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Faria AG, Molina-Bastos CG, Gonçalves MR, Schmitz CAA. Avaliação de adequabilidade de um serviço de telespirometria. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2022. [DOI: 10.5712/rbmfc17(44)3105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introdução: As doenças respiratórias crônicas estão entre os principais problemas de saúde pública no mundo. Mesmo sendo sensíveis ao tratamento na Atenção Primária à Saúde, são a terceira principal causa de morte no Brasil. Os serviços de telemedicina apresentam-se como aliados importantes dos profissionais de saúde no que tange ao manejo de doenças respiratórias como a asma e a doença pulmonar obstrutiva crônica. Objetivo: Avaliar a adequabilidade de um serviço de telemedicina diagnóstica em espirometria considerando os indicadores de oferta, utilização e cobertura populacional no estado do Rio Grande do Sul. Resultados: No período estudado, o serviço ofertou 27.672 exames de telespirometria aos usuários do Sistema Único de Saúde do Rio Grande do Sul encaminhados por médicos da Atenção Primária à Saúde. A utilização esteve abaixo de 50% da oferta em todas as macrorregiões de saúde do estado. Conclusões: O estudo demonstrou que a capacidade instalada pelo serviço esteve adequada para atender à demanda populacional do Rio Grande do Sul, no entanto a baixa utilização do serviço pode estar associada ao desconhecimento sobre ele e à dificuldade em reconhecer essas doenças por parte dos profissionais de saúde da Atenção Primária à Saúde.
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Marques GÁ, Wendt A, Wehrmeister FC. Temporal evolution of and factors associated with asthma and wheezing in schoolchildren in Brazil. J Bras Pneumol 2019; 45:e20180138. [PMID: 31271601 PMCID: PMC6715041 DOI: 10.1590/1806-3713/e20180138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 09/23/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To estimate the evolution of the prevalence of asthma and wheezing among schoolchildren in Brazil from 2012 to 2015, as well as to identify factors associated with both conditions. METHODS This was a cross-sectional study using data from the Brazilian National School-Based Adolescent Health Survey for 2012 and 2015. To characterize the evolution of the prevalence of asthma and wheezing, we used linear regression with weighted-least-squares estimation and presented the annual percent change (APC). RESULTS During the study period, there was a reduction in the prevalence of wheezing, from 23.2% in 2012 to 22.4% in 2015 (APC, -0.27). The prevalence of asthma increased from 12.4% in 2012 to 16.0% in 2015 (APC, 1.20). The increase in the prevalence of asthma was greatest in the southern region of the country (APC, 2.17). Having any history of smoking and having consumed alcohol in the last 30 days were factors that influenced the prevalence of wheezing and the prevalence of a self-reported diagnosis of asthma during the two years evaluated. CONCLUSIONS There has been an increase in the prevalence of asthma in recent years in Brazil. Our data underscore the importance of improving health strategies and policies aimed at the control of asthma.
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Affiliation(s)
- Gabriela Ávila Marques
- . Universidade Católica de Pelotas, Pelotas (RS) Brasil
- . Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas (RS) Brasil
| | - Andrea Wendt
- . Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas (RS) Brasil
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Valenti C, Pozzi P, Busia A, Mazza R, Bossi P, De Marco C, Ruprecht AA, Borgini A, Boffi R. Respiratory illness and air pollution from the steel industry: the case of Piquiá de Baixo, Brazil (Preliminary report). Multidiscip Respir Med 2016; 11:41. [PMID: 27833748 PMCID: PMC5101733 DOI: 10.1186/s40248-016-0077-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 09/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This report is based on an independent study carried out by medical professionals of the Fondazione IRCCS Istituto Nazionale dei Tumori (National Cancer Institute) in Milan, Italy, and aimed to assess the incidence of respiratory diseases in a Brazilian community (Piquiá de Baixo, in the city of Açailandia) exposed to extreme air pollution in connection to a local steel manufacturing plant. The study has the objective to contribute to the existing literature on the health risks associated with fine particle pollution (PM2.5) due to steel production with data from Brazil. METHODS The study is based on a cross-sectional sample of the resident population of Piquiá de Baixo age 16 or over consisting of 220 people. We collected data about the health conditions of participant subjects in two ways: a) medical history questionnaires and b) clinical assessment of respiratory function through spirometry testing. The results were evaluated based on comparative studies. RESULTS According to the spirometric tests performed, 28 % of the sample population suffers from respiratory pathologies (for the most part of restrictive rather than obstructive nature). This incidence rate is between six and two times higher than those reported in similar studies carried out in other countries (which range between 4.6 and 14.5 %). In addition, the incidence rate is also significantly high in light of the fact that our sample population did not include the category of subjects most at risk for pulmonary disorders in connection to air pollution caused by the Piquiá steel processing complex: in other words, men and women employed in the steel mills or in connection with their industrial cycle (as many as 434 Piquiá residents age 16 and over were unable to participate to our study due to "work-related reasons"). CONCLUSIONS In light of the above considerations, we believe that our findings contribute to the existing literature on the correlation between pulmonary disease and air pollution in industrialized areas, while warranting further scientific research on the public health consequences of industrial production in Piquiá de Baixo. In turn, on the ethical plane, we believe that research of this nature strengthens the need to advocate for more severe environmental and health policies aimed at limiting the hazards associated with the steel industry in Piquiá and in similar contexts around the world.
