Regional Variation in Asthma Symptom Prevalence in Latin American Children

Abstract

Objectives. This study investigates the distribution pattern of asthma symptom prevalence in Latin American children aged 13–14 years. Methods. A randomized, cross-sectional and multicentric study on the prevalence and severity of asthma symptoms (lifetime asthma, current wheezing, and frequent sleep disturbance by wheezing) was conducted in 165,917 schoolchildren from 56 centers in 17 Latin American countries, as part of the International Study of Asthma and Allergies in Childhood (ISAAC), Phase Three. Results. The prevalence of lifetime asthma prevalence ranged from 1.2% to 33.1%, whereas current wheezing went from 3.9% to 30.8% and frequent sleep disturbance from 0.6% to 6.1%. An important proportion of centers (55%) reported a prevalence of asthma symptoms over 15%. There was no significant correlation between asthma symptom prevalence and latitude, altitude, or tropical setting. At country level, the prevalence of asthma was not associated with gross national income (GNI), proportion of population under the poverty line, or ancestry. Conclusions. This study suggests that ecological interactions, probably typical for each locality, may be the main determinants for the large variability of asthma prevalence in Latin America. The high prevalence of asthma symptoms found in children living in areas with low socioeconomic development would challenge the protective role against asthma of factors related to low hygiene and poverty; contrarily, in this region they would act as risk factors.

Keywords :

• asthma
• children
• epidemiology
• ISAAC
• prevalence
• Latin
• America

Acknowledgments

We are grateful to the children and parents who participated in ISAAC Phase Three and the coordination and assistance by the school staff is sincerely appreciated.

Latin American ISAAC Phase Three Study Group (Regional Coordinator: Javier Mallol) (*National Coordinator). ARGENTINA: Carlos E. Baena-Cagnani*, Gustavo E. Zabert, Carlos D. Crisci, Maximiliano Gómez, Hugo Neffen; BOLIVIA: Rosario Pinto-Vargas; BRAZIL: Dirceu Solé*, Jackeline Machado-Motta, Ricardo A. Gurgel, Paulo A. Camargos, Wellington G. Borges, Almerinda Silva, Nelson A. Rosário, Leda Solano Costa Leda de Freitas Souza, Cláudia Dutra-Bernhardt, Francisco José Passos-Soares, Mercia Lamenha, Maria do Socorro Cardoso, Antônio Ledo Aves da Cunha, Arnaldo Porto-Neto, Gilberto Bueno Fischer, Victor E. Cassol, Cassia Gonzales, Karyn C. Melo, Cristina A. Jacob, Fabio Kuschnir, Emanuel Sarinho Murilo de Britto, Neusa Wandalsen, Antonio Carlos Pastorino; BOLIVIA: Rosario Pinto, Esther Serrate, Roberto Paz, Pitias Suárez, Oscar Gómez, Janet Aguirre; CHILE: Viviana Aguirre-Camposano*, Luis Vera-Benavides, Amanda Contreras, Lidia Amarales, Pedro Aguilar, Mario A. Calvo, Javier Mallol; COLOMBIA: Alfonso M. Cepeda*, Gustavo Aristizábal, Gustavo A. Ordoñez; COSTA RICA: Manuel Soto-Quiroz; CUBA: Patricia Varona-Peréz; ECUADOR: César Bustos*, Sergio Barba, Rocío de Janón, Mireya Rodas, Alfredo Sierra, José Ulloa; EL SALVADOR: Margarita Figueroa-Colorado; HONDURAS: Agustin Bueso-Engelhardt; MEXICO: Manuel Baeza-Bacab*, Blanca E. Del Río-Navarro, Mercedes Barragán-Meijueiro, Nelly Ramírez-Chanona, Roberto García-Almaraz, Isabelle Romieu, Valente Merida-Palacio, Sandra Nora González-Díaz, Francisco J. Linares-Zapién, Sergio Romero-Tapia; NICARAGUA: José F. Sánchez; PANAMA: Gherson Cukier; PARAGUAY: Jaime A. Guggiari-Chasse; PERU: Pascual Chiarella; URUGUAY: Dolores Holgado*, María Cristina Lapides; VENEZUELA: Oscar Aldrey.