Abstract
OBJECTIVE: To evaluate the prevalence and the clinical characteristics of wheezing in infants aged 12 to 15 months in the city of Cuiabá, Mato Grosso State, Midwest Brazil.METHODS: Parents and/or guardians of infants were interviewed and completed a written standardized questionnaire of the Estudio Internacional de Sibilancia en Lactantes (EISL) - phase 3 at primary healthcare clinics at the same day of children vaccination or at home, from August of 2009 to November of 2010.RESULTS: 1,060 parents and/or guardians completed the questionnaire, and 514 (48.5%) infants were male. Among the studied infants, 294 (27.7%) had at least one episode of wheezing during the first year of life, beggining at 5.8±3.0 months of age, with a predominance of male patients. The prevalence of occasional wheezing (<3 episodes of wheezing) was 15.0% and recurrent wheezing (≥3 episodes) was 12.7%. Among the infants with recurrent wheezing, the use of inhaled β2-agonist, oral corticosteroid, leukotriene receptor antagonist, as well as night symptoms, respiratory distress, and hospitalization due to severe episodes were significantly more frequent. Physician-diagnosed asthma was observed in 28 (9.5%) of the wheezing infants. Among the wheezing infants, 80 (27.7%) were diagnosed with pneumonia, of whom 33 (11.2%) required hospitalization; neverthless, no differences between occasional and recurrent wheezing infants were found.CONCLUSIONS: The prevalence of recurrent wheezing and physician-diagnosed asthma in infants were lower compared with those observed in other Brazilian studies. Recurrent wheezing had early onset and high morbity.
Highlights
Wheezing is one of the most common respiratory symptoms in childhood and can manifest in several respiratory diseases; asthma is the most common
The first data obtained in Brazil with the EISL were from 3,003 infants in the city of Curitiba, PR; it was observed that, in the first 12 months of life, 45.4% had at least one episode and 22.6% had recurrent wheezing episodes, evidencing a high prevalence of wheezing, with early onset and high morbidity.[4]
Considering that wheezing in infants is a very common symptom, whose prevalence varies in different centers, that the causes for such variations are still under investigation, and that Brazil is a country with a large territory with climatic, cultural, and socioeconomic differences, this study aimed to determine the prevalence and clinical characteristics of wheezing in infants living in Cuiabá, MT, using the standardized tool EISL – phase 3
Summary
Wheezing is one of the most common respiratory symptoms in childhood and can manifest in several respiratory diseases; asthma is the most common. It is estimated that approximately 50% to 80% of children with asthma develop symptoms in the first five years of life, but diagnosis is difficult in this age group due to the difficulties in performing pulmonary function tests and the high prevalence of other causes of wheezing.[1]. To assess the impact of recurrent wheezing in infants in the first year of life and determine its prevalence and associated risk factors, the international study Estudio Internacional de Sibilancias en Lactantes (EISL) was developed. This is an international multicenter study comprising Latin America countries, Spain, and the Netherlands.[3]. In São Paulo, the onset of wheezing was early, around five months of life, and the proportion of infants diagnosed and treated as asthmatics was low, which demonstrates the difficulty of attaining physician-diagnosed asthma in this age group.[5]
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