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Ferreira IBB, Gomes AN, Almeida IBC, Fernandes MD, Coutinho LF, Lago R, Menezes CA, Vianna NA, Oliveira RR, Fukutani ER, Menezes RC, Ladeia AM, Andrade BB. Childhood obesity is associated with a high degree of metabolic disturbance in children from Brazilian semi-arid region. Sci Rep 2024; 14:17569. [PMID: 39080451 PMCID: PMC11289272 DOI: 10.1038/s41598-024-68661-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 07/26/2024] [Indexed: 08/02/2024] Open
Abstract
Projected to impact 310 million children by the next decade, childhood obesity is linked to serious health issues like metabolic disturbance and cardiovascular diseases. This study introduces a novel approach for the integrated assessment of inflammatory, glycemic and lipid disorders in obese children in resources-limited settings and also identifies key factors contributing to these changes. Conducting a cross-sectional analysis of 231 children aged 5-12 years from public schools in Brazil's semi-arid region, the research involved collecting medical history, anthropometric measurements, and blood samples to analyze glycemic and lipid profiles, along with C-reactive protein levels. We used an adapted the Molecular Degree of Perturbation model to analyze deviations in metabolic markers from a healthy control group. Statistical analyses included Mann-Whitney and Fisher exact tests, backward logistic regression, and hierarchical cluster analysis. The study identified a direct and independent association between elevated Metabolic Disturbance Degree and both overweight and obesity in children, with significant differences in CRP, Triglycerides, and HDL levels noted between obese and healthy-weight groups. The findings highlight the critical need for early detection and comprehensive understanding of obesity-related changes to mitigate the severe health risks associated with childhood obesity.
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Affiliation(s)
- Isabella B B Ferreira
- Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Bahia, Brazil
| | - Alexvon N Gomes
- Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Bahia, Brazil
| | - Isadora B C Almeida
- Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Bahia, Brazil
| | - Mariana D Fernandes
- Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Bahia, Brazil
| | | | - Renata Lago
- Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Bahia, Brazil
| | - Camilla A Menezes
- Instituto Gonçalo Moniz (IGM), Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia, 40296-710, Brazil
| | - Nelzair A Vianna
- Instituto Gonçalo Moniz (IGM), Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia, 40296-710, Brazil
| | - Ricardo R Oliveira
- Instituto Gonçalo Moniz (IGM), Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia, 40296-710, Brazil
| | - Eduardo R Fukutani
- Instituto Gonçalo Moniz (IGM), Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia, 40296-710, Brazil
| | - Rodrigo C Menezes
- Instituto de Pesquisa Clínica e Translacional, Faculdade Zarns, Clariens Educação, Salvador, Bahia, Brazil
| | - Ana Marice Ladeia
- Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Bahia, Brazil
| | - Bruno B Andrade
- Instituto de Pesquisa Clínica e Translacional, Faculdade Zarns, Clariens Educação, Salvador, Bahia, Brazil.
- Instituto Gonçalo Moniz (IGM), Fundação Oswaldo Cruz (Fiocruz), Rua Waldemar Falcão, 121, Candeal, Salvador, Bahia, 40296-710, Brazil.
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do Amaral CSF, Jordão ÉADOC, de Oliveira CL, Felix MMR, Kuschnir MCC, Kuschnir FC. Asthma and vitamin D in Brazilian adolescents: Study of Cardiovascular Risks in Adolescents (ERICA). J Bras Pneumol 2021; 47:e20210281. [PMID: 34932722 PMCID: PMC8836642 DOI: 10.36416/1806-3756/e20210281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/08/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate the association between asthma prevalence and serum levels of vitamin D in Brazilian adolescents. METHODS This was a cross-sectional, school-based study involving adolescents between 12-17 years of age from four large Brazilian cities located at different latitudes (Fortaleza, Rio de Janeiro, Brasília, and Porto Alegre). Information on asthma diagnosis, lifestyle, and sociodemographic characteristics was collected by means of self-administered questionnaires. Serum concentrations of calcifediol were dichotomized as sufficient (≥ 20 ng/mL) or insufficient/deficient (< 20 ng/mL) levels. Bivariate analyses were carried out between vitamin D levels and prevalence of active asthma (AA), as well as other variables in study, using the chi-square test. Generalized linear models were configured to analyze potential confounding factors (p < 0.20). RESULTS Between 2013 and 2014, 1,053 adolescents were evaluated. The prevalences of AA and insufficient/deficient levels of calcifediol were 15.4% and 21%, respectively. There were no statistically significant associations between AA and hypovitaminosis D. The prevalences of AA and vitamin D insufficiency were, respectively, 2.34 (95% CI, 1,28-4.30) and 3.22 (95% CI, 1.75-5.95) times higher in Porto Alegre than in Rio de Janeiro, regardless of possible confounding factors. However, no significant associations were found between the prevalence of AA and vitamin-D-related variables in any of the cities. CONCLUSIONS No association was found between AA and low levels of vitamin D in adolescents living at different latitudes in Brazil.
