Improving influenza surveillance in Portuguese preschool children by parents' report.

UNLABELLED: Influenza surveillance is usually based on nationally organized sentinel networks of physicians and on hospital reports. This study aimed to test a different report system, based on parents' phone contact to the research team and in home collection of samples by a dedicated team. The identification of influenza and other respiratory viruses in children who attended a Hospital Emergency Department was also recorded. Real-time PCR and reverse transcription PCR were performed for influenza A and B, parainfluenza 1-4, adenovirus, human metapneumovirus, respiratory syncytial virus A and B, rhinovirus, enterovirus, group 1 coronaviruses, group 2 coronaviruses, and human bocavirus. One hundred children were included, 64 from the day care centers and 36 from the Hospital. Overall, 79 samples were positive for at least one respiratory virus. Influenza A (H3) was the virus most frequently detected: 25 cases, 20 of these in children under 5 years of age (ten from day care centers and ten who went to the hospital) which was higher than those reported by the National Influenza Surveillance Programme for this age. CONCLUSION: The results obtained in this study suggest that a surveillance system based on parents' reports could complement the implanted system of the National Influenza Surveillance Programme.

Respiratory diseases in children attending kindergartens: Health-related variables and mothers' psychological, parental, and marital functioning.

This study aimed to examine the differences between mothers of children with and without respiratory problems in variables related to psychological, parental, and marital functioning and to determine which contributed more to parenting stress, because there is a lack of information in this field. Participants were 459 mothers of children attending kindergartens, who accepted to participate. The instruments were The International Study of Asthma and Allergies in Childhood questionnaire, Hospital Anxiety and Depression Scale, Parenting Stress Index-Short Form, Parenting Stress Index-Long Form, and Escala de Avaliação da Satisfação em Áreas da Vida Conjugal. Anxiety, depression, and parenting stress were higher in the more symptomatic children and parenting stress was associated with anxiety, depression, and marital satisfaction. Findings support the relevance of children's respiratory-related variables to mothers' psychological, parental, and marital functioning.

Food allergy and anaphylaxis in infants and preschool-age children.

Food allergy (FA) prevalence data in infants and preschool-age children are sparse, and proposed risk factors lack confirmation. In this study, 19 children's day care centers (DCC) from 2 main Portuguese cities were selected after stratification and cluster analysis. An ISAAC's (International Study of Asthma and Allergies in Childhood) derived health questionnaire was applied to a sample of children attending DCCs. Outcomes were FA parental report and anaphylaxis. Logistic regression was used to explore potential risk factors for reported FA. From the 2228 distributed questionnaires, 1217 were included in the analysis (54.6%). Children's median age was 3.5 years, and 10.8% were described as ever having had FA. Current FA was reported in 5.7%. Three (0.2%) reports compatible with anaphylaxis were identified. Reported parental history of FA, personal history of atopic dermatitis, and preterm birth increased the odds for reported current FA. A high prevalence of parental-perceived FA in preschool-age children was identified. Risk factor identification may enhance better prevention.

[Reported drug allergy among children attending day care centers]. / Alergia a medicamentos reportada em crianças que frequentam infantários.

INTRODUCTION: Data about drug allergy prevalence in the general population, particularly in children, are lacking. This study aimed to estimate the prevalence of parent-reported drug allergy, in children attending day care centers in Lisbon and Oporto. MATERIAL AND METHODS: In Phase II of the "ENVIRH study - Environment and Health in Children Day Care Centers", a health questionnaire which included questions about drug allergies was administered to children by stratified, random sampling of day care centers. RESULTS: The final analysis included 1,169 questionnaires, 52.5% from boys. The mean age was 3.5 ± 1.5 years. The prevalence of reported drug allergy was 4.1% (95% CI: 3.0 - 5.2%). The most frequently reported drugs were antibiotics (27 cases) and NSAIDs (in 6 cases). In the multivariate analysis, reported drug allergy was directly associated with age (OR 1.19; 95% CI 1.01 - 1.41) and reported food allergy (OR 3.19; 95% CI 1.41 - 7.19). It was inversely associated with the level of parental education (OR 0.25; 95% CI 0.10 - 0.59). DISCUSSION: Even though the limitations of the study our results are in accordance with those reported by previous authors and suggest that there is a high prevalence of reported drug allergy in the considered age group. CONCLUSION: A correct assessment of these situations is needed in order to avoid unnecessary drug evictions.

Introdução: A prevalência de alergia a fármacos na população geral não se encontra devidamente caraterizada, existindo poucos estudos publicados que tenham abordado esta situação em crianças com idades inferior a seis anos de idade. Este estudo tem como objetivo principal estimar a prevalência de alergia a medicamentos reportada pelos pais de crianças de infantários de Lisboa e do Porto. Material e Métodos: No âmbito da Fase II do projeto "ENVIRH ­ Ambiente e Saúde em Creches e Infantários" foi aplicado um questionário sobre alergia a medicamentos aos pais das crianças, recrutadas por amostragem aleatória estratificada dos infantários. Resultados: Foram analisados 1 169 questionários, 52,5% de rapazes. A idade média foi de 3,5 ± 1,5 anos. A prevalência de alergia a medicamentos reportada foi de 4,1% (IC 95%: 3,0 - 5,2%). Os fármacos mais referidos foram os antibióticos (em 27 reações) e os AINEs (em seis reações). Na análise multivariável, a alergia a medicamentos reportada associou-se diretamente com a idade da criança (OR 1,19; IC 95% 1,01 - 1,41) e com a referência a alergia alimentar (OR 3,19; IC95% 1,41 - 7,19) e inversamente com o nível de escolaridade dos pais (OR 0,25; IC95% 0,10 - 0,59). Discussão: Apesar das limitações do estudo, os resultados encontram-se de acordo com o reportado por outros autores e sugerem que a prevalência reportada de alergia a medicamentos seja elevada no grupo etário estudado. Conclusão: Torna-se necessário que situações de alergia a medicamentos reportadas pelos pais sejam devidamente estudadas, no sentido de evitar evicções desnecessárias que possam condicionar opções terapêuticas em futuras situações de doença.