Susceptibility of asthmatic children to respiratory infection

Pereira, Júlio C. R.; Escuder, Maria Mercedes Loureiro

doi:10.1590/s0034-89101997000600001

Cited by 10 publications

(8 citation statements)

References 21 publications

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“…In the city of São Paulo, this rate was 34.9%. (19) The association between wheezing and pneumonia is well known (20) and clearly points to recurrent wheezing as a serious public health problem. However, in Brazil and in other developing countries, although of wheezing in a representative sample of the population in the southern part of the city, and slightly less than half of the infants had had at least one wheezing episode in the first year of life.…”

Section: Discussionmentioning

confidence: 99%

Prevalência e gravidade da sibilância no primeiro ano de vida

et al. 2010

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Objective: To determine the prevalence and severity of wheezing in infants, using the standardized protocol devised for the "Estudio Internacional de Sibilancias en Lactantes" (EISL, International Study of Wheezing in Infants), as well as to determine the relationship between such wheezing and physician-diagnosed asthma, in the first year of life. Methods: Between March of 2005 and August of 2006, the EISL questionnaire was administered to the parents or legal guardians of infants undergoing routine procedures or immunization at public primary health care clinics in the southern part of the city of São Paulo, Brazil. Results: Our sample comprised 1,014 infants (mean age = 5.0 ± 3.0 months), 467 (46.0%) of whom had at least one wheezing episode, 270 (26.6%) having three or more such episodes, in their first year of life. The use of inhaled β 2 agonists, inhaled corticosteroids, or antileukotrienes, as well as the occurrence of nocturnal symptoms, difficulty breathing, pneumonia, emergency room visits, and hospitalization due to severe wheezing, was significantly more common among those with recurrent wheezing (p < 0.05). Physician-diagnosed asthma was reported for 35 (7.5%) of the 467 wheezing infants and was found to be associated with the use of inhaled corticosteroids, difficulty breathing during the attacks, and six or more wheezing episodes in the first year of life. However, less than 40% of those infants were treated with inhaled corticosteroids or antileukotrienes. Conclusions: In this study, the prevalence of wheezing episodes among infants in their first year of life was high and had an early onset. The proportion of infants diagnosed with and treated for asthma was low.Keywords: Asthma/diagnosis; Asthma/epidemiology; Respiratory sounds. ResumoObjetivo: Avaliar a prevalência e a gravidade da sibilância, bem como sua relação com o diagnóstico médico de asma, em lactentes no primeiro ano de vida, utilizando o protocolo padronizado do "Estudio Internacional de Sibilancias en Lactantes" (EISL, Estudo Internacional de Sibilâncias em Lactentes). Métodos: Entre março de 2005 e agosto de 2006, os pais ou responsáveis de lactentes que procuraram unidades básicas de saúde na região centro-sul de São Paulo (SP) para procedimentos de rotina e imunização responderam ao questionário escrito do EISL. Resultados: A amostra foi constituída por 1.014 lactentes (média de idade = 5,0 ± 3,0 meses), 467 (46,0%) dos quais apresentaram sibilância no primeiro ano de vida, sendo que 270 (26,6%) tiveram três ou mais episódios. Entre esses últimos, o uso de β 2 -agonista inalatório, corticosteroide inalatório e antileucotrieno, assim como a presença de sintomas noturnos, dificuldade para respirar, pneumonia, idas ao pronto socorro e internação por sibilância grave, foram significantemente mais frequentes (p < 0,05). Os pais de 35 (7,5%) dos 467 lactentes relataram o diagnóstico médico de asma, o qual foi associado ao uso de corticosteroide inalatório, percepção de falta de ar durante as crises e seis ou mais episódios de s...