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Affiliation(s)
- Cláudia Soïdo Falcão do Amaral
- . Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro - UERJ - Rio de Janeiro (RJ) Brasil
| | | | - Cecília Lacroix de Oliveira
- . Departamento de Nutrição Aplicada, Universidade do Estado do Rio de Janeiro - UERJ - Rio de Janeiro (RJ) Brasil
| | - Mara Morelo Rocha Felix
- . Escola de Medicina e Cirurgia, Universidade Federal do Estado do Rio de Janeiro - UNIRIO - Rio de Janeiro (RJ) Brasil
| | - Maria Cristina Caetano Kuschnir
- . Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro - UERJ - Rio de Janeiro (RJ) Brasil
- . Núcleo de Estudos da Saúde do Adolescente, Universidade do Estado do Rio de Janeiro - NESA/UERJ - Rio de Janeiro (RJ) Brasil
| | - Fábio Chigres Kuschnir
- . Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro - UERJ - Rio de Janeiro (RJ) Brasil
- . Departamento de Pediatria, Universidade do Estado do Rio de Janeiro - UERJ - Rio de Janeiro (RJ) Brasil
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Estanislau NRDA, Jordão EADOC, Abreu GDA, Bloch KV, Kuschnir MCC, Felix MMR, Kuschnir FC. Association between asthma and sleep hours in Brazilian adolescents: ERICA. J Pediatr (Rio J) 2021; 97:396-401. [PMID: 32956628 PMCID: PMC9432073 DOI: 10.1016/j.jped.2020.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/10/2020] [Accepted: 07/24/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate the association between asthma and sleep duration in participants of the Study of Cardiovascular Risks in Adolescents. MATERIALS AND METHODS Cross-sectional, national, school-based study, involving adolescents aged 12-17 years. In the period between 2013-14, data from 59,442 participants were analyzed. Bivariate analysis between current asthma and short sleep duration, defined as < 7 h/night, was performed separately with the other variables analyzed: sex, age group, type of school, weight categories, and common mental disorders. Then, different generalized linear models with Poisson family and logarithmic link functions were used to assess the independence of potential confounding covariates associated with both asthma and short sleep duration in the previous analysis. Crude and adjusted prevalence ratios and respective 95% confidence intervals were calculated, and a value of p < 0.05 was considered significant for all analyses performed. RESULTS Prevalence of current asthma was 13.4%, being significantly higher among students with short sleep duration (PR: 1.17; 95% CI: 1.01-1.35; p = 0.034). This remained significant even after adjusting for the other study covariates. CONCLUSION There was a positive association between the prevalence of current asthma and short sleep duration among Brazilian adolescents. Considering the high prevalence and morbidity of the disease in this age group, the promotion of sleep hygiene should be considered as a possible health strategy aimed at contributing to better control of asthma in this population.
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Affiliation(s)
| | | | | | - Katia Vergetti Bloch
- Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos de Saúde Coletiva, Rio de Janeiro, RJ, Brazil
| | | | - Mara M R Felix
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil
| | - Fabio Chigres Kuschnir
- Universidade do Estado do Rio de Janeiro (UERJ), Programa de Pós-Graduação em Ciências Médicas, Rio de Janeiro, RJ, Brazil
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Mendes E, Casaro MB, Fukumori C, Ribeiro WR, Dos Santos AL, Sartorelli P, Lazarini M, Bogsan CSB, Oliveira MA, Ferreira CM. Preventive oral kefir supplementation protects mice from ovariectomy-induced exacerbated allergic airway inflammation. Benef Microbes 2021; 12:187-197. [PMID: 33789554 DOI: 10.3920/bm2020.0112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Asthma is an inflammatory lung disease that affects more women than men in adulthood. Clinical evidence shows that hormonal fluctuation during the menstrual cycle and menopause are related to increased asthma severity in women. Considering that life expectancy has increased and that most women now undergo menopause, strategies to prevent the worsening of asthma symptoms are particularly important. A recent study from our group showed that re-exposure of ovariectomised allergic mice to antigen (ovalbumin) leads to an exacerbation of lung inflammation that is similar to clinical conditions. However, little is known about the role of probiotics in the prevention of asthma exacerbations during the menstrual cycle or menopause. Thus, our objective was to evaluate the effects of supplementation with kefir, a popular fermented dairy beverage, as a preventive strategy for modulating allergic disease. The results show that the preventive kefir administration decreases the influx of inflammatory cells in the airways and exacerbates the production of mucus and the interleukin 13 cytokine. Additionally, kefir changes macrophage polarisation by decreasing the number of M2 macrophages, as shown by RT-PCR assay. Thus, kefir is a functional food that potentially prevents allergic airway inflammation exacerbations in ovariectomised mice.
