Evolución de las sibilancias en los diez primeros años de vida

Abstract

Abstract: Asthma is a chronic disease that affects about 334 million people of all ages worldwide. It represents a substantial burden that often provokes a decrease in quality of life. The EISL study (Estudio Internacional de Sibilancias en Lactantes) proved the hypothesis of different prevalence and severity of childhood asthma through countries and showed modifiable risk factors that could have a substantial impact on the decrease in the prevalence of the disease worldwide. The current survey is nothing but the updating and assessment of the population of children from Cartagena presented in that study today, when they are ten years old. Aims: 1) Determine the evolution of the prevalence of wheezing in the first ten years of life. 2) To determine the factors that may affect wheezing and continuity over time and assess the influence of factors already identified in other age ranges. 3) Obtain reference measurements to evoke future trends in treatment, prevalence and severity of this disease. Material and methods: The methodology followed the line of EISL study and therefore the one employed by ISAAC (The International Study of Asthma and Allergies in Childhood). The main instrument was a telephone questionnaire of wheezing in which epidemiological, therapeutic and ecological aspects are incorporated, adapted and focused on the twelve months preceding the survey. The study population was 867 children, behaving a total of 544 surveys, with a final study population of 478 children, after the application of cleaning criteria to the sample. To achieve the objectives of this study a descriptive analysis of the data was obtained in order to determine the evolution of the prevalence of wheezing in the first ten years of life. To determine the factors that may affect wheezing and assess the influence of factors already identified in other age ranges a case-control cross-sectional study was conducted. The variable "wheeze I-III" was created and an univariate and multivariate analisis were performed. Therefore it is a cross-sectional survey searching for statistically significant association between risk factors and protective factors already demonstrated in this population after ten years. Another variable called "Mediterranean diet" was used to analyze its potential influence as a protective factor of wheezing in the studied population. Results and conclusions: The prevalence of wheezing in the first ten years of life has been decreasing in the Cartagena's population studied, from 38.5% in the first 12 months of life to 13.2% at 9 years. Five variables, four risk factors and one protective factor, showed significant association in the univariate analysis: have at least one cold during the first three months of life, mother smoked during pregnancy, family history of asthma, presence of infant eczema in the first twelve months and the Mediterranean diet (protective factor). The knowledge of the factors affecting wheezing can help in the develop of early intervention strategies using predictive models for the risk of childhood asthma that could alter the course of disease, developing measures of primary and secondary prevention guided to the particular individual.