyes (29% vs. 21.8%: p<000001). Though prevalence decreased, the children were labelled as hayfever sufferers more often (32.3 vs. 40.7%: p<0.00001). Rhinitis symptoms seemed to interfere less with daily activities (p<0.01). In 2002, an itchy rash suggestive of eczema was also less present 'ever' (12.8% vs. 11.2%: p<0.05) or currently (10.1% vs. 8.5%: p<0.05) but again more likely to be diagnosed as eczema (p<0.001). This rash caused less sleepless nights in phase 3 of the study (p<0.05). These results indicate that asthma prevalence has reached a plateau between 1995 and 2002 while rhinitis and eczema are less common. All these allergic conditions are better controlled and more likely to be diagnosed in these schoolchildren by Maltese doctors in 2002 than in 1995.
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Affiliation(s)
- Stephen Montefort
- Departments of Medicine and Health Information, Mater Dei Hospital and University of Malta, Malta.
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Forns D, Prat R, Tauler E. Evaluation of quality of life among the caregivers of asthmatic children: the new IFABI-R questionnaire. Allergol Immunopathol (Madr) 2011; 39:32-8. [PMID: 20850921 DOI: 10.1016/j.aller.2010.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 03/03/2010] [Indexed: 12/01/2022]
Abstract
BACKGROUND The health-related quality of life (HRQoL) of asthmatic children and their caregivers is correlated to management of the disease and the presence of certain morbidity indicators. The integral assessment of paediatric asthma must include the evaluation of HRQoL among the caregivers, although existing questionnaires only partially assess the dimensions of this aspect. The present study describes a new questionnaire for evaluating HRQoL among the caregivers, comprising three dimensions (functional, emotional, and socio-occupational). MATERIAL AND METHODS The study involves two phases. A total of 81 patients between 3 and 9 years of age and their caregivers participated in the first phase, involving a qualitative and psychometric study of the preliminary version of the questionnaire (IFABI). A total of 137 patients between 2 and 17 years of age and their caregivers participated in the second phase, in which the revised version of the questionnaire (IFABI-R) was developed and subjected to psychometric evaluation. RESULTS First phase: The IFABI showed important reliability and internal consistency (Cronbach alpha=0.93), concurrent validity requiring improvement, and a scantly clear internal structure. Second phase: The IFABI-R showed important reliability and internal consistency (Cronbach alpha=0.90), adequate concurrent validity, and a three-dimensional structure whose three factors correspond to the three dimensions of the questionnaire. CONCLUSIONS The good psychometric results obtained with the IFABI-R justify its use in paediatric asthmatic patients. The questionnaire is currently being scaled, and its sensitivity to change is being assessed.
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Affiliation(s)
- D Forns
- Barcelona Autonomous University, Faculty of Psychology, Department of Clinical Psychology and Health, Barcelona, Spain.
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Garcia-Marcos L, González-Díaz C, Garvajal-Urueña I, Pac-Sa MR, Busquets-Monge RM, Suárez-Varela MM, Batlles-Garrido J, Blanco-Quirós A, Varela ALS, García-Hernández G, Aguinaga-Ontoso I. Early exposure to paracetamol or to antibiotics and eczema at school age: modification by asthma and rhinoconjunctivitis. Pediatr Allergy Immunol 2010; 21:1036-42. [PMID: 20444146 DOI: 10.1111/j.1399-3038.2010.01037.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The association between early exposure to paracetamol or to antibiotics and eczema is conflicting. This study aims to know whether the early exposure to those drugs is associated with eczema at school age, and whether the strength of the association is modified by the presence of asthma or rhinoconjunctivitis. Children aged 6-7 (n = 13908) from the International Study of Asthma and Allergies in Childhood in Spain provided data about current asthma, rhinoconjunctivitis and eczema. Parent-reported information was also obtained on paracetamol and antibiotic consumption during the first year of life. Logistic regression analysis with eczema as outcome and including exposure to paracetamol or to antibiotics, together with possible confounders, was carried out in the whole sample of children and in five different strata: no respiratory symptom and any respiratory symptom further subdivided into: asthma with rhinoconjunctivitis, asthma without rhinoconjunctivitis and rhinoconjunctivitis without asthma. In the whole sample, exposure to paracetamol was associated with eczema (aOR 1.56 [1.36-1.80]) as was antibiotic consumption (aOR 1.66 [1.43-1.92]). These associations did not substantially change after additionally adjusting for the other drug. A similar pattern was found among children without respiratory symptoms. In children with symptoms, adjusting for the other drug modified the association with paracetamol (aOR from 1.32 [1.03-1.71] to 1.09 [0.83-1.43]) but did not change that with antibiotics (aOR from 1.80 [1.38-2.35] to 1.81 [1.37-2.39]). Early exposure to paracetamol or to antibiotics is associated with an increased prevalence of eczema at school age. Asthma and/or rhinoconjunctivitis substantially modifies this association.
