Treatment of wheezing in Brazilian infants in the first year of life (original) (raw)
Risk Factors for Wheezing Disorders in Infants in the First Year of Life Living in Sao Paulo, Brazil
Journal of Tropical Pediatrics, 2012
The objective of this study was to identify risk factors for wheezing disorders in the first year of life in infants living in Sa˜o Paulo (SP), Brazil, applying the standardized protocol of the Estudio Internacional de sibilancia en lactentes-Phase 1. A total of 1014 parents or caregivers of infants, who attended for routine evaluation and immunization in public health centers were interviewed in Southern SP city. Risk factors significantly associated with recurrent wheezing were: history of previous pneumonia, daycare attendance, consumption of processed food, presence of a cat at home, more than five upper respiratory infection (URI) episodes and the first URI before the age of sixth month. Most of these risk factors for wheezing can be avoided or controlled. Prospective studies on wheezing, especially in children with a severe presentation, are needed to analyze the impact of these risk factors and the effect of preventive actions.
International Study of Wheezing in Infants (EISL) - phase 3, São Paulo - SP, Brazil
Journal of Allergy and Clinical Immunology, 2012
The multicenter International Study of Wheezing in Infants (EISL) was developed to study the prevalence of recurrent wheezing and related risk factors in infants during the fi rst year of life using a written questionnaire (EISL-WQ). Objectives: To constructively validate a modifi ed, shortened version of the EISL-WQ in children up to 36 months of age in São Paulo, Brazil, and to verify its usefulness in diagnosing probable asthma in these children. Methods: The parents of 170 infants aged 12 to 36 months answered the shortened EISL-WQ in an emergency room and were asked if their child was currently wheezing before a diagnosis was made by a physician. The consistency between parent perception and the physician's diagnosis was then evaluated. A second group (n = 55) participated in the validation of the short-term repeatability of the shortened questionnaire by completing it twice (mean interval, 23 days). Results: There was good agreement between parent perception of wheezing and the physician's diagnosis following auscultation (Kappa statistic = 0.7; odds ratio = 38.33; 95% confi dence interval, 15.8 to 92.8; P < .001); sensitivity (82.8%), specifi city (85.0%), positive predictive value (81.5%), and negative predictive value (86.0%) were all high. The short-term repeatability of the shortened version of the EISL-WQ was also high (κ > 0.75). Questions added to the shortened EISL-WQ improved the internal consistency of the original questionnaire (Cronbach α = 0.823, P < .001) and a high Youden index was found for patients defi ned as probable asthmatics. Conclusions: The shortened version of the EISL-WQ translated into Portuguese has high internal consistency, and is a valid, reliable, and reproducible instrument for obtaining data on wheezing in children below 36 months of age and for identifying those with probable asthma.
Epidemiological aspects of and risk factors for wheezing in the first year of life
Jornal Brasileiro de Pneumologia, 2014
OBJECTIVE: To determine, in a sample of infants, the prevalence of and risk factors for occasional wheezing (OW) and recurrent wheezing-wheezy baby syndrome (WBS). METHODS: Parents of infants (12-15 months of age) completed the International Study of Wheezing in Infants questionnaire. RESULTS: We included 1,269 infants residing in the city of Blumenau, Brazil. Of those, 715 (56.34%) had a history of wheezing, which was more common among boys. The prevalences of OW and WBS were 27.03% (n = 343) and 29.31% (n = 372), respectively. On average, the first wheezing episode occurred at 5.55 ± 2.87 months of age. Among the 715 infants with a history of wheezing, the first episode occurred within the first six months of life in 479 (66.99%), and 372 (52.03%) had had three or more episodes. Factors associated with wheezing in general were pneumonia; oral corticosteroid use; a cold; attending daycare; having a parent with asthma or allergies; mother working outside the home; male gender; no br...
Wheezing conditions in early childhood: Prevalence and risk factors in the city of São Paulo, Brazil
Bulletin of the World Health Organisation
Objective To investigate the prevalence and risk factors for wheezing disorders in early childhood in São Paulo, Brazil, the largest metropolitan area of South America. Methods A population-based cross-sectional survey of 1132 children aged 6-59 months was carried out between 1995 and 1996 to obtain information on recent wheezing and on independent variables such as demographic, socioeconomic, environmental, maternal and nutritional variables and immunization status. Intestinal parasitic infections were diagnosed using standard techniques. Multiple unconditional logistic regression was used to describe associations between outcome and independent variables. Findings The prevalence of recent wheezing (one or more reported episodes in the past 12 months) was 12.5%; 93% of children with wheezing were also reported to have a medical diagnosis of asthma. Recent wheezing was associated with low per capita income, poor quality of housing, day-care attendance, low birth weight and infection with intestinal helminths. Conclusion Wheezing in early childhood in São Paulo, although more common than in most developing countries, remains less prevalent than in urban areas of industrialized countries. Low income and conditions associated with poverty (poor housing, low birth weight and parasitic infections) are some of the main risk factors for wheezing disorders among young children in this city.
