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ObjectiveTo determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema in adolescents (AD; 13‐14 years) living in seven Brazilian cities, by applying the standardized written questionnaire (WQ) of the International Study of Asthma and Allergies in Childhood (ISAAC), and to evaluate the time trend nine years after the last assessment of ISAAC phase 3 (ISP3).MethodsThe ISAAC‐WQ was answered by 20,099 AD from the Northern, Northeastern, Southeastern, and Southern Brazilian regions. Values obtained were compared to those observed in ISP3 using nonparametric (chi‐squared or Fisher) tests, and the ratio of annual increment/decrement was established for each of the centers, according to the symptom assessed.ResultsConsidering the national data and comparing to values of ISP3, there was a decrease in the mean prevalence of active asthma (18.5% vs. 17.5%) and an increase in the frequency of severe asthma (4.5% vs. 4.7%) and physician‐diagnosed asthma (14.3% vs. 17.6%). An increase in prevalence of rhinitis, rhinoconjunctivitis, and atopic eczema was also observed.ConclusionsThe prevalence of asthma, rhinitis, and atopic eczema in Brazil was variable; higher prevalence values, especially of asthma and eczema, were observed in regions located closer to the Equator.ResumoObjetivoDeterminar a prevalência de sintomas relacionados à asma, à rinite e ao eczema atópico em adolescentes (13‐14 anos, AD) residentes em sete cidades brasileiras com o questionário escrito (QE) padronizado do International Study of Asthma and Allergies in Childhood (Isaac) e verificar a tendência temporal passados nove anos da última avaliação do Isaac fase 3 (ISF3).MétodosO QE Isaac foi respondido por 20.099 AD (13‐14 anos) moradores em centros das regiões Norte, Nordeste, Sudeste e Sul. Os índices obtidos foram comparados aos do ISF3 com o teste não paramétrico (qui‐quadrado ou Fisher) e foi estabelecida a taxa de incremento/decremento anual para cada um dos centros segundo o sintoma avaliado.ResultadosEm relação ao ISF3, considerando‐se os dados nacionais, houve queda da prevalência média de asma ativa (18,5% vs. 17,5%) com elevação da frequência de asma grave (4,5% vs. 4,7%) e de asma diagnosticada por médico (14,3% vs. 17,6%). Aumento da prevalência de rinite e rinoconjuntivite e de eczema flexural também ocorreram.ConclusõesA prevalência de asma, rinite e eczema atópico no Brasil foi variável. Valores mais altos, sobretudo de asma e eczema, foram observados nos centros localizados mais próximos ao Equador.

OBJECTIVES: to study risk factors related to atopic eczema (AE) in school children of São Paulo. METHODS: 1972 parents or guardians of 6-7 years old children in the Southern Central area of São Paulo answered to a written questionnaire (standardized questionnaire of the International Study of Asthma and Allergies in Childhood plus a complementary questionnaire regarding family history of asthma and allergies, and exposure to environmental allergens). AE was defined by the presence of an itchy rash in the last year. Risk factors were analyzed through logical regression. RESULTS: the following factors were significantly associated with AE: history of maternal (OR: 4.1; 95%CI: 2.4 to 7.1) and paternal eczema (OR: 2.6; 95%CI: 1.4 to 5.0), dust in the child's bedroom (OR: 1.6; 95%CI: 1.1 to 2.4), lower maternal education (OR: 1.7; 95%CI: 1.1 to 2.7), rhinitis fever (OR: 1.7; 95%CI: 1.1 to 2.9) and wheezing in the last year (OR: 1.9; 95%CI: 1.2 to 2.8). CONCLUSIONS: our data suggest that AE has a specific pattern of inheritance. The presence of dust in the child's bedroom was the single environmental risk factor found. Diagnose of other allergic diseases, as well as the presence of recent symptoms were strongly associated with AE in children.OBJETIVOS: identificar fatores de risco relacionados ao eczema atópico (EA) em escolares do município de São Paulo. MÉTODOS: 1972 pais de escolares de 6-7 anos da região centro-sul de São Paulo responderam a questionários escritos (questionário padrão do International Study of Asthma and Allergies in Childhood e questionário complementar sobre história familiar de doenças alérgicas e exposição ambiental a potenciais fontes de alérgenos e irritantes). A presença de manchas na pele com coceira nos últimos 12 meses, definiu os escolares com EA. Os fatores de risco foram analisados por regressão logística. RESULTADOS: as variáveis significantemente associadas ao EA foram: história materna (OR: 4,1; IC95%: 2,4 a 7,1) e paterna de eczema (OR: 2,6; IC95%: 1,4 a 5,0), presença de pó no dormitório (OR: 1,6; IC95%: 1,1 a 2,4), menor escolaridade materna (OR: 1,7; IC95%: 1,1 a 2,7), relato de sibilos no último ano (OR: 1,9; IC95%: 1,2 a 2,8) e de rinite alguma vez (OR: 1,7; IC95%: 1,1 a 2,9). CONCLUSÕES: a análise dos dados sugeriu haver um padrão específico de herança genética para o EA. A presença de pó no quarto foi o único fator de risco ambiental encontrado. Sintomas e diagnóstico de outras doenças atópicas associaram-se fortemente às manifestações de EA.

