ERICA: prevalência de asma em adolescentes brasileiros

OBJETIVO Descrever a prevalência de asma ativa e de diagnóstico médico de asma em adolescentes brasileiros. MÉTODOS Estudo transversal, nacional, de base escolar com adolescentes de 12 a 17 anos, participantes do Estudo de Riscos Cardiovasculares em adolescentes (ERICA). A amostra foi estratificada por região e conglomerada por escolas e turmas com representatividade para o conjunto de municípios com mais de 100 mil habitantes do País, macrorregiões, capitais e Distrito Federal. Os dados foram coletados em questionário autopreenchível. Foram calculadas as prevalências e respectivos intervalos de confiança de 95% (IC95%) segundo sexo, faixa etária, tipo de escola e cor da pele. RESULTADOS Entre 2013 e 2014 foram avaliados 74.589 adolescentes, 55,3% do sexo feminino. A prevalência total de asma ativa foi 13,1% (IC95% 12,1-13,9), sendo superior nas meninas (14,8%; IC95% 13,7-16,0) em relação aos meninos (11,2%; IC95% 10,3-12,2) em todos estratos geográficos analisados, e também entre os alunos da rede privada (15,9%; IC95% 14,2-17,7) em relação aos de escolas públicas (12,4%; IC95% 11,4-13,4). Foi mais elevada na região Sudeste (14,5%; IC95% 12,9-16,1) e na cidade de São Paulo (16,7%; IC95% 14,7-18,7). A menor prevalência foi observada na região Norte (9,7%; IC95% 9,7-10,5) e em Teresina (6,3%; IC95% 4,9-7,7). A prevalência de diagnóstico médico de asma foi 8,7% (IC95% 8,2-9,1); mais elevada na região Norte (13,5%; IC95% 12,7-14,2) e em Porto Alegre (19,8%; IC95% 17,5-22,3) e mais baixa no Centro-Oeste (6,9%; IC95% 6,0-7,8) e em Cuiabá (4,8%; IC95% 3,8-5,9). Não ocorreu diferença significativa na expressão desta taxa entre os sexos, assim como nas outras variáveis avaliadas pelo estudo. CONCLUSÕES A prevalência de asma em adolescentes brasileiros é alta. As taxas de asma ativa e de diagnóstico médico variam amplamente nas diferentes regiões e capitais avaliadas pelo ERICA. Estes resultados poderão auxiliar na elaboração de programas preventivos e de políticas de saúde e no melhor entendimento sobre os fatores associados à asma nessa faixa etária.OBJECTIVE To describe the prevalence of asthma and physician-diagnosed asthma in Brazilian adolescents. METHODS Cross-sectional, national, school-based study with adolescents from 12 to 17 years old, participants in the Study of Cardiovascular Risks in Adolescents (ERICA). The study stratified the sample by region and grouped according to schools and classes with representativeness to the set of cities with more than 100,000 inhabitants of the Country, macro-regions, capitals, and Federal District. A questionnaire collected data through a self-filled in method. We calculated the prevalences and their confidence intervals of 95% (95%CI) according to sex, age group, type of school and skin color. RESULTS Between 2013 and 2014, 74,589 adolescents were evaluated, 55.3% of the female sex. The total prevalence of active asthma was of 13.1% (95%CI 12.1-13.9), being higher in girls (14.8%; 95%CI 13.7-16.0) when compared to boys (11.2%; 95%CI 10.3-12.2) in all geographical strata examined. It was also higher between students of private schools (15.9%; 95%CI 14.2-17.7) when compared to public ones (12.4%; 95%CI 11.4-13.4). It was higher in the Southeast region (14.5%; 95%CI 12.9-16.1), and in the city of Sao Paulo (16.7%; 95%CI 14.7-18.7). The lowest prevalence was observed in North region (9.7%; 95%CI 9.7-10.5), and in Teresina (6.3%; 95%CI 4.9-7.7). The prevalence of physician-diagnosed asthma was of 8.7% (95%CI 8.2-9.1); higher in the North region (13.5%; 95%CI 12.7-14.2), and in Porto Alegre (19.8%; 95%CI 17.5-22.3). It was lower in the Midwest (6.9%; 95%CI 6.0-7.8), and in Cuiaba (4.8%; 95%CI 3.8-5.9). We found no significant difference in the expression of this rate between the sexes, as well as in other variables evaluated by the study. CONCLUSIONS The prevalence of asthma in Brazilian adolescents is high. Rates of active asthma and physician-diagnosed asthma vary widely in different regions and capitals evaluated by the ERICA. These results may assist in the preparation of preventive programs and policies on health and a better understanding of the factors associated with asthma in this age group

Asma em escolares de 13 e 14 anos do Município de Nova Iguaçu, Rio de Janeiro, Brasil: estimativas de prevalência, gravidade e diferenças de gênero Asthma in 13-14-year-old schoolchildren in the city of Nova Iguaçu, Rio de Janeiro State, Brazil: prevalence, severity, and gender differences