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Affiliation(s)
- E Mendes
- Institute of Environmental, Chemistry and Pharmaceutical Sciences, Department of Pharmaceutics Sciences, Universidade Federal de São Paulo, R. Sao Nicolau, 210, Diadema, SP 09913-03, Brazil
| | - M B Casaro
- Institute of Environmental, Chemistry and Pharmaceutical Sciences, Department of Pharmaceutics Sciences, Universidade Federal de São Paulo, R. Sao Nicolau, 210, Diadema, SP 09913-03, Brazil
| | - C Fukumori
- Institute of Environmental, Chemistry and Pharmaceutical Sciences, Department of Pharmaceutics Sciences, Universidade Federal de São Paulo, R. Sao Nicolau, 210, Diadema, SP 09913-03, Brazil
| | - W R Ribeiro
- Institute of Environmental, Chemistry and Pharmaceutical Sciences, Department of Pharmaceutics Sciences, Universidade Federal de São Paulo, R. Sao Nicolau, 210, Diadema, SP 09913-03, Brazil
| | - A L Dos Santos
- Chemistry Department, Institute of Environmental, Chemistry and Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, SP 09972-270, Brazil
| | - P Sartorelli
- Chemistry Department, Institute of Environmental, Chemistry and Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, SP 09972-270, Brazil
| | - M Lazarini
- Institute of Environmental, Chemistry and Pharmaceutical Sciences, Department of Pharmaceutics Sciences, Universidade Federal de São Paulo, R. Sao Nicolau, 210, Diadema, SP 09913-03, Brazil
| | - C S B Bogsan
- Department of Biochemical-Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, University of Sao Paulo, Av. Prof. Lineu Prestes, 580, B-16, Sao Paulo, SP 05508-900, Brazil
| | - M A Oliveira
- Department of Pharmacology, Institute of Biomedical Sciences I, University of Sao Paulo, Sao Paulo, Av. Prof. Lineu Prestes, 1374, SP 05508-000, Brazil
| | - C M Ferreira
- Institute of Environmental, Chemistry and Pharmaceutical Sciences, Department of Pharmaceutics Sciences, Universidade Federal de São Paulo, R. Sao Nicolau, 210, Diadema, SP 09913-03, Brazil
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Elias BC, Silva JB, Mais LA, Warkentin S, Konstantyner T, Solé D. FACTORS ASSOCIATED WITH ASTHMA IN BRAZILIAN ADOLESCENTS: NATIONAL ADOLESCENT SCHOOL-BASED HEALTH SURVEY (PENSE-2012). ACTA ACUST UNITED AC 2019; 37:406-413. [PMID: 31340242 PMCID: PMC6821479 DOI: 10.1590/1984-0462/;2019;37;4;00002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 07/27/2018] [Indexed: 11/30/2022]
Abstract
Objective: To identify factors associated with asthma in Brazilian adolescents. Methods: Cross-sectional study based on data from the 2012 National Adolescent
School-based Health Survey (PeNSE), a Brazilian survey applied by a
self-reported questionnaire in a representative sample of
9th-grade students. Descriptive and inferential analysis was made
based on the demographic, socioeconomic, clinical, food consumption and
environmental characteristics potentially associated with asthma.
Adolescents who presented wheezing in the last 12 months were considered
asthmatic. A multiple logistic regression model was adjusted for confounding
factors. Significance was defined as p≤0.05. Results: A total of 106,983 adolescents were studied. The prevalence of asthma was
23.2%. The final model was composed of 11 variables that were independently
associated with asthma: female sex (OR=1.17), <14 years old (OR=1.12),
not living with parents (OR=1.06), the highest number of days consuming
ultra-processed foods (OR=1.16), lunch or dinner time without presence of
parents or guardians (OR=1.13), meals in front of the TV or while studying
(OR=1.18), not having breakfast frequently (OR=1.22), having smoked
cigarettes (OR=1.36), having tried alcoholic beverage (OR=1.37), having used
illicit drugs (OR=1.29) and having sought health care in the last year
(OR=1.67). Conclusions: The results of the present study reinforce the multifactorial characteristic
of asthma diagnosis. Prevention and control strategies should focus on
groups of adolescents living in inadequate conditions when it comes to
family dynamics, food consumption and behavior (drug use).
