SciELO - Scientific Electronic Library Online

 
vol.14 issue6HLA class I and II and TNF-á gene polymorphisms in sarcoidosis patientsCorrelation between mild hypoxaemia and limb skeletal muscle function in chronic obstructive pulmonary disease - Pilot study author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • Have no similar articlesSimilars in SciELO

Share


Revista Portuguesa de Pneumologia

Print version ISSN 0873-2159

Rev Port Pneumol vol.14 no.6 Lisboa Dec. 2008

 

Prevalência da asma e da rinite em adolescentes de 13 anos do Porto, Portugal

 

Helena Falcão1

Elisabete Ramos2

Agostinho Marques3

Henrique Barros4

 

 

Resumo

Introdução: As prevalências da asma e rinite têm aumentado nas últimas décadas, mas nos últimos anos tem sido referida a sua estabilização ou mesmo diminuição.

Objectivo: O objectivo foi o de descrever a prevalência de rinite, asma ou sintomas do tipo da asma em adolescentes urbanos de 13 anos.

Métodos: Os participantes elegíveis foram todos os alunos das escolas públicas e privadas do Porto, nascidos em 1990; 2161 (77,5%) concordaram em participar. Através de questionários autoaplicados, a informação recolhida contemplou aspectos sociais, demográficos, comportamentais, história clínica de asma e doenças alérgicas do adolescente e família. Foi usada a versão portuguesa do International Study of Asthma and Allergies in Childhood’s (ISAAC) e foram efectuadas espirometrias.

Resultados: Nesta amostra de adolescentes urbanos de 13 anos, a prevalência da asma durante a vida foi de 12,9%, 84,4% com diagnóstico médico. A pieira durante a vida foi 18,3% e no último ano de 9,3%. A rinite foi relatada por 10,1%, mas a prevalência durante a vida de adolescentes com espirros, rinorreia serosa ou obstrução nasal, foi de 32,0%, e no último ano de 27,4%.

Conclusão: Verificou-se uma estabilização ou mesmo diminuição da prevalência dos sintomas e diagnóstico de asma e rinite nos adolescentes do Porto, quando comparada com os resultados do ISAAC em 2002, tal como noutras investigações na Europa. A asma e a rinite estão frequentemente presentes no mesmo doente e a tosse nocturna é um importante sintoma que surge associado aos sintomas nasais. A função pulmonar permitiu discriminar os adolescentes com queixas respiratórias.

Palavras-chave: Adolescentes, asma, rinite, estudos transversais, prevalência, tendência.

 

 

Prevalence of asthma and rhinitis in 13 year old adolescents in Porto, Portugal

Abstract

Background: The prevalence of asthma and rhinitis has been increasing over the past few decades, but the last few years have seen these rates stabilise or even decrease. Aim: The aim of our study was to describe the prevalence of rhinitis, asthma or asthma-like symptoms in 13 year-old urban adolescents.

Methods: Eligible participants were all students at state and private schools in Porto born in 1990. 2161 (77.5%) agreed to participate. Information was obtained using self-administered questionnaires inquiring into social, demographic, behavioural and clinical history including asthma and allergic diseases in the adolescent and the family. We used the Portuguese version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and we also performed spirometry tests.

Results: In this sample of 13 year old urban adolescents the prevalence of asthma ever was 12.9%, 84.4% with physician diagnosis. Lifetime wheezing was reported by 18.3% and current wheezing by 9.3% of the adolescents. Rhinitis was referred to by 10.1%, but the prevalence of adolescents with sneezing ever, or a runny/blocked nose, was 32.0% and the prevalence in the last 12 months was 27.4%.

Conclusion: We concluded that there was stabilisation or even decrease in the prevalence of asthma and rhinitis symptoms and diagnosis in adolescents reported in Porto, compared with the 2002 ISAAC study, as observed in other surveys in Europe. Asthma and rhinitis is frequently present in the same patient and nocturnal cough is an important symptom concomitant with nasal symptoms. Measures of lung function permitted the discrimination of adolescents with respiratory complaints.

Key-words: Adolescents, asthma, rhinitis, cross-sectional studies, prevalence, trends.

 

 

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

 

 

Bibliografia / Bibliography

1. Heinrich J, Hoelscher B, Frye C, Meyer I, Wjst M, Wichmann HE. Trends in prevalence of atopic diseases and allergic sensitization in children in Eastern Germany. Eur Respir J 2002; 19: 1040 -6.        [ Links ]

2. Maziak W, Behrens T, Brasky T, Duhme H, Rzehak P, Weiland S, Keil U. Are asthma and allergies in children and adolescents increasing? Results from ISAAC phase I and phase III surveys in Münster, Germany. Allergy 2003; 58: 572 -9.

