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Published on: October 25, 2018
Pediatric allergy and immunology in Brazil
Nelson A Rosario-Filho1, Cristina M Jacob, Dirceu Sole
1Department of Pediatrics, Federal University of Parana, Curitiba, PR, Brazil. nelson.rosario@ufpr.br
Insights
Pediatric allergy and immunology in Brazil shows high asthma and food allergy prevalence. Research indicates reduced asthma hospitalizations but persistent indoor allergen risks, alongside advances in diagnosing primary immunodeficiencies.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology
- Immunology
Background:
- The subspecialty of pediatric allergy and immunology in Brazil is developing.
- This review examines research on allergic and immunologic diseases in Brazil.
- It highlights disease characteristics and trends in the country.
Purpose of the Study:
- To review research on pediatric allergic and immunologic diseases in Brazil.
- To characterize the epidemiology of these conditions.
- To assess the state of education and training in the field.
Main Methods:
- Literature review of studies on pediatric allergy and immunology in Brazil.
- Analysis of epidemiological data on asthma, food allergy, and anaphylaxis.
- Examination of research on primary immunodeficiencies (PID).
Main Results:
- High prevalence of asthma in children and adolescents, with reduced hospitalization rates.
- Excessive indoor aeroallergen exposure and increased food allergy prevalence.
- Key etiological agents for anaphylaxis identified; insights into PID, including fungal and mycobacterial infections.
- Deficiencies in medical student education contrasted with effective residency programs.
Conclusions:
- Pediatric allergy and immunology in Brazil is advancing, with significant disease burdens.
- Further training is needed, particularly in primary immunodeficiencies.
- Residency programs are effective, but undergraduate education requires improvement.
Abstract:
The subspecialty of pediatric allergy and immunology in Brazil is in its early years and progressing steadily. This review highlights the research developed in the past years aiming to show the characteristics of allergic and immunologic diseases in this vast country. Epidemiologic studies demonstrated the high prevalence of asthma in infants, children, and adolescents. Mortality rates and average annual variation of asthma hospitalization have reduced in all pediatric age groups. Indoor aeroallergen exposure is excessively high and contributes to the high rates of allergy sensitization. Prevalence of food allergy has increased to epidemic levels. Foods (35%), insect stings (30%), and drugs (23%) are the main etiological agents of anaphylaxis in children and adolescents. Molecular diagnosis of primary immunodeficiencies (PID) showed a high incidence of fungal infections including paracoccidioidomycosis in X-linked hyper-IgM syndrome, and the occurrence of BCG adverse reactions or other mycobacterial infections in patients with chronic granulomatous disease. Education in pediatric allergy and immunology is deficient for medical students, but residency programs are effective in training internists and pediatricians for the practice of allergy. The field of PID requires further training. Last, this review is a tribute to Prof. Dr. Charles Naspitz, one of the pioneers of our specialty in Brazil.
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