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Affiliation(s)
- Carla Valenti
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Pozzi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Roberto Mazza
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Bossi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Cinzia De Marco
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Roberto Boffi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Miranda VC, Reis LAD, Morais KCSD, Ferreira JB, Alves TC. Percepção da mãe ou cuidador de crianças asmáticas sobre os resultados do tratamento. SAÚDE EM DEBATE 2016. [DOI: 10.1590/0103-1104201611015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO A percepção da mãe ou cuidador em relação aos resultados alcançados é um instrumento de grande relevância para identificar o grau de resolutividade do serviço e garantir uma maior qualidade da assistência. Nessa perspectiva, foi realizada pesquisa descritiva com abordagem quantitativa a partir da aplicação de questionário. O estudo objetivou avaliar a percepção da mãe ou cuidador em relação ao resultado do tratamento que a criança asmática recebe. Concluiu-se que um maior percentual de mães ou cuidadores consideraram o resultado como bom/muito bom e ruim/péssimo, além de identificar que essas crianças são acompanhadas apenas pelo pneumologista, e não pela equipe da unidade de saúde.
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Sá-Sousa A, Jacinto T, Azevedo LF, Morais-Almeida M, Robalo-Cordeiro C, Bugalho-Almeida A, Bousquet J, Fonseca JA. Operational definitions of asthma in recent epidemiological studies are inconsistent. Clin Transl Allergy 2014; 4:24. [PMID: 25136441 PMCID: PMC4136946 DOI: 10.1186/2045-7022-4-24] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/15/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The best combination of questions to define asthma in epidemiological asthma studies is not known. We summarized the operational definitions of asthma used in prevalence studies and empirically assess how asthma prevalence estimates vary depending on the definition used. METHODS We searched the Thomson Reuters ISI Web of knowledge and included (1) cross-sectional studies (2) on asthma prevalence (3) conducted in the general population and (4) containing an explicit definition of asthma. The search was limited to the 100 most-cited papers or published since January 2010. For each paper, we recorded the asthma definition used and other variables. Then we applied the definitions to the data of the Portuguese National Asthma survey (INAsma) and of the 2005-2006 National Health and Nutrition Examination Survey (NHANES) computing asthma prevalence estimates for the different definitions. RESULTS Of 1738 papers retrieved, 117 were included for analysis. Lifetime asthma, diagnosed asthma and current asthma were defined in 8, 12 and 29 different ways, respectively. By applying definitions of current asthma on INAsma and NHANES data, the prevalence ranged between 5.3%-24.4% and 1.1%-17.2%, respectively. CONCLUSIONS There is considerable heterogeneity in the definitions of asthma used in epidemiological studies leading to highly variable estimates of asthma prevalence. Studies to inform a standardized operational definition are needed. Meanwhile, we propose a set of questions to be reported when defining asthma in epidemiological studies.
