Validation of a Diagnostic Questionnaire on Asthma in Children and Adults For Epidemiological Studies

Background: Asthma is a chronic airway in ammatory disease, for identification in the population epidemiological studies are required. Objective: To validate a questionnaire of asthma diagnosis in children and adults. Patients and method: A prolective, cross-sectional, homodemic and multicenter study was done in which a questionnaire of asthma for children and adults was subjected to a validation process was developed from November 2012 to February 2014, 300 patients, 150 children and 150 adults of both sexes, obtained from the Allergy department. The questionnaire was applied to adults from 13 years of age and to parents who have children age 12 and under. Each question was assigned a score as the sum of the points according to symptoms, when it reached a score equal to or greater than 0.75, asthma was diagnosed. Results: The questionnaire of asthma was applied in adult population 13-70 years of age and fathers with children was 2-12 years old. The tests applied to questionnaire responses showed adults and children in good agreement in the test and retest interobserver agreement, this being substantial to almost perfect. The tests applied to criterion validity for both questionnaires showed a sensitivity of 90% in > 12y, and 90 % in children, and speci city of 91% and 90%, respectively PPV 92% and NPV 90% in > 12y and 90% PPV and 90% NPV in children. The criteria for content validity and expression are properly met. The homogeneity test Cronbach’s alpha was 0.7. Conclusion: The questionnaire for diagnosis of asthma in adults and children has good intra- and interobserver agreement, with high sensi- tivity and specificity in the criterion validity

Prevalence of allergic rhinitis and its symptoms in the school children population of Cuernavaca, Morelos, Mexico

Background: Studies on allergic rhinitis prevalence have found significant variations in their results, even in closely-living populations. Objective: To determine and compare the prevalence of allergic rhinitis and its symptoms in schoolchildren from Cuernavaca, Morelos, Mexico. Methods: Cross-sectional, descriptive study on the prevalence of allergic rhinitis diagnosis and symptoms, where the “Diagnostic questionnaire for epidemiological studies” was used between June and December 2015 in pre-school and primary and secondary school population, after authorization was granted by parents and school authorities. Results: In 7866 surveys in a population aged between 3 and 15 years, 939 cases of allergic rhinitis (11.94%) were identified, with 53% belonging to the female gender. The symptom with the highest prevalence was cold-induced nasal congestion (56.8%), followed by rhinitis accompanied by ocular symptoms (35.8%) and recurrent flu-like symptoms (20), which was the most common symptom in allergic rhinitis (100%). Conclusions: A significant variation was observed in the prevalence of symptoms, notably higher than that of questionnaire-obtained allergic rhinitis diagnosis (11.94%), which suggests that the independent prevalence of symptoms is not a good parameter to detect the prevalence of allergic rhinitis

Prevalence of asthma and its symptoms in schoolchildren from Cuernavaca, Morelos, Mexico

Background: Asthma is a chronic disease that has increased over the past 2 decades. Objective: To determine the prevalence of asthma and its symptoms in the city of Cuernavaca, Morelos, Mexico. Methods: A descriptive study of prevalence in public schools of the city of Cuernavaca, Morelos, at the preschool, elementary, and high school levels using the “Asthma diagnosis for epidemiological studies questionnaire.” Results: 7947 surveys were obtained from students ages 3 to 15 years, funding a prevalence of asthma of 11.9%, 49% in boys and 51% in girls. As for the symptoms of asthma, the highest prevalence was cough that increases with cold weather (63%), however, in asthma patients this symptom only occurred in 17%; chest tightness had the lowest prevalence of symptoms (10%); however, in asthma patients it was 49%. Conclusions: The asthma diagnosis for epidemiological studies questionnaire found an average asthma prevalence of 11.9% in preschool, elementary, and high school students, slightly below that diagnosed in other cities in central Mexico. The prevalence of asthma symptoms was higher than the diagnosis of asthma