3. Latvala J, von Hertzen L, Lindholm H, Haahtela T. Trends in prevalence of asthma and allergy in Finnish young men: nationwide study. BMJ 2005; 330:1186-7.

4. Campanella SG, Asher MI. Current controversies: sinus disease and the lower airways. Pediatr Pulmonol 2001; 31(2):165 -72.

5. Bugiani M, Carosso A, Migliore E, Piccioni P, Corsico A, Olivieri M, Ferrari M, Pirina P, de Marco R on behalf of ISAYA (ECRHS Italy) Study Group. Allergic rhinitis and asthma comorbidity in a survey of young adults in Italy. Allergy 2005; 60: 165 -70.

6. Bousquet J, van Cauwenberge P, Khaltaev N. World Health Organization. Allergic rhinitis and its impact on asthma. In collaboration with the World Health Organization. Executive summary of the workshop report. Allergy 2002; 57:841 -55.

7. Rusconi F, Galassi C, Corbo G, Forastiere F, Biggeri A, Ciccone G, Renzoni E and the SIDRIA Collaborative Group. Risk factors for early, persistent, and late-onset wheezing in young children. Am J Respir Crit Care Med 1999; 160: 1617 -22.

8. Spector S. Overview of comorbid associations of allergic rhinitis. J Allergy Clin Immunol 1997; 99: S773 -80.

9. Corren J. Allergic rhinitis and asthma: how important is the link? J Allergy Clin Immunol 1997; 99(2):S781 -6.

10. Hublet A, Andersen A, Godeau E, Vereecken C, Valimaa R, Tynjala J, Boyce W, Maes L. Asthma and wheezing symptoms in young people in six Western countries. Rev Epidemiol Sante Publique 2006; 54(4):305 -12.

11. Caussade L, Valdivia C, Navarro M, Perez B, Aquevedo S, Sanchez D. Risk factors and prevalence of allergic rhinitis among Chilean children. Rev Med Chil 2006; 134(4): 456 -64.

12. Johnson C, Ownby D, Zoratti E, Alford S, Williams K, Joseph C. Environmental epidemiology of pediatric asthma and allergy. Epidemiol Rev 2002; 24(2):154 -75.

13. Wiesch D, Meyers D, Bleeker E. Genetics of asthma. J Allergy Clin Immunol 1999; 104: 895 -901.

14. Foliaki S, Annesi -Maesano I, Daniel R, Fakakovikaetau T, Magatongia M, Tuuau -Potoi N, Waqatakirewa L, Cheng S, Pearce N. Prevalence of symptoms of childhood asthma, allergic rhinoconjunctivitis and eczema in the Pacific: The International Study of Asthma and Allergies in Childhood (ISAAC). Allergy 2007; 62(3):259 -64.

15. Mercer M, Joubert G, Ehrlich R, Nelson H, Poyser M, Puterman A, Weinberg E. Socioeconomic status and prevalence of allergic rhinitis and atopic eczema symptoms in young adolescents. Pediatr Allergy Immunol 2004; 15: 234 -41.

16. Asher M, Keil U, Anderson H, Beasley R, Crane J, Martinez F, Mitchell E, Pearce N, Sibbald B, Stewart A, Strachan D, Weiland S, Williams H. International study of asthma and allergies in childhood (ISAAC): rationale and methods. Eur Respir J 1995; 8, 483 -91.

17. American Thoracic Society. Standardization of spirometry: 1994 update. Am J Respir Crit Care Med 1995; 152:1107 -36.

18. Masoli M, Fabian D, Holt S, Beasley R for the Global Initiative for asthma (GINA). Program The global burden of asthma: executive summary of the GINA Dissemination Committee Report. Allergy 2004; 59: 469 -78.

19. Verlato G, Corsico A, Villani S, Cerveri I, Migliore E, Accordini S, Carolei A, Piccioni P, Bugiani M, Lo Cascio V, Marinoni A, Poli A, de Marco R. Is the prevalence of adult asthma and allergic rhinitis still increasing? Results of an Italian study. J Allergy Clin Immunol 2003; 111:1232 -8.