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Affiliation(s)
| | | | | | | | | | - Dirceu Solé
- Universidade Federal de São Paulo, São Paulo, SP, Brazil
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6
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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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Amaral SCDO, Pimenta F, Marôco J, Sant'Anna CC. Stress reduction intervention with mothers of children/adolescents with asthma: a randomized controlled study in Brazil. Health Care Women Int 2019; 41:266-283. [PMID: 30958141 DOI: 10.1080/07399332.2019.1570201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Brazil has a high prevalence of pediatric asthma, which can be a stressor to parents/caretakers. Researchers aimed to assesses the efficacy of a stress reduction intervention for mothers of children/adolescents with asthma through a randomized controlled study. Stress, anxiety, and depression were evaluated in three moments. The intervention group (n = 20), entailed 5-weekly sessions; the control group (n =34) had waiting list format. There was a significant decrease in stress, anxiety, and depression in the intervention group. This study indicates that the intervention directed to mothers of children/adolescents with asthma was efficient not only in reducing stress but also anxiety and depression reduction.
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Affiliation(s)
| | - Filipa Pimenta
- ISPA - Instituto Universitário/WJCR - William James Center for Research, Lisbon, Portugal
| | - João Marôco
- ISPA - Instituto Universitário/WJCR - William James Center for Research, Lisbon, Portugal
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Ribeiro-Silva RC, Malta DC, Rodrigues LC, Ramos DO, Fiaccone RL, Machado DB, Barreto ML. Social, Environmental and Behavioral Determinants of Asthma Symptoms in Brazilian Middle School Students-A National School Health Survey (Pense 2012). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122904. [PMID: 30572563 PMCID: PMC6313389 DOI: 10.3390/ijerph15122904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/30/2018] [Accepted: 12/03/2018] [Indexed: 11/30/2022]
Abstract
Biological and psychosocial factors are recognized contributors to the worldwide burden of asthma. However, the relationship between psychosocial factors and asthma symptoms among students in low- and middle-income countries remains underexplored. We aimed to identify socioeconomic, environmental, psychosocial, family-related and lifestyle factors associated with the self-reporting of asthma symptoms in Brazilian adolescents. This is a cross-sectional study using data from the 2012 PeNSE survey (n = 109,104). We analyzed the following variables: socioeconomic conditions, demographic characteristics, lifestyle, family context and dynamics, psychosocial indicators, smoking, and exposure to violence. Our outcome variable was the self-report of asthma symptoms in the past 12 months. The prevalence of wheezing was 22.7% (21.5–23.9). After adjusting for sex, age and the variables from higher hierarchical levels, exposure to violence (feeling unsafe at school, being frequently bullied, being exposed to fights with firearms) and physical aggression by an adult in the family were the environmental factors that showed the strongest associations with self-reporting of asthma symptoms. For psychosocial indicators of mental health and social integration, feelings of loneliness and sleeping problems were the strongest factors, and among individual behavioral factors, the largest associations were found for tobacco consumption. Our findings were consistent with previous studies, showing an association between self-reported asthma symptoms and socio-economic status, family context and dynamics, psychosocial indicators of mental health, exposure to violence and social integration, as well as a sedentary lifestyle and tobacco use.
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Affiliation(s)
| | - Deborah C Malta
- School of Nursery, Federal University of Minas Gerais, Belo Horizonte 30.130-100, Brazil.
| | - Laura C Rodrigues
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
| | - Dandara O Ramos
- Center for Data and Knowledge Integration for Health (CIDACS), Institute Gonçalo Moniz (IGM), Oswaldo Cruz Foundation (FIOCRUZ), Salvador 41.745-715, Brazil.
| | - Rosemeire L Fiaccone
- Institute of Mathematics and Statistics, Federal University of Bahia, Salvador 40.170-110, Brazil.
| | - Daiane B Machado
- Center for Data and Knowledge Integration for Health (CIDACS), Institute Gonçalo Moniz (IGM), Oswaldo Cruz Foundation (FIOCRUZ), Salvador 41.745-715, Brazil.
| | - Maurício L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Institute Gonçalo Moniz (IGM), Oswaldo Cruz Foundation (FIOCRUZ), Salvador 41.745-715, Brazil.
- Institute of Collective Health (ISC), Federal University of Bahia, Salvador 40110-040, Brazil.