O objetivo deste estudo foi descrever a prevalência, a gravidade e os sintomas associados à asma e sua relação com o gênero em escolares de 13 e 14 anos do Município de Nova Iguaçu, Rio de Janeiro, Brasil. Trata-se de estudo transversal, no qual se utilizou o questionário escrito auto-aplicável para asma do International Study of Asthma and Allergies in Childhood (ISAAC). Participaram 3.033 escolares de 37 escolas públicas e privadas selecionadas aleatoriamente. A prevalência de sibilância alguma vez na vida foi de 26% e nos últimos 12 meses (asma atual) de 11,7%, sendo essas taxas maiores entre as meninas (razão de prevalência - RP = 1,46; IC95%: 1,31-1,62 e RP =1,72; IC95%: 1,35-2,21, respectivamente). Sintomas associados à gravidade da doença, como distúrbio do sono e limitação da fala por sibilos, também se associaram positivamente com o gênero feminino (RP = 2,57; IC95%:1,77-3,73 e RP = 2,07; IC95%:1,25-3,43). A prevalência da asma mostrou-se menor quando comparada com as de outras cidades brasileiras, porém ainda é alta entre adolescentes de Nova Iguaçu, sendo mais freqüente e mais grave no gênero feminino. Outros estudos são necessários para explicar tais diferenças.This study aimed to assess the prevalence and severity of asthma and related symptoms and the associations with gender in 13-14-year-old schoolchildren in the city of Nova Iguaçu, Rio de Janeiro State, Brazil. The cross-sectional study used the self-applied International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The sample included 3,033 students randomly selected from 37 public and private schools. Prevalence of "any history of wheezing" was 26%, as compared to 11.7% within the last 12 months ("current asthma"), and was higher among girls (PR = 1.46; 95%CI: 1.31-1.62 and PR = 1.72; 95%CI: 1.35-2.21). Symptoms associated with severity, like "sleep disorders" and "speech limited by wheezing" were associated with female gender (PR = 2.57; 95%CI: 1.77-3.73 and PR = 2.07; 95%CI: 1.25-3.43). Although asthma prevalence was lower than in other Brazilian cities, it was still high among schoolchildren in Nova Iguaçu, and was more frequent and severe among girls. Further research is needed to explain the observed differences

IV Brazilian Consensus on Rhinitis - an update on allergic rhinitis,

Abstract Introduction The guidelines on allergic rhinitis aim to update knowledge about the disease and care for affected patients. The initiative called "Allergic Rhinitis and its Impact on Asthma", initially published in 2001 and updated in 2008 and 2010, has been very successful in disseminating information and evidence, as well as providing a classification of severity and proposing a systemized treatment protocol. In order to include the participation of other medical professionals in the treatment of allergic rhinitis, it is important to develop algorithms that accurately indicate what should and can be done regionally. Objective To update the III Brazilian Consensus on Rhinitis - 2012, with the creation of an algorithm for allergic rhinitis management. Methods We invited 24 experts nominated by the Brazilian Association of Allergy and Immunology, Brazilian Association of Otorhinolaryngology and Head and Neck Surgery and Brazilian Society of Pediatrics to update the 2012 document. Results The update of the last Brazilian Consensus on Rhinitis incorporated and adapted the relevant information published in all "Allergic Rhinitis and its Impact on Asthma" Initiative documents to the Brazilian scenario, bringing new concepts such as local allergic rhinitis, new drugs and treatment evaluation methods. Conclusion A flowchart for allergic rhinitis treatment has been proposed

IV Brazilian Consensus on Rhinitis - an update on allergic rhinitis,

<div><p>Abstract Introduction The guidelines on allergic rhinitis aim to update knowledge about the disease and care for affected patients. The initiative called "Allergic Rhinitis and its Impact on Asthma", initially published in 2001 and updated in 2008 and 2010, has been very successful in disseminating information and evidence, as well as providing a classification of severity and proposing a systemized treatment protocol. In order to include the participation of other medical professionals in the treatment of allergic rhinitis, it is important to develop algorithms that accurately indicate what should and can be done regionally. Objective To update the III Brazilian Consensus on Rhinitis - 2012, with the creation of an algorithm for allergic rhinitis management. Methods We invited 24 experts nominated by the Brazilian Association of Allergy and Immunology, Brazilian Association of Otorhinolaryngology and Head and Neck Surgery and Brazilian Society of Pediatrics to update the 2012 document. Results The update of the last Brazilian Consensus on Rhinitis incorporated and adapted the relevant information published in all "Allergic Rhinitis and its Impact on Asthma" Initiative documents to the Brazilian scenario, bringing new concepts such as local allergic rhinitis, new drugs and treatment evaluation methods. Conclusion A flowchart for allergic rhinitis treatment has been proposed.</p></div

Is the prevalence of asthma and related symptoms among Brazilian children related to socioeconomic status?

Objective. To evaluate the relationship between socioeconomic status (SES) and the prevalence of asthma and related symptoms among Brazilian children. Methods. The International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire was applied to 23,457 six- to seven- year-old schoolchildren (SC) and 58,144 thirteen- to fourteen-year-old adolescents (AD) from 20 Brazilian cities. SES was evaluated by infant mortality index, poverty index, and average nominal income for people older than 10 years of age. Results. Current asthma ranged from 16.5% to 31.2% among SC and from 11.8% to 30.5% among AD and severe asthma from 2.9% to 8.5% (SC) and 2.6% to 9.1% (AD). Higher values were observed in Brazilian-Northern, -Northeastern and -Southeastern centers. No significant association between SES and prevalence of asthma and related symptoms was observed. Conclusions. In Brazil, the prevalence of asthma and related symptoms is quite variable and independent of SES. Copyright © 2008 Informa Healthcare USA, Inc