Comparação da prevalência da asma e impacto da doença na qualidade de vida de escolares de dois núcleos urbanos do estado do Rio Grande do Sul

Abstract

Introduction: Asthma is the most prevalent chronic disease in childhood. It is a heterogenous and complex disease, and is associated with internal and external factors. Individual characteristics and different lifestyles cause different forms of asthma impact and disease control measures make it possible to live with asthma adequately, that is, with quality of life. The elements related to the quality of life of asthmatics include physical, emotional, sociability and learning aspects; however, besides these items, the practice of physical activity and the nutritional condition are also related to the disease and impact or are impacted by it. Knowing the prevalence of asthma, its particularities and possible regional differences are important to create strategies for improvements in clinical care and quality of life of patients. Objective: To compare the prevalence of asthma and the impact of the disease on the quality of life of asthmatic schoolchildren in two urban centers in the state of Rio Grande do Sul. Methods: This is a cross-sectional study. Participants were children and adolescents enrolled in primary education in the cities of Porto Alegre/RS and Caxias do Sul/RS, aged between 8 and 16 years. The study was divided into two phases, the first to determine the prevalence and the second to assess the impact of the disease. To collect data, we used the standard ISAAC (International Study on Asthma and Allergies in Children), economic classification questionnaire, generic and specific KINDL (Kinder Lebensqualität Fragebogen), and physical activity questionnaire. Anthropometric measurements and spirometry tests were also performed. The categorical data were presented by absolute and relative frequencies and analyzed by the chi-square test. The continuous variables were presented by mean and standard deviation and analyzed by the Student t test. Differences were considered significant at p <0.05. Results: In Phase I of the study, 2.500 and 1.975 students participated in Porto Alegre/RS and Caxias do Sul/RS, respectively. The prevalence of asthma was 28,6% in Porto Alegre/RS (POA) and 16.1% in Caxias do Sul/RS (CXS). For the second phase, asthmatic schoolchildren were divided into: POA group (n = 290) and CXS group (n = 266). Females were 51,7% and 51,9%, respectively, in the POA and CXS groups, with a mean age between 10 and 11 years. In the comparison between groups of asthmatics in the cities, the results presented better economic and educational conditions of the parents in the CXS Group (p <0.001). The body mass index was similar between the groups, and the use of the criterion of classification of the waist and height ratio indicated 31,6% of the students of the CXS Group with high health risk (p <0.001). The mean time in front of the screens was 5 hours/day, and in the classification of the physical activity profile, 54,9% of the asthmatic students of the CXS Group were considered sedentary, whereas in the POA Group this percentage was 43,1%. The quality of life indexes of asthmatic schoolchildren were higher in the CXS Group. Conclusion: The increased prevalence of asthma in POA is associated with urbanization and its elements, such as: agglomeration of people, pollution and lower socioeconomic levels. Sedentary lifestyle is associated with poor physical activity at the time spent by the student in front of the screens, although schoolchildren consider their health to be adequate. In addition, quality of life also appears to be related to cultural, social and economic phenomena, which lead to inadequate nutritional conditions, sedentary lifestyle and a strong risk to the health of children and adolescents. New studies need to be conducted to better understand the disease and implement more effective public health programs.