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Costa E, Caetano R, Werneck GL, Bregman M, Araújo DV, Rufino R. Estimated cost of asthma in outpatient treatment: a real-world study. Rev Saude Publica 2018; 52:27. [PMID: 29641652 PMCID: PMC5893272 DOI: 10.11606/s1518-8787.2018052000153] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 04/24/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To estimate the cost of diagnosis and treatment of asthma. METHODS We used the perspective of society. We sequentially included for 12 months, in 2011-2012, 117 individuals over five years of age who were treated for asthma in the Pneumology and Allergy-Immunology Services of the Piquet Carneiro Polyclinic, Universidade do Estado do Rio de Janeiro. All of them were interviewed twice with a six-month interval for data collection, covering 12 months. The cost units were identified and valued according to defined methods. We carried out a sensitivity analysis and applied statistical methods with a significance level of 5% for cost comparisons between subgroups. RESULTS The study consisted of 108 patients, and 73.8% of them were women. Median age was 49.5 years. Rhinitis was present in 83.3% of the individuals, and more than half were overweight or obese. Mean family income was U$915.90/month (SD = 879.12). Most workers and students had absenteeism related to asthma. Total annual mean cost was U$1,291.20/patient (SD = 1,298.57). The cost related to isolated asthma was U$1,155.43/patient-year (SD = 1,305.58). Obese, severe, and uncontrolled asthmatic patients had higher costs than non-obese, non-severe, and controlled asthmatics, respectively. Severity and control level were independently associated with higher cost (p = 0.001 and 0.000, respectively). The direct cost accounted for 82.3% of the estimated total cost. The cost of medications for asthma accounted for 62.2% of the direct costs of asthma. CONCLUSIONS Asthma medications, environmental control measures, and long-term health leaves had the greatest potential impact on total cost variation. The results are an estimate of the cost of treating asthma at a secondary level in the Brazilian Unified Health System, assuming that the treatment used represents the ideal approach to the disease.
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Affiliation(s)
- Eduardo Costa
- Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Departamento de Medicina Interna. Rio de Janeiro, RJ, Brasil
| | - Rosangela Caetano
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Política, Planejamento e Administração em Saúde. Rio de Janeiro, RJ, Brasil
| | - Guilherme Loureiro Werneck
- Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Maurício Bregman
- Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Programa de Bolsas de Iniciação Científica. Rio de Janeiro, RJ, Brasil
| | - Denizar Vianna Araújo
- Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Departamento de Clínica Médica. Rio de Janeiro, RJ, Brasil
| | - Rogério Rufino
- Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Departamento de Doenças do Tórax. Rio de Janeiro, RJ, Brasil
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Cardoso TDA, Roncada C, Silva ERD, Pinto LA, Jones MH, Stein RT, Pitrez PM. The impact of asthma in Brazil: a longitudinal analysis of data from a Brazilian national database system. J Bras Pneumol 2017; 43:163-168. [PMID: 28746526 PMCID: PMC5687945 DOI: 10.1590/s1806-37562016000000352] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 04/14/2017] [Indexed: 11/21/2022] Open
Abstract
Objective: To present official longitudinal data on the impact of asthma in Brazil between 2008 and 2013. Methods: This was a descriptive study of data collected between 2008 and 2013 from an official Brazilian national database, including data on asthma-related number of hospitalizations, mortality, and hospitalization costs. A geographical subanalysis was also performed. Results: In 2013, 2,047 people died from asthma in Brazil (5 deaths/day), with more than 120,000 asthma-related hospitalizations. During the whole study period, the absolute number of asthma-related deaths and of hospitalizations decreased by 10% and 36%, respectively. However, the in-hospital mortality rate increased by approximately 25% in that period. The geographic subanalysis showed that the northern/northeastern and southeastern regions had the highest asthma-related hospitalization and in-hospital mortality rates, respectively. An analysis of the states representative of the regions of Brazil revealed discrepancies between the numbers of asthma-related hospitalizations and asthma-related in-hospital mortality rates. During the study period, the cost of asthma-related hospitalizations to the public health care system was US$ 170 million. Conclusions: Although the numbers of asthma-related deaths and hospital admissions in Brazil have been decreasing since 2009, the absolute numbers are still high, resulting in elevated direct and indirect costs for the society. This shows the relevance of the burden of asthma in middle-income countries.
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Affiliation(s)
- Thiago de Araujo Cardoso
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Cristian Roncada
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | | | - Leonardo Araujo Pinto
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Marcus Herbert Jones
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Renato Tetelbon Stein
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Paulo Márcio Pitrez
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
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