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Section: Discussionmentioning

confidence: 99%

Prevalência e gravidade da sibilância no primeiro ano de vida

et al. 2010

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“…28,29 Thus, the complexity of a clinical presentation that may include pneumonia and bronchial obstruction implies not only an underlying clinical challenge, but also interdependence between the two conditions.…”

Section: Discussionmentioning

confidence: 99%

Inter-observer agreement in interpreting chest X-rays on children with acute lower respiratory tract infections and concurrent wheezing

et al. 2007

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CONTEXT AND OBJECTIVE: Many children with acute lower respiratory tract infections (ALRI) present to the emergency ward with concurrent wheezing. A chest x-ray is often requested to rule out pneumonia. We assessed inter-observer agreement in interpreting x-rays on such children. DESIGNS AND SETTING: Prospective consecutive case study at Instituto de Salud del Niño, Lima, Peru. METHODS: Chest x-rays were obtained from eligible children younger than two years old with ALRI and concurrent wheezing who were seen in the emergency ward of a nationwide pediatric referral hospital. The x-rays were read independently by three different pediatric residents who were aware only that the children had a respiratory infection. All the children had received inhaled beta-adrenergic agonists before undergoing chest x-rays. Lobar and complicated pneumonia cases were excluded from the study. RESULTS: Two hundred x-rays were read. The overall kappa index was 0.2. The highest individual kappa values for specific x-ray findings ranged from 0.26 to 0.34 for rib horizontalization and from 0.14 to 0.31 for alveolar infiltrate. Inter-observer variation was intermediate for alveolar infiltrate (kappa 0.14 to 0.21) and for air bronchogram (kappa 0.13 to 0.23). Reinforcement of the bronchovascular network (kappa 0.10 to 0.16) and air trapping (kappa 0.05 to 0.20) had the lowest agreement. CONCLUSIONS: There was poor inter-observer agreement for chest x-ray interpretation on children with ALRI and concurrent wheezing seen at the emergency ward. This may preclude reliable diagnosing of pneumonia in settings where residents make management decisions regarding sick children. The effects of training on inter-observer variation need further studies.

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“…Risk factors associated with pneumonia include asthma and day-care use [4,[6][7][8][9]. The association between asthma and pneumonia has been described several times, but the precise relationship between the two conditions is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Community-based estimates of incidence and risk factors for childhood pneumonia in Western Sydney

2003

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The aim was to estimate the community incidence and risk factors for all-cause pneumonia in children in Western Sydney, Australia. A cross-sectional randomized computer-assisted telephone interview was conducted in July 2000, in Western Sydney. Parents of 2020 children aged between 5 and 14 years were interviewed about their child's respiratory health since birth. No verification of reported diagnosis was available. Logistic regression analysis was used to determine risk factors for pneumonia. A lifetime diagnosis of pneumonia was reported in 137/2020 (68%) children, giving an estimated incidence in the study sample of 7.6/1000 person-years. Radiological confirmation was reported in 85% (117/137). Hospitalization was reported in 41% (56/137) and antibiotic therapy in 93% (127/137) of cases. Using logistic regression modelling, statistically significant associations with pneumonia were a reported history of either asthma, bronchitis or other lung problems and health problems affecting other systems. In most cases, the diagnosis of asthma preceded the diagnosis of pneumonia. The community incidence of all causes of pneumonia is not well enumerated, either in adults or in children. This study provides community-based incidence data. The incidence of hospitalization for pneumonia in this study is comparable to estimates from studies in comparable populations, suggesting that retrospective parental report for memorable events is likely to be valid. We found a relationship between pneumonia and childhood respiratory diseases such as asthma, which has implications for targeted vaccination strategies.

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Susceptibility of asthmatic children to respiratory infection

Cited by 10 publications

References 21 publications

Prevalência e gravidade da sibilância no primeiro ano de vida

Prevalência e gravidade da sibilância no primeiro ano de vida

Inter-observer agreement in interpreting chest X-rays on children with acute lower respiratory tract infections and concurrent wheezing

Community-based estimates of incidence and risk factors for childhood pneumonia in Western Sydney

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