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Vol. 41. Issue 12.
Pages 659-666 (December 2005)
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Vol. 41. Issue 12.
Pages 659-666 (December 2005)
Original Articles
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Geographic Variation in the Prevalence of Asthma Symptoms in Spanish Children and Adolescents. International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3, Spain
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I. Carvajal-Urueñaa,
Corresponding author
ignacio.carvajal@sespa.princast.es

Correspondence: Dr. I. Carvajal-Urueña. Centro de Salud de Las Vegas. Rubén Darío, s/n. 33404 Las Vegas. Corvera de Asturias. Asturias. España
, L. García-Marcosb, R. Busquets-Mongec, M. Morales Suárez-Varelad, N. García de Andoine, J. Batlles-Garridof, A. Blanco-Quirósg, A. López-Silvarreyh, G. García-Hernándezi, F. Guillén-Grimaj, C. González-Díazk, J. Bellido-Blascol
a Centro de Salud de Las Vegas, Área Sanitaria III, Avilés, Servicio de Salud del Principado de Asturias, Asturias, Spain
b Unidad de Investigación de Cartagena y Departamento de Pediatría, Universidad de Murcia, Murcia, Spain
c Unidad de Neumología, Hospital del Mar, Barcelona, Spain
d Unidad de Salud Pública, Departamento de Medicina Preventiva, Universidad de Valencia, Valencia, Spain
e Departamento de Pediatría, Hospital Donostia, San Sebastián, Guipúzcoa, Spain
f Departamento de Pediatría, Hospital Torrecárdenas, Almería, Spain
g Departamento de Pediatría, Universidad de Valladolid, Valladolid, Spain
h Fundación María José Jove, A Coruña, Spain
i Unidad de Neumoalergia Pediátrica, Hospital Infantil 12 de Octubre, Madrid, Spain
j Departamento de Ciencias de la Salud, Universidad Pública de Navarra, Pamplona, Navarra, Spain
k Departamento de Pediatría, Hospital de Basurto, Bilbao, Vizcaya, Spain
l Sección de Epidemiología, Centro de Salud Pública, Conselleria de Sanitat, Castellón, Spain
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Objective

TO analyze geographic variations in the prevalence of symptoms related to asthma in Spanish children and adolescents.

Population and methods

In 2001 and 2002, the Spanish arm of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3 collected information on 28 445 children in the age bracket of 6-7 years in 10 metropolitan areas (A Coruña, Asturias, Barcelona, Bilbao, Cartagena, Castellón, Madrid, Pamplona, San Sebastián, and Valencia) and on 31 257 adolescents in the bracket 13-14 years in 11 areas (the previously named areas plus Valladolid). An asthma symptom questionnaire was filled in by parents or the adolescents themselves. Differences in symptoms between geographic areas were analyzed by fitting a logistic regression model. The relationship between symptoms and age was analyzed by linear correlation.

Results

The prevalence of recent wheezing (last 12 months) ranged from 7.1% to 12.9% among 6-7-year-olds and from 7.1% to 15.3% among the 13-14-year-olds. The greatest risk of recent wheezing was observed for children in A Coruña (odds ratio [OR] =1.96 in comparison with the area of lowest prevalence; 95% confidence interval [CI], 1.65-2.33) and Bilbao (OR=1.83; 95% CI, 1.54-2.18) and for adolescents in A Coruña (OR=2.38; 95% CI, 2.04-2.79) and Asturias (OR=2.37; 95% CI, 2.03-2.77). A strong correlation (r=0.72) was observed between the prevalence of recent wheezing and age in each of the geographic areas.

Conclusions

Considerable geographic variation in the prevalence of asthma symptoms can be seen in Spain even among young children. Symptoms are more frequent in children and adolescents who live on the Spain's northern Atlantic coast.

Key Words:
Asthma
Prevalence
ISAAC
Child Adolescent
Objetivo

Analizar las variaciones geográficas en la prevalencia de síntomas relacionados con el asma en niños y adolescentes españoles.

Población y métodos

Durante los años 2001 y 2002, el International Study of Asthma and Allergies in Childhood (ISAAC) fase III estudió a 28.445 niños de 6-7 años de 10 áreas (A Coruña, Asturias, Barcelona, Bilbao, Cartagena, Castellón, Madrid, Pamplona, San Sebastián y Valencia) y 31.257 adolescentes de 13-14 años de 11 áreas (las anteriores más Valladolid) españolas. Los síntomas de asma se recogieron en un cuestionario escrito completado por los padres de los niños o por los propios adolescentes. Las variaciones geográficas de las prevalencias de los síntomas se analizaron con un modelo de regresión logística y su correspondencia por edad mediante correlación lineal.

