Prevalência de asma pediátrica no Brasil : uma meta-análise com meta-regressão

Abstract

Introduction: asthma is characterized as a chronic disease of high prevalence, mainly in the infant population. During the last decades, it has been observed the importance of conducting studies directed to its prevalence, in order to serve as a subsidy for actions of prevention and control of the disease by the world public health. Objective: To evaluate the prevalence of pediatric asthma in Brazil, according to the criteria of the International Study of Asthma and Allergies in Childhood (ISAAC), through a meta-analysis. Methods: This study is characterized by a systematic review with meta-analysis and meta-regression, based on the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). The researches were applied in the PubMed (Medline), Embase and ScienceDirect (Elsevier), SciELO and LILACs (Bireme) databases, identifying the studies that evaluated the prevalence of pediatric asthma in Brazil. The search for articles was made in March 2017. For the inclusion in the systematic review, the articles should be cross-sectional studies on the prevalence of pediatric asthma (groups: 6-7 years of age, 13-14 years of age or in both age groups) based on the ISAAC protocol. The evaluation of the estimated prevalence of asthma in Brazil was through a meta-regression. Results: almost two decades after the first publication on asthma prevalence in Brazil, following the ISAAC criteria, a total of 945 articles were found, and it was possible to choose 35 original articles for the meta-analysis. From these, a total of 88 evaluations were carried out between the two age groups, amongst regions and cities. The prevalence of asthma in the period from 1994 to 2012 presents a variation from 11 to 32% in the 6-7 years of age group, with a heterogeneity (I2) of 97% (p <0.001), and 12 to 30% in the age group of 13-14 years of age, with a heterogeneity (I2) of 96% (p <0.001), having as an estimate a prevalence of the disease of 20.4% in the general picture of pediatric asthma in Brazil. The meta-regression showed that the prevalence of asthma, even with high heterogeneity, remained stable throughout the two decades for the two age groups studied (p = 0.555 and p = 0.052), as well as in the general picture (p = 0,181). Conclusion: the prevalence of pediatric asthma in Brazil remains elevated since the first studies conducted, with no significant changes in prevalence over the years