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Prevalence and risk factors for wheezing in Salvador, Brazil: a population-based study
G G Reis1, V M Miranda1, M-R A Cardoso1
1From the Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine, Salvador, Brazil, Department of Paediatrics, Federal University of Bahia School of Medicine, Salvador, Brazil, Department of Epidemiology, São Paulo University School of Public Health, São Paulo, Brazil, Division of Allergy, Clinical Immunology and Rheumatology, Department of Paediatrics, Federal University of São Paulo, São Paulo, Brazil and Pathology Department, Federal University of Bahia School of Medicine and Centro de Pesquisa Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil.
Insights
Wheezing affects one-third of children under 4 years old. Maternal atopy, home smoking, and low birth weight are key risk factors for childhood wheezing and asthma.
Area of Science:
- Pediatric respiratory health
- Epidemiology of childhood illnesses
Background:
- Wheezing is a common reason for pediatric emergency room visits, yet community-level data, especially for children under four, is limited.
- Existing research often focuses on infants, leaving a gap in understanding wheezing prevalence in a broader young child population.
Purpose of the Study:
- To determine the community prevalence of wheezing in children younger than 4 years.
- To identify potential risk factors associated with wheezing in this age group.
Main Methods:
- A cross-sectional, population-based cohort study was conducted in Salvador, Brazil.
- Data were gathered through home visits and interviews with parents/guardians of children under 4 years old.
Main Results:
- Out of 1534 children, 33% reported wheezing in the past 12 months. Recurrent wheezing affected 12% and asthma 10% of the cohort.
- Maternal atopic disease was linked to recurrent wheezing and asthma. Home smoking and low birth weight were associated with occasional wheezing.
Conclusions:
- Approximately one-third of children under 4 experience wheezing, highlighting a significant community health burden.
- Maternal atopy, environmental smoke exposure, and low birth weight are identified as independent risk factors for different types of wheezing and asthma in young children.
Background:
Wheezing is one of the most frequent causes of visit to emergency rooms among children. However, data on wheezing burden are mostly provided at healthcare setting, and particularly only for infants.
Aims:
We sought to estimate the prevalence of wheezing in children under 4 years and to assess potential risk factors in the community.
Design:
This was a cross-sectional analysis of a population-based cohort study.
Methods:
The sample comprised children aged <4 years living in Salvador, Brazil. Data were collected via home visits when the parents/guardians were interviewed. Data were recorded on standardized forms.
Results:
Of 1534 children, mean age was 21 ± 14 months (minimum 3 days; maximum 47 months; 6% <2 months); 780 (51%) were males and 501 [33%; 95% confidence interval (95% CI): 30-35%] reported wheezing in the last 12 months. Among wheezers, 321 (64%) had occasional wheezing. Overall, 180 (12%; 95% CI: 10-14%) had recurrent wheezing and 157 (10%; 95% CI: 9-12%) had asthma. For children in the first, second, third and fourth year of life wheezing was reported in 23, 41, 34 and 37%, respectively. Mother atopic-related disease was independently associated with recurrent wheezing (AdjPR[95% CI]: 1.54 [1.12-2.11]) and asthma (AdjPR[95% CI]: 1.54 [1.10-2.16]). Smoker at home (AdjPR[95% CI]: 1.34 [1.07-1.67]) and low birth weight (AdjPR[95%CI]: 1.38 [1.05-1.81]) were independently associated with occasional wheezing.
Conclusions:
One-third of under 4 years reported wheezing; history of mother's atopic-related disease was an independent risk factor for recurrent wheezing and asthma; smoker at home and low birth weight were independent risk factors for occasional wheezing.
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