Prevalence and associated factors for asthma in adults in Quito: a cross-sectional study
Abstract
Background
Although several epidemiological studies of asthma have been carried out in Ecuador in the last two decades, none of these has estimated the prevalence of asthma in adult populations.
Objective
To estimate the prevalence of asthma symptoms in adults in the city of Quito and to identify possible associated factors.
Methods
A cross-sectional study was carried out on subjects older than 18 years residing in the Metropolitan District of Quito. The Global Asthma Network (GAN) questionnaire was applied to collect information on asthma symptoms and sociodemographic and lifestyle data. Bivariate and multivariate analyses with logistic regression were used to identify asthma-associated factors.
Results
2,476 subjects answered the questionnaire (80.9% women, mean age 40 years). The prevalence of wheezing in the last 12 months, asthma ever, and asthma diagnosed by a doctor were 6.3%, 1.9% and 1.6%, respectively. The prevalence of rhinitis and eczema was 13.7% and 5.5%. The presence of mould at home (OR: 2.13; 95% CI: 1.48-3.06; p <0.001), cat at home (OR: 1.06; 95% CI: 1.06-2.13; p <0.022) and rhinitis at some time (OR: 3.65; 95% CI: 2.53-5.29; p <0.022) were associated with the presence of wheezing in the last 12 months.
Conclusions
Our study shows that, compared to other cities in Latin America, the prevalence of asthma in adults in Quito is relatively low. Along with the presence of rhinitis, factors related to housing quality are closely linked to the occurrence of asthma in adult populations.
Authors
Downloads
Keywords
- asthma,
- prevalence of asthma
- asthma in adults
- Quito
- Latin America
- Respiratory symptoms
Author Biographies
, 1 Universidad Central del Ecuador, Facultad de Ciencias Médicas, Quito, Ecuador. 2 Universitat de Barcelona, Barcelona, España.
https://orcid.org/0000-0003-4507-5519
, Universitat de Barcelona, Barcelona, España. Institut d’Investigacions Biomèdiques Pi i Sunyer, Barcelona, España. 4 Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES). Madrid, España
https://orcid.org/0000-0001-7400-4993
, Centro Médico Axxis, Quito, Ecuador
https://orcid.org/0000-0002-4308-0798
, Sul Ross State University, School of Medicine USA
https://orcid.org/0000-0002-5971-6586
, Universidad Central del Ecuador, Facultad de Ciencias Médicas, Quito, Ecuador
https://orcid.org/0000-0002-9360-3374
, University of Murcia, Arrixaca University Children’s Hospital, Respiratory and Allergy Units, Murcia, España, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia - Spain. Carlos III Health Institute, Network of Asthma, and Adverse and Allergy Reactions (ARADyAL) Network, Madrid, España,
https://orcid.org/0000-0002-0925-3851
, Universidad Internacional del Ecuador, Facultad de Ciencias Médicas de la Salud y la Vida, Quito, Ecuador
https://orcid.org/0000-0002-1867-0331
References
Agache I, Akdis CA. Global Atlas of Asthma. Eur Acad Allergy Clin Immunol [Internet]. 2021;(April). Available from: http://www.eaaci.org/resources/global-atlas-of-allergy.html.