Resultados

La prevalencia de sibilancias recientes (últimos 12 meses) varió entre el 7,1 y el 12,9% a los 6-7 años, y entre el 7,1 y el 15,3% a los 13-14 años. El riesgo más elevado (odds ratio [OR] respecto al área de menor prevalencia) de presentar sibilancias recientes correspondió a los niños de A Coruña (OR = 1,96; interva-lo de confianza [IC] del 95%, 1,65-2,33) y Bilbao (OR = 1,83; IC del 95%, 1,54-2,18) y los adolescentes de A Coruña (OR = 2,38; IC del 95%, 2,04-2,79) y Asturias (OR = 2,37; IC del 95%, 2,03-2,77). Se comprobó una fuerte correlación por edad en las prevalencias de sibilancias recientes de cada área geográfica (r = 0,72).

Conclusiones

En España existen, desde edades tempranas, variaciones geográficas notables en la prevalencia de síntomas de asma. Éstos son más frecuentes en los niños y adolescentes que habitan en la fachada atlá ntica del país.

Palabras clave:
Asma
Prevalencia
ISAAC
Niño
Adolescente
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REFERENCES
[1]
M Masoly, D Fabian, S Holt, R Beasley.
Global Burden of Asthma Report [Internet Monograph]. Global Initiative for Asthma (GINA), 2004 [consulted 04/07/2004].
[2]
The International Study of Asthma and Allergies in Childhood Steering Committee.
Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC.
Lancet, 351 (1998), pp. 1225-1232
[3]
MI Asher, U Keil, HR Anderson, R Beasley, J Crane, F Martínez, et al.
The International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods.
Eur Respir J, 8 (1995), pp. 483-491
[4]
The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee.
Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood.
Eur Respir J, 12 (1998), pp. 315-335
[5]
R Beasley, P Ellwood, I Asher.
International patterns of the prevalence of pediatric asthma. The ISAAC program.
Pediatr Clin N Am, 50 (2003), pp. 539-553
[6]
I Aguinaga Ontoso, A Arnedo-Pena, J Bellido, F Guillén Grima, MM Suárez Varela, por el Grupo Español del Estudio ISAAC.
Prevalencia de síntomas relacionados con el asma en niños de 13-14 años de 9 poblaciones españolas. Estudio ISAAC (International Study of Asthma and Allergies in Childhood).
Med Clin (Barc), 112 (1999), pp. 171-175
[7]
L García-Marcos, A Blanco Quirós, G García Hernández, F Guillén Grima, C González Díaz, I Carvajal Urueña, et al.
Stabilization of asthma prevalence among adolescents and increase among schoolchildren (ISAAC phases I and III) in Spain.
[8]
N Pearce, S Weiland, U Keil, P Langridge, HR Anderson, D Strachan, et al.
Self-reported prevalence of asthma symptoms in children in Australia, England, Germany and New Zealand: an international comparison using the ISAAC protocol.
Eur Respir J, 6 (1993), pp. 1455-1461
[9]
PG Burney, S Chinn, JR Britton, AE Tattersfield, AO Papacosta.
What symptoms predict the bronchial response to histamine? Evaluation in a community survey of the bronchial symptoms questionnaire (1984) of the International Union Against Tuberculosis and Lung Disease.
Int J Epidemiol, 18 (1989), pp. 165-173
[10]
CK Lai, JK Chan, A Chan, G Wong, A Ho, D Choy, et al.
Comparison of the ISAAC video questionnaire (AVQ3.0) with the ISAAC written questionnaire for estimating asthma associated with bronchial hyperreactivity.
Clin Exp Allergy, 27 (1997), pp. 540-545
[11]
CE Kuehni, AM Brooke, M Silverman.
Prevalence of wheeze during childhood: retrospective and prospective assessment.
Eur Respir J, 16 (2000), pp. 81-85
[12]
MA Jenkins, JR Clarke, JB Carlin, CF Robertson, JL Hopper, MF Dalton, et al.
Validation of questionnaire and bronchial hyperresponsiveness against respiratory physician assessment in the diagnosis of asthma.
Int J Epidemiol, 25 (1996), pp. 609-616
[13]
A Arnedo-Pena, L García-Marcos, A Blanco-Quirós, A Martínez Gimeno, I Aguinaga Ontoso, C González Díaz, et al.
Evolución temporal de la prevalencia de síntomas de rinitis alérgica en escolares de 13-14 años de 8 áreas españolas entre 1993-1994 y 2001-2002 según el Estudio Internacional sobre Asma y Alergias en la Infancia (ISAAC).