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Affiliation(s)
- Luis Garcia-Marcos
- Arrixaca University Children's Hospital, University of Murcia, Murcia, Spain.
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Gonzalez Barcala F, Aboal Viñas J, Valdes Cuadrado L, Bourdin A, Alvarez Dobaño J, Takkouche B. Trends in hospital admissions due to asthma in north-west Spain from 1995 to 2007. Allergol Immunopathol (Madr) 2010; 38:254-8. [PMID: 20452117 DOI: 10.1016/j.aller.2009.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 10/31/2009] [Accepted: 11/07/2009] [Indexed: 10/19/2022]
Abstract
PURPOSE Asthma is the most common chronic disease in childhood. Hospital admissions in the child population appear to be reducing in different populations. METHODS We have retrospectively analysed admissions into hospitals in our region due to asthma in a 0 to 14 years population, between the years 1995 and 2007. The age, sex, date of admission, and length of hospital stay of each patient was recorded and analysed. RESULTS A total of 9106 admissions (64% males) have been included. A gradual trend towards a reduction in admissions is observed during the period analysed. There were more admissions in 1996, with 2.91 per thousand inhabitants, gradually reducing to 1.33 per thousand in 2007. There were more admissions in May and between September and December, being less frequent in July and August. The mean stay in this period was 4.18 days, which was stable during the whole period of the study. Older children tended to have a longer hospital stay. CONCLUSIONS Our study shows that admissions due to childhood asthma tend to be decreasing, particularly due to younger males, with no change in the length of hospital stay. Asthma exacerbations seemed to be associated with infections and exposure to allergens.
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Kahwa EK, Younger NO, Wint YB, Waldron NK, Hewitt HH, Knight-Madden JM, Bailey KA, Edwards NC, Talabere LR, Lewis-Bell KN. The Jamaica asthma and allergies national prevalence survey: rationale and methods. BMC Med Res Methodol 2010; 10:29. [PMID: 20361871 PMCID: PMC2861068 DOI: 10.1186/1471-2288-10-29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Accepted: 04/03/2010] [Indexed: 11/10/2022] Open
Abstract
Background Asthma is a significant public health problem in the Caribbean. Prevalence surveys using standardized measures of asthma provide valid prevalence estimates to facilitate regional and international comparisons and monitoring of trends. This paper describes methods used in the Jamaica Asthma and Allergies National Prevalence Survey, challenges associated with this survey and strategies used to overcome these challenges. Methods/Design An island wide, cross-sectional, community-based survey of asthma, asthma symptoms and allergies was done among adults and children using the European Community Respiratory Health Survey Questionnaire for adults and the International Study of Asthma and Allergies in Children. Stratified multi-stage cluster sampling was used to select 2, 163 adults aged 18 years and older and 2, 017 children aged 2-17 years for the survey. The Kish selection table was used to select one adult and one child per household. Data analysis accounted for sampling design and prevalence estimates were weighted to produce national estimates. Discussion The Jamaica Asthma and Allergies National Prevalence Survey is the first population- based survey in the Caribbean to determine the prevalence of asthma and allergies both in adults and children using standardized methods. With response rates exceeding 80% in both groups, this approach facilitated cost-effective gathering of high quality asthma prevalence data that will facilitate international and regional comparison and monitoring of asthma prevalence trends. Another unique feature of this study was the partnership with the Ministry of Health in Jamaica, which ensured the collection of data relevant for decision-making to facilitate the uptake of research evidence. The findings of this study will provide important data on the burden of asthma and allergies in Jamaica and contribute to evidence-informed planning of comprehensive asthma management and education programs.