20. Woods R, Walters E, Wharton C, Watson N, Abramson M. The rising prevalence of asthma in young Melbourne adults is associated with improvement in treatment. Ann Allergy Asthma Immunol 2001; 87:117 -23.

21. Wang X, Tan T, Shek L, Chng S, Hia N, Ma S, Lee B, Goh D. The prevalence of asthma and allergies in Singapore; data from two ISAAC surveys seven years apart. Arch Dis Child 2004; 89:423 -6.

22. Anderson H, Ruggles R, Strachan D, Austin J, Burr M, Jeffs D, Stranding P, Steriu A, Goulding R. Trends in prevalence of symptoms of asthma, hay fever, and eczema in 12 -14 year olds in the British Isles, 1995 -2002: questionnaire survey. BMJ 2004; 328:1052 - 3.

23. Ronchetti R, Villa M, Barreto M, Rota R, Pagani J, Martella S, Falasca C, Paggi B, Guglielmi F, Ciofetta G. Is the increase in childhood asthma coming to an end? Findings from three surveys of schoolchildren in Rome, Italy. Eur Respir J 2001; 17:881 -6.

24. Toelle B, Ng K, Belusova E, Salome M, Peat K, Marks B. Prevalence of asthma and allergy in schoolchildren in Belmont, Australia: three cross -sectional surveys over 20 years. BMJ 2004; 328:386 -7.

25. Braun -Fahrlander C, Gassner M, Grize L, Takken-Sahli K, Neu U, Stricker T, Varonier H, Wuthrich B, Sennhauser F; Swiss Study on Childhood Allergy and Respiratory symptoms; Air Pollution (SCARPOL) team. No further increase in asthma, hay fever and atopic sensitisation in adolescents living in Switzerland. Eur Respir J 2004; 23:407 -13.

26. Lee L, Wong W, Lau L. Increasing prevalence of allergic rhinitis but not asthma among children in Hong Kong from 1995 to 2001 (Phase 3 International Study of Asthma and Allergies in Childhood). Pediatr Allergy Immunol 2004; 15:72 -8.

27. García -Marcos L, A. Blanco Quirós, G. Garcia Hernández, F. Guillan -Grima, C. Gonzalez Díaz, UreòaI, Pena A, Monge R, Suárez -Varela M, Varela A, Cabanillas P, Garrido J. Stabilization of asthma prevalence among adolescents and increase among schoolchildren (ISAAC phases I and III) in Spain. Allergy 2004; 59: 1301 -7.

28. Flemming M, Sunderland R, Cross W, Ross M. Declining incidence of episodes of asthma: a study of trends in new episodes presenting to general practitioners in the period 1989 -98. Thorax 2000; 55:657 -61.

29. Senthilselvan A, Lawson J, Rennie C, Dosman A. Stabilization of an increasing trend in physician-diagnosed asthma prevalence in Saskatchewan, 1991 to 1998. Chest 2003; 124:438 -48.

30. Hedman L, Lindgren B, Perzanowski M, Ronmark E. Agreement between parental and self –completed questionnaires about asthma in teenagers. Pediatr Allergy Immunol 2005; 16: 176 -81.

31. von Hertzen L, Haahtela T. Signs of reversing trends in prevalence of asthma. Allergy 2005;60:283 -92.

32. Nystad W, Magnus P, Gulsvik A, Skarpaas I, Carlsen K. Changing prevalence of asthma in school children: evidence for diagnostic changes in asthma in two surveys 13 yrs apart. Eur Respir J 1997; 10:1046 -51.

33. Barraclough R, Devereux G, Hendrick D, Stenton S. Apparent but not real increase in asthma prevalence during the 1990s. Eur Respir J 2002; 20: 826 -33.

34. Magnus P, Jaakkola J. Secular trend in the occurrence of asthma among children and young adults: critical

appraisal of repeated cross sectional surveys. BMJ 1997; 314: 1795 -99.

35. Kwong G, Proctor A, Billings C, Duggan R, Das C, Whyte K, Powell V, Primhak R. Increasing prevalence of asthma diagnosis and symptoms in children is confined to mild symptoms. Thorax 2001;56: 312 -4.

36. Haahtela T, Klaukka T, Koskela K, Erhola M, Laitinen L. Asthma programme in Finland: a community problem needs community solutions. Thorax 2001; 56:806 -14.

37. Upton M, McConnachie A, Mc Sharry C, Hart C, Smith G, Gillis C, Watt G. Intergenerational 20 year trend in the prevalence of asthma and hay fever in adults: the Midspan family study surveys of parents and offspring. BMJ 2000; 321:88 -92.