OBJETIVO: Determinar a prevalência de eczema atópico e de sintomas relacionados entre estudantes da região centro-sul da cidade de São Paulo, em 1996 e 1999. MÉTODOS: Em 1996 e 1999, o questionário escrito do International Study of Asthma and Allergies in Childhood (ISAAC) foi aplicado aos pais de crianças com 6-7 anos (3.005 em 1996 e 3.033 em 1999) e a adolescentes de 13-14 anos (3.008 em 1996 e 3.487 em 1999). Para o ISAAC: a) o relato de eczema alguma vez indica que, pelo menos uma vez na vida, foi fornecido por um médico o diagnóstico de eczema atópico, sendo utilizado para definir "diagnóstico médico" b) o relato concomitante de lesões no último ano evidenciadas em locais característicos constitui o "critério combinado" para o diagnóstico de eczema atópico e foi, também, utilizado por nós. Os dados obtidos foram transcritos no banco de dados Epi-Info 6.0 e analisados. RESULTADOS: No grupo dos 6-7 anos houve redução significante do "diagnóstico médico" de eczema atópico em 1999 (11,4%) em comparação a 1996 (13,2%). O aumento da prevalência de "diagnóstico médico" observado em 1999, entre os adolescentes, não foi significante (14% x 15%). Considerando-se o "critério combinado", não houve diferenças significantes, entre 1996 e 1999, em ambos os grupos (6,6% x 6,8% para crianças de 6-7 anos e 3,7% x 4,4% para adolescentes). CONCLUSÕES: Apesar do aumento da prevalência das doenças atópicas em várias partes do mundo, documentamos redução na prevalência de "diagnóstico médico" de eczema atópico entre crianças de 6 a 7 anos. Contudo, o eczema atópico é doença relevante na população pediátrica.OBJECTIVE: To determine the prevalence of atopic dermatitis and associated symptoms in schoolchildren from the city of São Paulo in 1996 and 1999. METHODS: The International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire was applied to the parents of 6 to 7-year-old children in 1996 and 1999 (3,005 in 1996 and 3,033 in 1999) and to 13 to 14-year-old adolescents (3,008 in 1996 and 3,487 in 1999). In the ISAAC, the option eczema ever indicates that a diagnosis of atopic eczema was made by a physician at least once in the subject's life. This was used to define "medical diagnosis" in the present study. The concomitant report of lesions in the last year in characteristic places constitutes the "combined criterion" for the diagnosis of atopic eczema and was also employed in the present study. Data were analyzed using the Epi-Info 6.0 software. RESULTS: In the 6 to 7-year-old group, there was a significant decrease in the number of "medical diagnoses" of atopic eczema in 1999 (11.4%) in comparison to 1996 (13.2%). The increase in the prevalence of "medical diagnoses" observed in 1999 among adolescents was not significant (14 vs. 15%). Considering the "combined criterion," there were no significant differences between 1996 and 1999 in either group (6.6% vs. 6.8% for 6 to 7 year-old children; 3.7% vs. 4.4% for adolescents). CONCLUSIONS: Despite the increase in the prevalence of atopic diseases worldwide, we documented a reduction in the prevalence of "medical diagnoses" of atopic eczema in 6 to 7-year-old children. Nevertheless, atopic eczema remains as a relevant disease in the pediatric population.

Sole D, Mallol J, Camelo-Nunes IC, Wandalsen GF, Latin American ISAAC Study Group. Prevalence of rhinitis-related symptoms in Latin American children – Results of the International Study of Asthma and Allergies in Childhood (ISAAC) phase three. Pediatr Allergy Immunol 2010: 21: e127–e136. © 2009 John Wiley & Sons A/S The aim of this study was to evaluate the prevalence of rhinitis-related symptoms among children living in different parts of Latin America (LA) considering all centers involved in ISAAC Phase Three (Ph3). 93,851 children (6–7 yr-old) from 35 centers in 14 LA countries and 165,917 adolescents (13–14 yr-old) from 56 centers in 17 LA countries were enrolled. The mean prevalence rate of current rhinoconjunctivitis was 12.7% and ranged from 5.5% in Rosario City (Argentina) to 21.2% in Caracas (Venezuela) for the schoolchildren. The mean prevalence rate of current rhinoconjunctivitis was 18.5% and ranged from 7.1% in Cuernavaca (Mexico) to 45.1% in Asuncion (Paraguay) for the adolescents. These indexes were among the higher observed during ISAAC Ph3. In general the prevalence of rhinitis-related symptoms was higher among the Spanish speaking centers. Environmental risk factors must be evaluated in order to explain the differences observed even in centers from the same country.

To determine the prevalence of atopic dermatitis and associated symptoms in schoolchildren from the city of São Paulo in 1996 and 1999.The International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire was applied to the parents of 6 to 7-year-old children in 1996 and 1999 (3,005 in 1996 and 3,033 in 1999) and to 13 to 14-year-old adolescents (3,008 in 1996 and 3,487 in 1999). In the ISAAC, the option eczema ever indicates that a diagnosis of atopic eczema was made by a physician at least once in the subject's life. This was used to define "medical diagnosis" in the present study. The concomitant report of lesions in the last year in characteristic places constitutes the "combined criterion" for the diagnosis of atopic eczema and was also employed in the present study. Data were analyzed using the Epi-Info 6.0 software.In the 6 to 7-year-old group, there was a significant decrease in the number of "medical diagnoses" of atopic eczema in 1999 (11.4%) in comparison to 1996 (13.2%). The increase in the prevalence of "medical diagnoses" observed in 1999 among adolescents was not significant (14 vs. 15%). Considering the "combined criterion," there were no significant differences between 1996 and 1999 in either group (6.6% vs. 6.8% for 6 to 7 year-old children; 3.7% vs. 4.4% for adolescents).Despite the increase in the prevalence of atopic diseases worldwide, we documented a reduction in the prevalence of "medical diagnoses" of atopic eczema in 6 to 7-year-old children. Nevertheless, atopic eczema remains as a relevant disease in the pediatric population.