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Affiliation(s)
- Ana Sá-Sousa
- Center for research in health technologies and information systems.– CINTESIS, Universidade do Porto, Porto, Portugal
| | - Tiago Jacinto
- Center for research in health technologies and information systems.– CINTESIS, Universidade do Porto, Porto, Portugal
- Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal
| | - Luís Filipe Azevedo
- Center for research in health technologies and information systems.– CINTESIS, Universidade do Porto, Porto, Portugal
- Health Information and Decision Sciences Department – CIDES, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Mário Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisboa, Portugal
| | - Carlos Robalo-Cordeiro
- Allergy and Clinical Immunology Department, Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | | | - Jean Bousquet
- Hôpital Arnaud de Villeneuve, Centre Hospitalier Universitaire Montpellier, Montpellier, France
- Centre de recherche en Epidémiologie et Santé des Populations, CESP Inserm U1018, Villejuif, France
| | - João Almeida Fonseca
- Center for research in health technologies and information systems.– CINTESIS, Universidade do Porto, Porto, Portugal
- Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal
- Health Information and Decision Sciences Department – CIDES, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
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Sousa CAD, César CLG, Barros MBDA, Carandina L, Goldbaum M, Pereira JCR. [Prevalence of asthma and risk factors associated: population based study in São Paulo, Southeastern Brazil, 2008-2009]. Rev Saude Publica 2013; 46:825-33. [PMID: 23128259 DOI: 10.1590/s0034-89102012000500009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 04/23/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the prevalence of asthma and risk factors associated in children and adolescents. METHODS Population-based cross-sectional study with 1,185 female and male children and adolescents carried out in the city of São Paulo, Southeastern Brazil, from 2008 to 2009. Data were collected through home interviews. Respondents were selected from two-stage (census tract, household) cluster random sampling stratified by gender and age. Multiple Poisson regression was used in the adjusted analysis between the outcome and socioeconomic, demographic, lifestyle and health condition variables. RESULTS Of all respondents, 9.1% (95%CI 7.0;11.7) reported asthma. After adjustment, the following variables were found independently associated with asthma: age (0 to 4 years vs. 15 to 19) (PR 3.18, 95%CI 1.20;8.42); age (5 to 9 years vs. 15 to 19) (PR 6.37, 95%CI 2.64;15.39); age (10 to 14 years vs. 15 to 19) (PR 4.51, 95%CI 1.95;10.40); allergy (yes vs. no) (PR 2.22, 95%CI 1.24;4.00); rhinitis (yes vs. no) (PR 2.13, 95%CI 1.22;3.73); health conditions in the 15 days preceding the interview (yes vs. no) (PR 1.96, 95%CI 1.23;3.11); number of rooms in the household (1 to 3 vs. 4 and more) (PR 1.67, 95%CI 1.05;2.66); and skin color (black and mixed vs. white) (PR 2.00, 95%CI 1.14;3.49). CONCLUSIONS This study showed the importance of factors associated with asthma including rhinitis and allergy; age between 5 to 9 years old; black and mixed skin color; and household with few rooms. Frequent health problems are seen as a common consequence of asthma.
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Affiliation(s)
- Clóvis Arlindo de Sousa
- Programa de Pós-Graduação em Saúde Pública, Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil.
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Lima WL, Lima EVNCL, Costa MDRDSR, Santos AMD, Silva AAMD, Costa ES. [Asthma and associated factors in students 13 and 14 years of age in São Luís, Maranhão State, Brazil]. CAD SAUDE PUBLICA 2012; 28:1046-56. [PMID: 22666809 DOI: 10.1590/s0102-311x2012000600004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 03/19/2012] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to estimate the prevalence of asthma and associated factors among students 13 and 14 years of age in São Luís, Maranhão State, Brazil. A cross-sectional study was conducted using the questionnaire developed by ISAAC (International Study of Asthma and Allergies in Childhood) and an additional questionnaire from July 2008 to May 2009, including 3,069 adolescents. Asthma prevalence (wheezing in the previous 12 months) was 12.7%, lifetime prevalence was 32.4%, 3.9% reported difficulty speaking due to wheezing, and 9.8% reported wheezing after exercise. In the multivariate analysis, factors associated with increased asthma prevalence were family history of asthma, respiratory infection and wheezing in early life, eczema, allergic rhinitis, and passive smoking. Asthma prevalence was lower than for Brazil as a whole. Factors most strongly associated with asthma prevalence in these adolescents were family history of asthma (PR = 3.86), wheezing in early childhood (PR = 4.58), and allergic rhinitis (PR = 3.21).
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Wehrmeister FC, Menezes AMB, Cascaes AM, Martínez-Mesa J, Barros AJD. Time trend of asthma in children and adolescents in Brazil, 1998-2008. Rev Saude Publica 2012; 46:242-50. [PMID: 22310651 DOI: 10.1590/s0034-89102012005000008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 10/09/2011] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze the trends in asthma prevalence in children and adolescents between 1998 and 2008 in Brazil. METHODS Data on asthma prevalence from the 1998, 2003 and 2008 National Household Sample Surveys were analyzed. The sample was comprised of 141,402, 144,443 and 134,032 individuals in 1998, 2003 and 2008, respectively, and the analysis was adjusted for the sample design. Trends in asthma prevalence were described for sex, Brazilian regions and place of residence of children (zero to nine years of age) and adolescents (ten to 19 years of age). RESULTS The prevalence of asthma in children was 7.7% in 1998, 8.1% in 2003 and 8.5% in 2008, with an annual increase of 1%. The highest annual increase was observed in the Southeast and North regions (1.4%). Among adolescents, the prevalence of asthma was 4.4% in 1998, 5.0% in 2003 and 5.5% in 2008, with an increase of 2.2% per year. In the Northeast region, the annual increase in the prevalence of asthma was 3.5%. The greatest increases were observed in boys and in residents of rural areas. CONCLUSIONS Although asthma has decreased in some developing countries, the results found in Brazil point to an increase in this disease in children and adolescents between 1998 and 2008, especially in rural areas.
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