38. Reijula K, Haahtela T, Klaukka T, Rantanen J. Incidence of occupational asthma and persistent asthma in young adults has increased in Finland. Chest 1996; 110:58 -61.

39. Strachan D, Harkins L, Johnston I, Anderson H. Childhood antecedents of allergic sensitization in young British adults. J Allergy Clin Immunol 1997; 99(1 Pt 1): 6 -12.

40. Gdalevich M, Mimouni D, Mimouni M. Breast-feeding and the risk of bronchial asthma in childhood: a systematic review with meta -analysis of prospective studies. J Pediatr 2001; 139(2): 261 -6.

41. von Mutius E. Environmental factors influencing the development and progression of pediatric asthma. J Allergy Clin Immunol 2002; 109(suppl 6): S525 -32.

42. Lanner E, Wickman M, Pershagen G, Nordvall L. Maternal smoking during pregnancy increases the risk of recurrent wheezing during the first years of life (BAMSE). Respir Res 2006; 7(1): 3.

43. Benn C, Wohlfahrt J, Aaby P, Westergaard T, Benfeldt E, Michaelsen K, Björkstén B, Melbye M. Breastfeeding and Risk of Atopic Dermatitis, by Parental History of Allergy, during the First 18 Months of Life. Am J Epidemiol 2004; 160:217 -23.

44. Sarafino E. Connections among parent and child atopic illnesses. Pediatr Allergy Immunol 2000: 11: 80 -6.

45. Strachan D, Butland B, Anderson H. Incidence and prognosis of asthma and wheezing illness from early childhood to age 33 in a national British cohort. BMJ 1996; 312: 1195 -9.

46. Anderson H, Pottier A, Strachan D. Asthma from birth to age 23: incidence and relation to prior and concurrent atopic disease. Thorax 1992; 47: 537 -42.

47. Nicolai T, Pereszlenyiova -Bliznakova L, Illi S, Reinhardt D, von Mutius E. Longitudinal follow up of the changing gender ratio in asthma from childhood to adulthood: role of delayed manifestation in girls. Pediatr Allergy Immunol 2003; 14: 280 -3.

48. Borrego L, César M, Leiria -Pinto P, Rosado -Pinto J. Prevalence of asthma in a Portuguese countryside town: repercussions in absenteeism and self -concept. Allergol et Immunopathol 2005; 33(2): 92 -9.

49. Nunes C, Ladeira S, Rosado -Pinto J. Definição, Epidemiologia e Classificação da asma na criança. In: Rosado Pinto J, Morais Almeida (Eds.). A criança asmática no mundo da alergia. Lisboa; Euromédice: 2003: 35 -55.

50. Leynaert B, Neukirch F, Demoly P, Bousquet J. Epidemiologic evidence for asthma and rhinitis comorbidity. J Allergy Clin Immunol 2000; 106 (Suppl.5): 201 -5.

51. Vignola A, Bousquet J. Rhinitis and asthma: a continuum of disease? Clin Exp Allergy 2001; 31:674 -7. 52. Grossman J. One airway, one disease. Chest 1997; 111(Suppl. 2):11S -16S.

53. Simons F. Allergic rhinobronchitis: the asthma-allergic rhinitis link. J Allergy Clin Immunol 1999; 104(3 Pt 1):534 -40.

54. Mortimer S, Fallot A, Balmes J, Tager I. Evaluating the use of a Portable Spirometer in a Study of Pediatric Asthma. CHEST 2003; 123:1899–907.

 

 

1 Investigadora, Serviço de Higiene e Epidemiologia, Faculdade de Medicina da Universidade do Porto / Researcher, Hygiene and Epidemiology Unit, School of Medicine, University of Porto.

2 Professora, Serviço de Higiene e Epidemiologia, Faculdade de Medicina da Universidade do Porto / Professor, Hygiene and Epidemiology Unit, School of Medicine, University of Porto.

3 Professor Catedrático, Serviço de Pneumologia, Faculdade de Medicina da Universidade do Porto / Cathedratic Professor, Pulmonology Unit, , School of Medicine, University of Porto.

4 Professor Catedrático e Director do Serviço de Higiene e Epidemiologia, Faculdade de Medicina da Universidade do Porto / Cathedratic Professor and Head, Hygiene and Epidemiology Unit, School of Medicine, University of Porto.