Prevalence and risk factors associated with wheezing in the first year of life
Jornal de Pediatria, 2014
Objective: to investigate the prevalence and risk factors associated with wheezing in infants in the first year of life. Methods: this was a cross-sectional study, in which a validated questionnaire (Estudio Internacional de Sibilancias en Lactantes -International Study of Wheezing in Infants -EISL) was applied to parents of infants aged between 12 and 15 months treated in 26 of 85 primary health care units in the period between 2006 and 2007. The dependent variable, wheezing, was defined using the following standards: occasional (up to two episodes of wheezing) and recurrent (three or more episodes of wheezing). The independent variables were shown using frequency distribution to compare the groups. Measures of association were based on odds ratio (OR) with a confidence interval of 95% (95% CI), using bivariate analysis, followed by multivariate analysis (adjusted OR [aOR]). Results: a total of 1,029 (37.7%) infants had wheezing episodes in the first 12 months of life; of these, 16.2% had recurrent wheezing. Risk factors for wheezing were family history of asthma (OR = 2.12; 95% CI: 1.76-2.54) and six or more episodes of colds (OR = 2.38; 95% CI: 1.91-2.97) and pneumonia (OR = 3.02; 95% CI: 2.43-3.76). For recurrent wheezing, risk factors were: familial asthma (aOR = 1.73; 95% CI 1.22---2.46); early onset wheezing (aOR = 1.83; 95% CI: 1.75-3.75); nocturnal symptoms (aOR = 2.56; 95% CI: 1.75-3.75), and more than six colds (aOR = 2.07; 95% CI 1.43-.00). ଝ Please cite this article as: Bessa OAAC, Leite ÁJM, Solé D, Mallol J. Prevalence and risk factors associated with wheezing in the first year of life. J Pediatr (Rio J). 2013. http://dx.---7 ARTICLE IN PRESS +Model 2
Risk Factors for Recurrent Wheezing in Infants
Journal of Human Growth and Development, 2013
ResumoIntrodução: a sibilância é um dos sintomas respiratórios mais comuns na infância. Independentemente da causa, é motivo de procura por atendimento médico em serviços de urgência, sobretudo se há recorrência dos episódios. Muito frequente na infância, a sibilância de repetição tem seus primeiros episódios no primeiro ano de vida. Objetivo: verificar os fatores de risco para sibilância recorrente em lactentes no primeiro ano de vida. Método: pesquisa de campo do tipo exploratória, transversal com abordagem quantitativa, onde foi aplicado um questionário padronizado do Estudo Internacional de Sibilância em Lactentes, traduzido e validado no Brasil, constituído por questões objetivas. Foram questionadas 40 mães cadastradas em duas Unidades de Saúde da Família. Resultados: os fatores de risco encontrados: tabagismo durante a gestação, histórico familiar de asma, rinite e dermatite alérgica, presença de pelo menos um animal doméstico em domicílio na época do nascimento e idade do pri...
Jornal Brasileiro de Pneumologia, 2016
Objective : To present the Programa Infantil de Prevenção de Asma (PIPA, Program for the Prevention of Childhood Asthma) and the characteristics of the patients followed in this program. Methods : Implemented in the city of Uruguaiana, Brazil, PIPA has as its target population children and adolescents (< 18 years of age) with asthma or suspected asthma. Patients either enroll in PIPA spontaneously or are referred by pediatricians or primary care physicians. In this retrospective study, we use a standardized protocol to assess PIPA patients. Results : By the end of the study period, 646 patients were being followed. Of those, 298 (46.1%) were ≤ 3 years of age. In this group of patients, recurrent wheezing was identified in 60.7%, and the first episode of wheezing occurred in the first six months of life in 86.0%. Severe wheezing was identified in 29.5% and 45.4% in the children ≤ 3 and > 3 years of age, respectively. Physician-diagnosed asthma was reported in 26.5% and 82.2%, r...
Journal of Clinical Medicine
Wheezing at preschool age (i.e., before the age of six) is common, occurring in about 30% of children before the age of three. In terms of health care burden, preschool children with wheeze show double the rate of access to the emergency department and five times the rate of hospital admissions compared with school-age asthmatics. The consensus document aims to analyse the underlying mechanisms involved in the pathogenesis of preschool wheezing and define the risk factors (i.e., allergy, atopy, infection, bronchiolitis, genetics, indoor and outdoor pollution, tobacco smoke exposure, obesity, prematurity) and the protective factors (i.e., probiotics, breastfeeding, vitamin D, influenza vaccination, non-specific immunomodulators) associated with the development of the disease in the young child. A multidisciplinary panel of experts from the Emilia-Romagna Region, Italy, addressed twelve key questions regarding managing preschool wheezing. Clinical questions have been formulated by the...