Prevalence, Severity, and Treatment of Recurrent Wheezing During the First Year of Life: A Cross-Sectional Study of 12,405 Latin American Infants

Prevalence, Severity, and Treatment of Recurrent Wheezing During the First Year of Life: A Cross-Sectional Study of 12,405 Latin American Infants

Author Mallol, Javier Google Scholar
Sole, Dirceu Autor UNIFESP Google Scholar
Garcia-Marcos, Luis Google Scholar
Rosario, Nelson Google Scholar
Aguirre, Viviana Google Scholar
Chong, Herberto Google Scholar
Urrutia-Pereira, Marilyn Google Scholar
Szulman, Gabriela Google Scholar
Niederbacher, Jurg Google Scholar
Arruda-Chavez, Erika Google Scholar
Toledo, Eliana Google Scholar
Sanchez, Lillian Google Scholar
Pinchak, Catalina Google Scholar
Abstract Purpose: This study aimed to determine the prevalence and severity of recurrent wheezing (RW) defined as 3 episodes of wheezing, risk factors, and treatments prescribed during the first year of life in Latin American infants. Methods: In this international, cross-sectional, and community-based study, parents of 12,405 infants from 11 centers in 6 South American countries (Argentina, Brazil, Chile, Colombia, Peru, and Uruguay) completed a questionnaire about wheezing and associated risk/protective factors, asthma medications, and the frequency of and indications for the prescription of antibiotics and paracetamol during the first year of life. Results: The prevalence of RW was 16.6% (95% Cl 16.0-17.3)

of the 12,405 infants, 72.7% (95% Cl 70.7-74.6) visited the Emergency Department for wheezing, and 29.7% (27.7-31.7) was admitted. Regarding treatment, 49.1% of RW infants received inhaled corticosteroids, 55.7% oral corticosteroids, 26.3% antileukotrienes, 22.9% antibiotics >= 4 times mainly for common colds, wheezing, and pharyngitis, and 57.5% paracetamol >= 4 times. Tobacco smoking during pregnancy, household income per month <1,000 USD, history of parental asthma, male gender, and nursery school attendance were significant risk factors for higher prevalence and severity of RW, whereas breast-feeding for at least 3 months was a significant protective factor. Pneumonia and admissions for pneumonia were significantly higher in infants with RW as compared to the whole sample (3.5-fold and 3.7-fold, respectively). Conclusions: RW affects 1.6 out of 10 infants during the first year of life, with a high prevalence of severe episodes, frequent visits to the Emergency Department, and frequent admissions for wheezing. Besides the elevated prescription of asthma medications, there is an excessive use of antibiotics and paracetamol in infants with RW and also in the whole sample, which is mainly related to common colds.
Keywords Asthma
respiratory sounds
recurrent wheezing
antibiotics
prevalence
epidemiologyRespiratory-Tract Infections
Paracetamol Use
Antibiotic Use
Birth Cohort
Asthma
Children
Childhood
Risk
Symptoms
Exposure
Language English
Date 2016
Published in Allergy Asthma & Immunology Research. Jongno-Gu, v. 8, n. 1, p. 22-31, 2016.
ISSN 2092-7355 (Sherpa/Romeo, impact factor)
Publisher Korean Acad Asthma Allergy & Clinical Immunology
Extent 22-31
Origin http://dx.doi.org/10.4168/aair.2016.8.1.22
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000367758400004
URI http://repositorio.unifesp.br/handle/11600/46056

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