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Anandan C, Nurmatov U, van Schayck OCP, Sheikh A. Is the prevalence of asthma declining? Systematic review of epidemiological studies. Allergy 2010; 65:152-67. [PMID: 19912154 DOI: 10.1111/j.1398-9995.2009.02244.x] [Citation(s) in RCA: 354] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Asthma prevalence has increased very considerably in recent decades such that it is now one of the commonest chronic disorders in the world. Recent evidence from epidemiological studies, however, suggests that the prevalence of asthma may now be declining in many parts of the world, which, if true is important for health service planning and also because this offers the possibility of generating and testing new aetiological hypotheses. Our objective was to determine whether the prevalence of asthma is declining worldwide. We undertook a systematic search of EMBASE, Medline, Web of Science and Google Scholar, for high quality reports of cohort studies, repeat cross-sectional studies and analyses of routine healthcare datasets to examine international trends in asthma prevalence in children and adults for the period 1990-2008. There were 48 full reports of studies that satisfied our inclusion criteria. The large volume of data identified clearly indicate that there are, at present, no overall signs of a declining trend in asthma prevalence; on the contrary, asthma prevalence is in many parts of the world still increasing. The reductions in emergency healthcare utilization being reported in some economically developed countries most probably reflect improvements in quality of care. There remain major gaps in the literature on asthma trends in relation to Africa and parts of Asia. There is no overall global downward trend in the prevalence of asthma. Healthcare planners will for the foreseeable future, therefore, need to continue with high levels of anticipated expenditure in relation to provision of asthma care.
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Affiliation(s)
- C Anandan
- Centre for Population Health Sciences, University of Edinburgh, UK
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Respuesta de los autores. Arch Bronconeumol 2010. [DOI: 10.1016/j.arbres.2009.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Carvajal Urueña I, Díaz Vázquez C, Cano Garcinuño A, García Merino A, Morell Bernabé J, Pascual Pérez J, Jiménez Cortés A, Blanco González J, Montón Álvarez J, Pérez Porcuna X, Torregrosa Bertet M, Callén Blecua M. Perfil de sensibilización alérgica en niños de 0 a 5 años con sibilancias o dermatitis atópica. An Pediatr (Barc) 2010; 72:30-41. [DOI: 10.1016/j.anpedi.2009.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2009] [Revised: 09/03/2009] [Accepted: 09/28/2009] [Indexed: 12/22/2022] Open
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Kusunoki T, Morimoto T, Nishikomori R, Yasumi T, Heike T, Fujii T, Nakahata T. Changing prevalence and severity of childhood allergic diseases in kyoto, Japan, from 1996 to 2006. Allergol Int 2009; 58:543-8. [PMID: 19700935 DOI: 10.2332/allergolint.09-oa-0085] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Accepted: 04/29/2009] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Published data regarding changes in the prevalence of childhood allergic diseases in Japan have been limited. METHODS To observe changes in the recent trends of the childhood allergy epidemic in Japan, a population-based questionnaire survey of allergic diseases was conducted among 13,215 schoolchildren, aged 7 to 15 years, in Kyoto, Japan in 2006. The results were compared with those obtained in the 1996 survey using the same scale and methods in the same region. RESULTS The prevalences of bronchial asthma (BA), atopic dermatitis (AD), allergic rhinitis (AR), and allergic conjunctivitis (AC) in 1996 and 2006 were 5.1% and 5.0% (p = 0.58), 4.2% and 5.6% (p < 0.0001), 20.3% and 27.4% (p < 0.0001), and 13.3% and 25.2% (p < 0.0001), respectively. Although the distribution of BA severity improved, the severity distribution of AD, AR, and AC all deteriorated. The lifetime prevalence (present prevalence and past history combined) of BA increased from 6.5% to 7.6% (p < 0.0001). The sex ratio analysis showed that the female predominance in the prevalence of AD observed in 1996 disappeared in 2006, indicating a particular rise in AD prevalence among boys. CONCLUSIONS Overall, the results indicate that the rising trend of allergic diseases, especially in AD, AR, and AC, continues among schoolchildren living in Kyoto, Japan. Special attention should be paid to skin and nasoocular symptoms.
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Affiliation(s)
- Takashi Kusunoki
- Department of Pediatrics, Shiga Medical Center for Children, Shiga, Japan.
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