Global Initiative for Asthma: Global strategy for asthma management and prevention (Updated 2020). Rev Fr d'Allergologie d'Immunologie Clin [Internet]. 2020;36(6):685-704. Available from: https://ginasthma.org/wp-content/uploads/2020/04/GINA-2020-full-report_-final-_wms.pdf. https://doi.org/10.1016/S0335-7457(96)80056-6
Asher I, Pearce N. Global burden of asthma among children. Int J Tuberc Lung Dis. 2014;18(11):1269-78. https://doi.org/10.5588/ijtld.14.0170
Nunes C, Pereira AM, Morais-Almeida M. Asthma costs and social impact. Asthma Res Pract. 2017;3(1):1. https://doi.org/10.1186/s40733-016-0029-3
To T, Stanojevic S, Moores G, Gershon AS, Bateman ED, Cruz AA, et al. Global asthma prevalence in adults: Findings from the cross-sectional world health survey. BMC Public Health. 2012;12(1):204. https://doi.org/10.1186/1471-2458-12-204
Promsopa C, Kansara S, Citardi MJ, Fakhri S, Porter P, Luong A. Prevalence of confirmed asthma varies in chronic rhinosinusitis subtypes. Int Forum Allergy Rhinol. 2016; 6(4): 373-7. https://doi.org/10.1002/alr.21674
Solé D, Aranda CS, Wandalsen GF. Asthma: epidemiology of disease control in Latin America - short review. Asthma Res Pract. 2017;3:4. Published 2017 May 11. https://doi.org/10.1186/s40733-017-0032-3
Cooper PJ, Rodrigues LC, Cruz AA, Barreto ML. Asthma in Latin America: A public health challenge and research opportunity. Allergy Eur J Allergy Clin Immunol. 2009;64(1):5-17 https://doi.org/10.1111/j.1398-9995.2008.01902.x
Forno E, Gogna M, Cepeda A, Yañez A, Solé D, Cooper P, et al. Asthma in Latin America. Thorax. 2015;70(9):898-905. https://doi.org/10.1136/thoraxjnl-2015-207199
Sembajwe G, Cifuentes M, Tak SW, Kriebel D, Gore R, Punnett L. National income, self-reported wheezing and asthma diagnosis from the World Health Survey. Eur Respir J. 2010;35(2):279-86. https://doi.org/10.1183/09031936.00027509
INEC. Instituto Nacional de Estadística y Censos. 2020 [cited 2020 Apr 26]. Available from: http://www.ecuadorencifras.gob.ec
Cabrera A, Picado C, Rodriguez A, Garcia-Marcos L. Asthma, rhinitis and eczema symptoms in Quito, Ecuador: A comparative cross-sectional study 16 years after ISAAC. BMJ Open Respir Res. 2021;8(1):1-9. https://doi.org/10.1136/bmjresp-2021-001004
Ellwood P, Asher MI, Billo NE, Bissell K, Chiang C-Y, Ellwood EM, et al. The Global Asthma Network rationale and methods for Phase I global surveillance: prevalence, severity, management and risk factors. Eur Respir J [Internet]. 2017 Jan 1;49(1):1601605. https://doi.org/10.1183/13993003.01605-2016
Cooper PJ, Chico ME, Rodrigues LC, Strachan DP, Anderson HR, Rodriguez EA, et al. Risk factors for atopy among school children in a rural area of Latin America. Clin Exp Allergy. 2004;34(6):845-52. https://doi.org/10.1111/j.1365-2222.2004.01958.x
Cooper PJ, Chico ME, Vaca MG, Rodriguez A, Alcântara-Neves NM, Genser B, et al. Risk factors for asthma and allergy associated with urban migration: background and methodology of a cross-sectional study in Afro-Ecuadorian school children in Northeastern Ecuador (Esmeraldas-SCAALA Study). BMC Pulm Med. 2006;6(1):24. https://doi.org/10.1186/1471-2466-6-24
Chico ME, Vaca MG, Rodriguez A, Cooper PJ. Soil-transmitted helminth parasites and allergy: Observations from Ecuador. Parasite Immunol. 2019; 41(6):e12590. https://doi.org/10.1111/pim.12590
Cooper PJ, Chico ME, Platts-Mills TAE, Rodrigues LC, Strachan DP, Barreto ML. Cohort Profile: The Ecuador Life (ECUAVIDA) study in Esmeraldas Province, Ecuador. Int J Epidemiol. 2015;44(5):1517-27. https://doi.org/10.1093/ije/dyu128
Ochoa-Avilés C, Morillo D, Rodriguez A, Cooper PJ, Andrade S, Molina M, et al. Prevalence and risk factors for asthma, rhinitis, eczema, and atopy among preschool children in an Andean city. PLoS One. 2020;15(7):e0234633. https://doi.org/10.1371/journal.pone.0234633
Arias SJ, Neffen H, Bossio JC, Calabrese CA, Videla AJ, Armando GA, et al. Prevalence and Features of Asthma in Young Adults in Urban Areas of Argentina. Arch Bronconeumol. 2018;54(3):134-9. https://doi.org/10.1016/j.arbres.2017.08.021
Menezes AMB, Wehrmeister FC, Horta B, Szwarcwald CL, Vieira ML, Malta DC. Prevalence of asthma medical diagnosis among Brazilian adults: National Health Survey, 2013. Rev Bras Epidemiol. 2015;18(Suppl 2):204-13. https://doi.org/10.1590/1980-5497201500060018
García-Sancho C, Fernández-Plata R, Martínez-Briseño D, Franco-Marina F, Pérez-Padilla JR. Prevalencia y riesgos asociados con pacientes adultos con asma de 40 años o más de la Ciudad de México: estudio de base poblacional [Adult asthma in Mexico City: a population-based study]. Salud Publica Mex. 2012 Jul-Aug;54(4):425-32. Spanish. https://doi.org/10.1590/S0036-36342012000400013
Dennis RJ, Caraballo L, García E, Rojas MX, Rondon MA, Pérez A, et al. Prevalence of asthma and other allergic conditions in Colombia 2009-2010: a cross-sectional study. BMC Pulm Med. 2012;12(1):1-9. https://doi.org/10.1186/1471-2466-12-17
Polosa R, Thomson NC. Smoking and asthma: dangerous liaisons. Eur Respir J. 2013 Mar;41(3):716-26. https://doi.org/10.1183/09031936.00073312
MSP/INEC. Indicadores de Salud del Ecuador-2012. Indicadores Bàsicos. 2012;12(312):16.
