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¿Están todos los trastornos respiratorios sibilantes en niños muy pequeños (preescolares) aumentando en prevalencia?
C E Kuehni1, A Davis, A M Brooke
1Department of Child Health, University of Leicester, Leicester Royal Infirmary, Leicester, UK. claudia.kuehni@insel.ch
Lancet (London, England)
|June 19, 2001
Resumen
La prevalencia de los trastornos respiratorios sibilantes en la infancia, incluida la sibilancia viral, aumentó significativamente entre 1990 y 1998. Este aumento en la respiración sibilante preescolar sugiere que los factores más allá de la atopia están impulsando los problemas respiratorios infantiles.
Área de la Ciencia:
- Salud respiratoria pediátrica en la salud respiratoria pediátrica.
- Epidemiología de los trastornos respiratorios sibilantes en la infancia.
- Investigación de la atopia y el asma.
Sus antecedentes:
- Distintos trastornos respiratorios sibilantes en niños pequeños, incluidos los no relacionados con la atopia, presentan desafíos diagnósticos.
- Investigar los cambios en la prevalencia de los trastornos respiratorios sibilantes preescolares puede revelar los mecanismos detrás del aumento de las tasas de asma infantil.
Objetivo del estudio:
- Examinar los cambios en la prevalencia de diversos trastornos respiratorios sibilantes en niños en edad preescolar durante un período de ocho años.
- Identificar los factores potenciales que contribuyen a la creciente prevalencia del asma infantil.
Principales métodos:
- Encuestas basadas en la población realizadas en Leicestershire, Reino Unido, utilizando cuestionarios postales completados por los padres.
- Muestras aleatorias de niños caucásicos de entre 1 y 5 años encuestados en 1990 y 1998.
Principales resultados:
- Se observaron aumentos significativos en los casos de sibilancias reportadas alguna vez (16% a 29%), sibilancias actuales (12% a 26%), diagnóstico de asma (11% a 19%) y tratamiento de sibilancias (15% a 26%).
- Se observaron aumentos en todos los tipos de trastornos respiratorios sibilantes, incluida la sibilancia viral (9% a 19%) y las sibilancias tempranas transitorias (3% a 5%).
- La prevalencia de las sibilancias persistentes aumentó del 5% al 13%, y las sibilancias de aparición tardía del 6% al 8%.
Conclusiones:
- El aumento universal de los trastornos respiratorios sibilantes preescolares, incluida la respiración sibilante viral, apunta a factores no relacionados con la atopia.
- Estos hallazgos sugieren que los factores ambientales u otros factores no relacionados con la sensibilización alérgica juegan un papel en el cambio de la epidemiología de la respiración sibilante infantil.
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