Med Clin (Barc), 123 (2004), pp. 490-495
[14]
AL Ponsonby, D Couper, T Dwyer, A Carmichael, R Wood-Baker.
Exercise-induced bronchial hyperresponsiveness and parental ISAAC questionnaire responses.
Eur Respir J, 9 (1996), pp. 1356-1362
[15]
FD Martínez, AL Wright, LM Taussig, CJ Holberg, M Halonen, WJ Morgan.
Asthma and wheezing in the first six years of life.
N Engl J Med, 332 (1995), pp. 133-138
[16]
A Bercedo Sanz, C Redondo Figuero, L Lastra Martínez, M Gómez Serrano, E Mora González, M Pacheco Cumani, et al.
Prevalencia de asma bronquial, rinitis alérgica y dermatitis atópica en adolescentes de 13-14 años de Cantabria.
Bol Pediatr, 44 (2004), pp. 9-19
[17]
J Pekkanen, ST Remes, T Husman, M Lindberg, M Kajosaari, A Koivikko, et al.
Prevalence of asthma symptoms in video and written questionnaires among children in four regions of Finland.
Eur Respir J, 10 (1997), pp. 1787-1794
[18]
B Kaur, HR Anderson, J Austin, M Burr, LS Harkins, DP Strachan, et al.
Prevalence of asthma symptoms, diagnosis, and treatment in 12-14 year old children across Great Britain (International Study of Asthma and Allergies in Childhood, ISAAC UK).
BMJ, 316 (1998), pp. 118-124
[19]
J Mallol, E Cortez, L Amarales, I Sánchez, M Calvo, S Soto, et al.
Prevalencia del asma en escolares chilenos: estudio descriptivo de 24.470 niños. ISAAC-Chile.
Rev Med Chile, 128 (2000), pp. 279-285
[20]
D Sole, E Yamada, AT Vana, G Werneck, L Solano de Freitas, MJ Sologuren, et al.
International Study of Asthma and Allergies in Childhood (ISAAC): prevalence of asthma and asthma-related symptoms among Brazilian schoolchildren.
J Investig Allergol Clin Immunol, 11 (2001), pp. 123-128
[21]
MI Asher, D Barry, T Clayton, J Crane, W d'Souza, P Ellwood, et al.
International Study of Asthma and Allergies in Childhood (ISAAC) Phase One. The burden of symptoms of asthma, allergic rhinoconjunctivitis and atopic eczema in children and adolescents in six New Zealand centres: ISAAC Phase One.
N Z Med J, 114 (2001), pp. 114-120
[22]
Instituto Nacional de Estadística.
Migraciones. Estadística de variaciones residenciales [consulted 30/10/2004].
[23]
J Subiza Garrido-Lestache.
Pólenes alergénicos en España.
Allergol Immunopathol (Madr), 32 (2004), pp. 121-124
[24]
AH Brandenburg, PY Jeannet, HA Steensel-Moll, A Ott, PH Rothbarth, W Wunderli, et al.
Local variability in respiratory syncytial virus disease severity.
Arch Dis Child, 77 (1997), pp. 410-414
[25]
DP Strachan.
Family size, infection and atopy: the first decade of the “hygiene hypothesis.”.
Thorax, 55 (2000), pp. 2-10
[26]
A de Diego Damiá.
Asma: del niño al adulto.
Arch Bronconeumol, 39 (2003), pp. 51-53
[27]
J Sunyer, JM Anto, J Harris, M Torrent, O Vall, P Cullinan, on behalf of the AMICS study group, et al.
Asthma Multi-centre Infants Cohort Study. Maternal atopy and parity.
Clin Exp Allergy, 31 (2001), pp. 1352-1355
[28]
R de Marco, C Pattaro, F Locatelli, C Svanes, for the ECRHS Study Group.
Influence of early life exposures on incidence and remission of asthma throughout life.
J Allergy Clin Immunol, 113 (2004), pp. 845-852

Institutions and foundations that have helped fund this study: Public Health and Planning Authority (Dirección General de Salud Pública y Planificación), Health and Healthcare Services Council of Asturias (Consejería de Salud y Servicios Sanitarios del Principado de Asturias); Óscar Rava Foundation 2001, Barcelona; Health Department of Navarra (Departamento de Salud del Gobierno de Navarra); Rotaria Luis Vives Foundation 2002-2003, Valencia; Health Department of the Autonomous Government of Murcia (Departamento de Salud del Gobierno Autónomo de Murcia); Instituto de Salud Carlos III, Red de Centros RCESP (C03/09); AstraZeneca, España.

Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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