Written questionnaires (WQ) have been widely used in epidemiologic studies. In order to yield comparable results, they must be validated after translation to another language. The International Study of Asthma and Allergies in Childhood (ISAAC) WQ has been previously validated by a comprehensive study, but its validation in Brazil has not been performed. Our objectives were to validate the rhinitis component of the ISAAC's self-applicable WQ following its translation to Portuguese, and to determine the prevalence of rhinitis and related symptoms among Brazilian children living in the city of São Paulo. A group of 10 pediatricians and 10 pediatric allergists graded the questions from 0 to 2 and established a maximum score for each question. The WQ was answered by parents or guardians of children 6-7 years of age with rhinitis (R) (n = 27) and of control children of the same age without rhinitis (C) (n = 27). The WQ was also completed by adolescents 13-14 years of age with rhinitis (R) (n = 32) and without rhinitis (C) (n = 32). Half of these individuals answered the same WQ after 2-4 weeks, to ensure reproducibility. Cut-off scores of 4 and 3 were identified for the 6-7- and 13-14-year-old groups, respectively, as scores predictive of rhinitis. The prevalence of rhinitis was 28.8% in the group of 3005 children 6-7 years of age and 31.7% in the group of 3008 children 13-14 years of age, respectively. Using the global cut-off score, these prevalences were even higher, in the order of 34.7% and 40.7%, respectively. In conclusion, the rhinitis component of the ISAAC WQ was proven to be reproducible, adequate and able to discriminate children and adolescents with and without rhinitis, and revealed that the prevalence of rhinitis among Brazilian children living in the city of São Paulo was as high as the prevalence of rhinitis in other areas of the world.
We studied the prevalence of asthma and related symptoms using a standard written questionnaire designed for the International Study of Asthma and Allergies in Children (ISAAC). The written questionnaire (questions 1-8 related to asthma) was applied to 3005 children aged 6-7 years and to 3008 children aged 13-14 years. The parents of the 6-7-year-old children answered the questionnaire, whereas the 13-14-year-old children answered the questionnaire themselves. Response rates were 72% in the 6-7-year-old group and 94% in the 13-14-year-old group. There was a slight predominance of females in the population studied (male:female ratio 0.94). In the group of the 6-7-year-old children, the prevalence of diagnosed asthma was 7.3% for boys and 4.9% for girls, and in the group of the 13-14-year-old children, the prevalence was 9.8% and 10.2% for boys and girls, respectively. Asthma severity was similar for both age groups, and wheezing following exercise was more frequent among the adolescents. In keeping with studies in other parts of the world, comparison between reported symptoms and diagnosed asthma revealed significantly lower frequency of diagnosed asthma, suggesting that in the population we have studied, asthma is underdiagnosed. Using a global cut-off score to define asthma, we found a significantly higher prevalence of asthma among 6-7-year-old boys, as compared to girls (23.8% vs. 20.4%), and no significant differences among adolescent boys and girls (22.5% and 21.9%, respectively).
By using the standard written questionnaire (WQ), designed for the International Study of Asthma and Allergies in Childhood (ISAAC) we determined the prevalence of rhinitis and its related-symptoms, in Brazilian children and adolescents, living in different cities of the country. The WQ was answered by the parents of 11,403 children aged 6-7 years from five Brazilian cities: Porto Alegre (South, N = 2,846), São Paulo (Southeast, N = 3,005) Uberlândia (Southeast, N = 2,991), Itabira (Southeast, N = 1,151) and Recife (Northeast, N = 1,410). The WQ was also applied to 20,587 adolescents (13-14 years old) living in: Porto Alegre (South, N = 3,195), Curitiba (South, N = 3,004), São Paulo (Southeast, N = 3,008), Uberlândia (Southeast, N = 2,998), Itabira (Southeast, N = 2,134), Salvador (Northeast, N = 3,162) and Recife (Northeast, N = 3,086). The mean response rates were 75% and 95%, for the 6-7 year-old children and for the adolescents, respectively. The data was transcribed to a database (Epi-Info) and analyzed regarding the answers to questions of rhinitis module. The mean prevalence of rhinitis (affirmative response to question 2) was 26.6% and 34.2% in the groups of 6-7 and 13-14 year-old, respectively. Applying the criteria that evaluate the association between nasal and ocular symptoms (affirmative response to question 3) the mean prevalence of allergic rhinitis were 12.8% for the 6-7 year-old children and 18.0% for the adolescents. In conclusion, the prevalence of rhinitis and its related symptoms among children and adolescents living in different Brazilian cities was as high as the prevalence observed in other areas of the world.
A existência de tuberculose na infância é um bom indicador da extensão da doença bacilífera e daineficiência do controle do agravo na população adulta. Objetivo: descrever o perfil clínico eepidemiológico de crianças e adolescentes que evoluíram clinicamente com tuberculose. Método:Realizou-se um estudo retrospectivo de levantamento de dados de prontuários envolvendo todos ospacientes com o diagnóstico de tuberculose, assistidos na unidade de internação e ambulatório depneumologia de um Hospital Infantil da Secretaria Estadual da Saúde de São Paulo, SP, Brasil, noperíodo de 31/07/2005 a 31/07/2010. Resultados: Foram diagnosticados 45 casos de tuberculose,a maioria na faixa etária de menores de 4 anos de idade e adolescentes, todos vacinados com BCGID. A forma clínica mais comum foi a pulmonar seguida da pleural e meníngea. Dos casos atendidos,98% procuraram o hospital espontaneamente para investigação diagnóstica. Tosse e febre foram ossintomas mais relatados. Dos casos levantados, 18 (40%) possuíam contatos intradomiciliares comadultos portadores de tuberculose pulmonar. As características radiológicas mais encontradas forama opacidade e o derrame pleural. Dos casos investigados 32,5% apresentaram positividade paraidentificação de micobactéria. A maioria dos pacientes era fortes reatores à prova tuberculínica. Atuberculose na infância é um aspecto negligenciado, na maioria das vezes, na avaliação decomunicantes de um adulto com tuberculose pulmonar bacilífera. Frequentemente as crianças sãoassistidas quando apresentam sintomas da doença já instalada. O controle de comunicantes é umaforma precoce e eficiente de diagnosticar e tratar crianças com tuberculose, reduzindo o sofrimentoe diminuindo a chance de aparecimento de formas graves da doença.
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