Chang Campos CJ. Evolución del sistema de salud de Ecuador: Buenas prácticas y desafíos en su construcción en la última década 2005-2014. In: Anales de la Facultad de Medicina. UNMSM. Facultad de Medicina; 2017. p. 452-60. https://doi.org/10.15381/anales.v78i4.14270
Cabrera A, Rodriguez A, Romero-Sandoval N, Barba S, Cooper PJ. Trends in hospital admissions and mortality rates for asthma in Ecuador: a joinpoint regression analysis of data from 2000 to 2018. BMJ Open Respir Res. 2021 Apr;8(1):e000773. https://doi.org/10.1136/bmjresp-2020-000773
Estrella B, Sempértegui F, Franco OH, Cepeda M, Naumova EN. Air pollution control and the occurrence of acute respiratory illness in school children of Quito, Ecuador. J Public Health Policy. 2019;40(1):17-34. https://doi.org/10.1057/s41271-018-0148-6
Rodriguez A, Romero-Sandoval A, Sandoval BA, Romero N. Medical specialist distributions in Ecuador : a geographical and temporal analysis of data from 2000 to 2017. BMC Health Serv Res [Internet]. 2022;5:1-12. https://doi.org/10.1186/s12913-022-08056-5
Maziak, W. The asthma epidemic and our artificial habitats. BMC Pulm Med 5, 5 (2005). https://doi.org/10.1186/1471-2466-5-5
Krieger J. Home is Where the Triggers Are: Increasing Asthma Control by Improving the Home Environment. Pediatr Allergy Immunol Pulmonol. 2010;23(2):139-45. https://doi.org/10.1089/ped.2010.0022
Wang J, Engvall K, Smedje G, Norbäck D. Exacerbation of asthma among adults in relation to the home environment in multi-family buildings in Sweden. Int J Tuberc Lung Dis. 2017;21(2):223-9. https://doi.org/10.5588/ijtld.16.0307
Chen CM, Thiering E, Doekes G, Zock JP, Bakolis I, Norbäck D, et al. Geographical variation and the determinants of domestic endotoxin levels in mattress dust in Europe. Indoor Air. 2012;22(1):24-32. https://doi.org/10.1111/j.1600-0668.2011.00740.x
Ilmarinen P, Tuomisto LE, Kankaanranta H. Phenotypes, risk factors, and mechanisms of adult-onset asthma. Mediators of Inflammation. 2015 Oct 11;2015. https://doi.org/10.1155/2015/514868
Zein JG, Erzurum SC. Asthma is Different in Women. Curr Allergy Asthma Rep. 2015 Jun;15(6):28. https://doi.org/10.1007/s11882-015-0528-y
Moncayo AL, Vaca M, Oviedo G, Erazo S, Quinzo I, Fiaccone RL, Chico ME, Barreto ML, Cooper PJ. Risk factors for atopic and non-atopic asthma in a rural area of Ecuador. Thorax. 2010 May;65(5):409-16. https://doi.org/10.1136/thx.2009.126490
Souza da Cunha S, Barreto ML, Fiaccone RL, Cooper PJ, Alcantara-Neves NM, Simões Sde M, Cruz AA, Rodrigues LC. Asthma cases in childhood attributed to atopy in tropical area in Brazil. Rev Panam Salud Publica. 2010 Dec;28(6):405-11. https://doi.org/10.1590/S1020-49892010001200001
Copyright (c) 2022 Universidad del Valle
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The copy rights of the articles published in Colombia Médica belong to the Universidad del Valle. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Colombia Médica without prior authorization for non-commercial use
