Estudos epidemiológicos e seus impactos na saúde da criança: international study of asthma and allergies in childhood (ISAAC)

Solé, Dírceu

doi:10.1590/s1519-38292005000300001

Cited by 8 publications

(14 citation statements)

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“…The prevalence and incidence of allergic diseases are increasing worldwide, particularly in the urban populations of developed countries. The International Study of Asthma and Allergies in Childhood (ISAAC), conducted in several Brazilian cities, showed that the city of Salvador, where the present work was completed, had a very high prevalence (24.0%) of wheezing among children [ 1 ]. Among the environmental factors that may trigger allergic diseases, infections are the most studied.…”

Section: Introductionmentioning

confidence: 99%

The presence of serum anti-Ascaris lumbricoides IgE antibodies and of Trichuris trichiura infection are risk factors for wheezing and/or atopy in preschool-aged Brazilian children

et al. 2010

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BackgroundThe elucidation of factors that trigger the development of transient wheezing in early childhood may be an important step toward understanding the pathogenesis of asthma and other allergic diseases later in life. Transient wheezing has been mainly attributed to viral infections, although sensitisation to aeroallergens and food allergens may occur at an early age. In developing countries, intestinal helminthic infections have also been associated with allergy or atopy-related disorders.ObjectiveThe aim of this study was to explore the association of Trichuris trichiura and Ascaris lumbricoides infections with wheezing and atopy in early childhood.Study designA cross-sectional study using a Portuguese-language ISAAC phase I questionnaire, adapted for preschool-aged children, nested in a cohort study of childhood diarrhoea, was conducted on 682 children. Two faecal samples per child were examined for the presence of intestinal helminthic infection. IgE antibodies against three allergenic preparations (Dermatophagoides pteronyssinus, Blomia tropicalis and common child food), as well as against A. lumbricoides antigens, were measured in a sub-sample of these children, whose parents allowed the procedure. Atopy was defined by the presence of levels of serum IgE antibodies ≥0.35 kU/L against at least one of the three tested allergenic preparations.ResultsActive T. trichiura infection but not A. lumbricoides infection was positively associated with wheezing in the total studied children population [adjusted OR = 2.60; CI = 1.54;4.38] and in the atopic children sub-population [adjusted OR = 3.07; CI = 1.00;9.43]. The association with atopy was also positive and statistically significant only in the brute analysis [OR = 2.13; CI = 1.03;4.40]. Anti-A. lumbricoides IgE antibodies, but not current A. lumbricoides infection, were positively associated with wheezing in atopic children [adjusted OR = 2.01; CI = 1.00;4.50] and in non-atopic children [adjusted OR = 3.07; CI = 1.13;8.35] and it was also associated with atopy [adjusted OR = 7.29; CI = 3.90; 13.4]. On the other hands, reports of wheezing were not significantly associated with atopy.ConclusionsThese data corroborate previous studies showing that wheezing is predominantly associated with infection in early childhood and shows that anti-A. lumbricoides IgE antibodies, but not active Ascaris infections, are associated with wheezing and atopy. Additionally, the data demonstrate that T. trichiura infection may play a role in the pathogenesis of atopic wheezing in early childhood.

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Section: Introductionmentioning

confidence: 99%

The presence of serum anti-Ascaris lumbricoides IgE antibodies and of Trichuris trichiura infection are risk factors for wheezing and/or atopy in preschool-aged Brazilian children

et al. 2010

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“…Some possible explanations for these findings include: 1) patients with severe asthma tend to avoid physical exertion due to limited lung function; 2) some children may overestimate exercise-related symptoms and believe them to be asthma- Estimation of asthma severity in the present study was based on a combination of questions from two questionnaires, one standardized and validated worldwide and the other novel and as yet non-validated. We therefore accept that some study limitations are present, as these estimates are subject to error due to varying knowledge of asthma and its symptoms 26 or by the absence of clinical examination and complementary testing to increase accuracy of the diagnosis and of severity assessment. 5 As it had not been validated, the GINA-based instrument was compared to the ISAAC questionnaire by simultaneous administration to the study sample.…”