Prevalence of rhinitis allergic in populations of several states of Mexico

Background: Allergic rhinitis is an inflammatory disorder of the nasal mucosa, characterized by symptoms of itching, rhinorrhea, nasal congestion and sneezing induced by an IgE-mediated response. In Mexico we have reports of prevalence, with fluctuations of 5.5% to 47.7% with the question of rhinitis symptoms the past 12 months. Objective: To determine the prevalence of allergic rhinitis in schoolchildren from various states of Mexico. Material and method: A descriptive study of prevalence in which a questionnaire was applied to preschool, elementary-, middle- and high-school population. It was performed in four cities in four states of Mexico: Puebla, Puebla, Tulancingo, Hidalgo, Tlaxcala, Tlaxcala and Cancun, Quintana Roo. Parents answered questionnaires of preschool and elementary school and middle- and high-school students answered their questionnaires. The study was conducted from June 2014 to January 2015. The instrument used was: questionnaire diagnosis of allergic rhinitis for epidemiological studies. Results: Of the surveys, 8,159 completed questionnaires were obtained, in the city of Puebla: 2,267, Tulancingo, Hidalgo: 2,478, Tlaxcala, Tlaxcala: 2,574, Cancun, Quintana Roo: 840; total male: 4,190 (51%). The overall average rate of prevalence of allergic rhinitis among four states including all respondents ages was 15%. Conclusions: With the use of the questionnaire diagnosis of allergic rhinitis for epidemiological studies in the four cities in four different states, we found a prevalence of allergic rhinitis of 15% in ≥13 yearpopulation and 13% in ≤12 year-old children

Prevalence of asthma and determination of symptoms as risk indicators

Background: Asthma is a chronic inflammatory airway disease whose prevalence has increased, especially in developed countries; the results of studies of asthma prevalence vary in different populations and even within the same country; in Mexico we observed fluctuations in prevalence of asthma from 7% to 33%. Objetive: To determine the prevalence of asthma and severity of symptoms as risk indicators in school population in cities in various states of Mexico. Material and method: A descriptive study of detection of asthma prevalence and analytical-comparative observational study of determination of symptoms of asthma. The surveys were applied to preschool, elementary, middle and high school population, in the cities of Puebla, Puebla; Tulancingo, Hidalgo; Tlaxcala, Tlaxcala, and Cancún, Quintana Roo; new validated questionnaire was used as instrument: Asthma Diagnostic Questionnaire for Epidemiologic Studies, consisting of eight questions with summation value for diagnosis. Results: 8,754 surveys showed a 14% prevalence in Puebla, 17% in Tulancingo, 7% in Tlaxcala, and 14% in Cancún; average in four cities surveyed was 13%; the strength of association with asthma symptoms in descending order with significant odds ratio were: recurrent wheezing, breathlessness, chest tightness, recurrent cough, cough cold, recurrent cold symptoms, predominantly nocturnal cough, cough that increases with exercise. Conclusions: The average prevalence of asthma in the surveyed cities was 13% and the main symptoms indicators of risk of asthma in school children were: recurrent wheezing, breathlessness, chest tightness and recurrent cough

ARIA Mexico 2014 Adaptation of the Clinical Practice Guide ARIA 2010 for Mexico. Methodology ADAPTE

Background: The global prevalence of allergic rhinitis is high. International Study of Asthma and Allergies in Childhood (ISAAC) Phase III reports a total estimated prevalence of 4.6% in Mexico. There is evidence based on allergic rhinitis Clinical Practice Guidelines (CPG), but its promotion, acceptance and application is not optimal or adequate in Mexico. Objective: To generate a guideline for the treatment of allergic rhinitis and its impact on asthma by adaptating the 2010 ARIA Guideline to Mexican reality, through a transculturation process applying the ADAPTE methodology. Material and method: Using the ADAPTE Methodology, the original 2010 ARIA CPG recommendations were evaluated by the guideline development group (GDG) into which multiple medical specialities managing patients with allergic rhinitis were incoorporated. The GDG valorated the quality of 2010 ARIA, checked and translated key clinical questions. Moreover, the GDG adjusted recommendations, patient preferences and included comments in the context of the Mexican reality (safety, costs and cultural issues). To accomplish this, we ran Delphi panels with as many rounds as necessary to reach agreement. One extra question, not included in the original 2010 ARIA, on the use of Nasal Lavages for AR was created sustained by a systematic literature review. Results: A total of 45 questions from the original 2010 ARIA were included and divided into six groups covering prevention, medical treatment, immunotherapy and alternative medicine to treat patients with allergic rhinitis with or without asthma. Most of the questions reached agreement in one or two rounds; one question required three rounds. Conclusions: An easy-to-use, adaptated, up-to-date and applicable allergic rhinitis guideline for Mexico is now available