Caracterização da asma entre populações pediátricas distintas : metrópole industrializada e cidade de porte médio no Sul do Brasil

Abstract

This study aimed the caracherization between distinct pediatric populations, schoolchildren living in an industrialized metropolis (Porto Alegre, capital of Rio Grande do Sul state, Brazil) and a medium-size city in the south of Brazil (Ijuí, located in the northwest of the same state, with less than 100 thousand inhabitants). The research groups and analyzes data from two epidemiological studies on the prevalence and clinical characteristics of asthma in schoolchildren between 8 and 16 years of age, in the cities of Porto Alegre and Ijuí in a simultaneous period (2013-2014). Both schoolchildren groups answered the questionnaires of epidemiological diagnosis of asthma, respiratory symptoms and clinical characteristics of asthma, asthma control test, physical activity, as well as atopy tests and anthropometric measurements. In Porto Alegre / RS, the prevalence of asthma was 20.4%, while in Ijuí / RS it was 19.2%. There was no difference in disease control, in Porto Alegre it was 51.9% and in Ijuí 47.2% (p = 0.378). The children of Ijuí had a higher frequency of rhinitis (87% vs 48.8%, p <0.001), atopy (81.4% vs 63.5%, p = 0.005) and overweight / obesity (47.2% vs 32 , 8%, p = 0.008). The frequency of sedentarism was also the same among the research sites (Porto Alegre 67.2% vs Ijuí 58.5%, p = 0.091). The association of asthma, rhinitis and atopy presented a risk for disease control in schoolchildren in Porto Alegre (OR: 1,599, 95% CI: 1,064 - 2,404). The combination of asthma and rhinitis or atopy is a risk for the control of the disease in Ijuí (OR: 2,300; 95% CI: 1,867 - 2,833). The values referring to having a treatment plan (Porto Alegre 36.9% vs Ijuí 49.2%, p = 0.061), clinical follow-up (Porto Alegre 25.7% vs Ijuí 39.3%, p = 0.026) and continuous use of medication (Porto Alegre 34.5% vs Ijuí 38.3%, p = 0.551) were also low. The highest impact of perceived disease in both populations refers to school absenteeism (Porto Alegre 61.3% vs. Ijuí 64.8%, p = 0, 357). It was concluded that asthma has high prevalence rates in cities in the south of Brazil with different environmental and socioeconomic profiles. Rhinitis and atopy were significantly more frequent among Ijuí asthmatics (although elevated at both sites). Environmental factors such as dust pollution derived from agricultural products may potentially have a significant impact on the high prevalence of atopy and rhinitis in these areas, compared to the more industrialized urban area. These findings suggest that asthma in populations with such distinct environments has unique characteristics and should be taken into account in the definition of strategies for prevention and clinical management.