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

dc.contributor.authorMallol, Javier
dc.contributor.authorSole, Dirceu [UNIFESP]
dc.contributor.authorGarcia-Marcos, Luis
dc.contributor.authorRosario, Nelson
dc.contributor.authorAguirre, Viviana
dc.contributor.authorChong, Herberto
dc.contributor.authorUrrutia-Pereira, Marilyn
dc.contributor.authorSzulman, Gabriela
dc.contributor.authorNiederbacher, Jurg
dc.contributor.authorArruda-Chavez, Erika
dc.contributor.authorToledo, Eliana
dc.contributor.authorSanchez, Lillian
dc.contributor.authorPinchak, Catalina
dc.description.abstractPurpose: 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)en
dc.description.abstractof 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.en
dc.description.affiliationUniv Santiago Chile USACH, Hosp El Pino, Dept Pediat Resp Med, Santiago, Chile
dc.description.affiliationFed Univ Sao Paulo UNIFESP, Dept Pediat, Div Allergy Clin Immunol & Rheumatol, Sao Paulo, Brazil
dc.description.affiliationUniv Murcia, Virgen de la Arrixaca Univ Childrens Hosp, Pediat Resp & Allergy Units, Murcia, Spain
dc.description.affiliationFed Univ Parana UFPR, Hosp Clin, Dept Pediat, Curitiba, Parana, Brazil
dc.description.affiliationPediat Asthma Prevent Program PIPA, Uruguaiana, Brazil
dc.description.affiliationHosp Ninos Dr Ricardo Gutierrez, Buenos Aires, DF, Argentina
dc.description.affiliationUniv Ind Santander, Escudo Med, Bucaramanga, Colombia
dc.description.affiliationBritish Amer Hosp, Sect Allergy & Clin Immunol, Lima, Peru
dc.description.affiliationFac Med Sao Jose do Rio Preto, Hosp Base Sao Jose do Rio Preto, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Mato Grosso, Dept Pediat, Cuiaba, Brazil
dc.description.affiliationUniv Republica, Fac Med, Clin Pediat B Hosp Pereira Rossell, Montevideo, Uruguay
dc.description.affiliationUnifespDivision of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
dc.description.sourceWeb of Science
dc.identifier.citationAllergy Asthma & Immunology Research. Jongno-Gu, v. 8, n. 1, p. 22-31, 2016.
dc.publisherKorean Acad Asthma Allergy & Clinical Immunology
dc.relation.ispartofAllergy Asthma & Immunology Research
dc.rightsAcesso aberto
dc.subjectrespiratory soundsen
dc.subjectrecurrent wheezingen
dc.subjectepidemiologyRespiratory-Tract Infectionsen
dc.subjectParacetamol Useen
dc.subjectAntibiotic Useen
dc.subjectBirth Cohorten
dc.titlePrevalence, Severity, and Treatment of Recurrent Wheezing During the First Year of Life: A Cross-Sectional Study of 12,405 Latin American Infantsen