Objectives: To assess the prevalence of respiratory disease in schoolaged children and to determine the value of field spirometry.Methods: Data on 313 1st and 4th graders from four public schools in Lisbon were analyzed. A respiratory self-answered questionnaire and standard spirometry were performed. Descriptive and bivariate analysis was followed by multiple logistic regression.Results: Thirty-five percent of the children presented at least one episode of wheezing (18% ≥ 2 episodes), and 4% had asthma. Wheezing was more frequent with family history of atopy (adjusted OR = 2.7; 95%CI 1.4-5.1), maternal smoking during pregnancy, lower respiratory tract infection (LRTI) (adjusted OR = 2.8; 95%CI 1.2-6.2), bronchiolitis (adjusted OR = 3.3; 95%CI 1.3-8.2), and allergy to aeroallergens (adjusted OR = 3.2; 95%CI 1.4-7.2). Asthma was more frequent with previous history of LRTI (adjusted OR = 14.6;) and allergy to aeroallergens (adjusted OR = 8.2; 95%CI 2.0-34.2). Fifty-five percent of spirometry measurements met the acceptability criteria of the American Thoracic Society and of the European Respiratory Society. Wheezers presented mean lower z scores for forced expiratory volume in 1 second (FEV 1 ), ratio between FEV 1 and forced vital capacity (FVC) (FEV 1 /FVC), and forced expiratory flow between 25 and 75% (FEF 25-75 ) (p < 0.05), as well as higher percentage of abnormal FEV 1 , FEV 1 /FVC and FEF , p < 0.05).
Conclusions:This pilot study showed a high prevalence of obstructive airway symptoms in school-aged children in Lisbon. Symptoms assessed by the questionnaire showed good correlation with spirometric values. The small prevalence of asthma leads us to speculate that asthma is under-diagnosed in this population.J Pediatr (Rio J). 2011;87(2):123-130: Questionnaire, wheezing, asthma, portable spirometry.
ResumoObjetivos: Avaliar a prevalência de doença respiratória em crianças em idade escolar e determinar o valor da espirometria de campo.
Métodos:Avaliaram-se 313 alunos do primeiro e quarto ano de quatro escolas de Lisboa. Aplicou-se questionário respiratório autopreenchido, e efetuou-se espirometria. Realizou-se análise descritiva e bivariada seguida de análise de regressão logística múltipla.Resultados: Trinta e cinco por cento das crianças tiveram pelo menos um episódio de sibilância (18% ≥ 2 episódios), e 4% tiveram diagnóstico de asma. Sibilância foi mais frequente com história familiar de atopia (OR ajustado = 2,7, IC95% 1,4-5,1), tabagismo na gravidez, infecção respiratória baixa (IRB) (OR ajustado = 2,8; IC95% 1,2-6,2), bronquiolite (OR ajustado = 3,3; IC95% 1,3-8,2) e alergia a aeroalér-genos (OR ajustado = 3,2; IC95% 1,4-7,2). Asma foi mais frequente com história de IRB (OR ajustado = 14,6; IC95% 1,7-122,9) e alergia a aeroalérgenos (OR ajustado = 8,2; IC95% 2,0-34,2). Cento e sessenta e nove (54%) valores espirométricos preencheram critérios de aceitabilidade. O grupo com sibilância tinha em média valores de escore z inferiores para volume expiratório forçado no primeiro segundo (VEF 1 ), r...