Section: Discussionmentioning

confidence: 99%

Distribuição da gravidade da asma na infância

Simões¹,

Cunha²,

Barreto³

et al. 2010

J. Pediatr. (Rio J.)

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Objective: To estimate the distribution of asthma severity in a population-based sample of children from Salvador, Brazil.Methods: An epidemiologically oriented questionnaire (International Study of Asthma and Allergies in Childhood, ISAAC) and a questionnaire based on criteria used in clinical practice (The Global Initiative for Asthma, GINA) were administered simultaneously to 417 children aged 5 to 12 years who reported symptoms of asthma in the past 12 months. According to the ISAAC instrument, children were classified into severe and non-severe asthma, whereas GINA clinical criteria produced four categories of severity: intermittent, mild persistent, moderate persistent and severe asthma.Results: Ninety children reported symptoms indicative of severity according to the ISAAC questionnaire. According to GINA criteria, 143 children had intermittent asthma, 160 mild persistent, 51 moderate and 43 severe asthma. Agreement between the two instruments was 81.3% (kappa = 0.5). Conclusions:Most asthmatic children in the Salvador urban area have persistent asthma. Agreement between epidemiological and clinical classifications of asthma severity was satisfactory.

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“…3 It is worth noting that the term "cansaço" did also not appear in the Brazilian version of the questionnaire designed to be used in Phase I of the ISAAC in Brazil. 5 Finally, other three English versions of questionnaires designed to study respiratory diseases have used the terms "wheeze", "breathless" and "short of breath" in separate questions or as "shortness of breath with wheezing" (IUATLD, ATS and MRC). 2 And it has been shown that questions that use the terms "breathless" and "short of breath" have lower specificity in correctly identifying asthma than those using the term "wheeze".…”

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confidence: 99%

Comparação das estimativas de prevalência de asma em Recife

Cunha¹,

Pujades-Rodríguez²

2005

J. Pediatr. (Rio J.)

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Comparing asthma prevalence estimates in RecifeDear Sir,We would like to comment on a number of methodological issues related to an article by Britto et al. 1 recently published in this journal.One of the objectives of that study was to evaluate the diagnostic accuracy of the annual prevalence of wheezing as an indicator of asthma. To do this the authors compared answers to two different questions: question 2 (Q2) of the core asthma module of the ISAAC questionnaire -Have you had wheezing in the past 12 months ? and question 6 (Q6) -Have you ever had asthma? . It has been previously suggested that, in the absence of a gold standard, results obtained by administering a questionnaire of the signs and symptoms of asthma can be compared to documented diagnosis of asthma made by physicians in the same patients. 2 In our opinion, information obtained through Q6 cannot be taken as equivalent to a history of physiciandiagnosed asthma (clinical examination and diagnosis made by a health professional), since participants replies to this question will be determined by their own understanding of the term asthma rather than by an objective measure of the presence of that disease. Therefore, the reported information seems to merely represent data on the agreement between answers to two separate questions rather than information on the validation of Q2. Validating this question would have required the comparison of replies to Q2 with results from either an objective test (e.g. lung function test), or a clinical examination by a physician, or documented information on a previous diagnosis of asthma from medical records. 2 A second methodological issue is concerned with the use of the term cansaço (which in English means feeling breathless or short of breath) as part of the translation of the term "wheeze". Although the ISAAC study group had suggested that asthmatic children and their parents could be asked to describe breathing patterns during an asthma episode, 3 we think that the translation of the term "wheeze" as "cansaço" used in the present study might not be appropriate. First, the term "wheeze" included in the core module of the ISAAC questionnaire corresponds to the terms "sibilos", "piado" or "chiado", in Brazilian Portuguese. In contrast, the term "cansaço" (shortness of breath) has a broader meaning and, in the Brazilian context, it is frequently associated with several clinical conditions other than asthma. Second, the English version of the questionnaire that was used in phase I of the ISAAC only included the terms "wheeze", "cough" and "asthma" (and not "breathless" or "short of breath"). 4 The term "breathless" or "short of breath" was only introduced later in the English version of the phase II ISAAC core questionnaire (module Wheeze and Breathlessness Supplementary Questionnaire). 3 It is worth noting that the term "cansaço" did also not appear in the Brazilian version of the questionnaire designed to be used in Phase I of the ISAAC in Brazil. 5 Finally, other three English versions of questionnaires designe...

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Estudos epidemiológicos e seus impactos na saúde da criança: international study of asthma and allergies in childhood (ISAAC)

Cited by 8 publications

References 0 publications

The presence of serum anti-Ascaris lumbricoides IgE antibodies and of Trichuris trichiura infection are risk factors for wheezing and/or atopy in preschool-aged Brazilian children

The presence of serum anti-Ascaris lumbricoides IgE antibodies and of Trichuris trichiura infection are risk factors for wheezing and/or atopy in preschool-aged Brazilian children

Distribuição da gravidade da asma na infância

Comparação das estimativas de prevalência de asma em Recife

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