ABSTRACT
BACKGROUND: Social and family factors may influence the probability of achieving asthma control in children. Parents' quality of life has been insufficiently explored as a predictive factor linked to the probability of achieving disease control in asthmatic children. OBJECTIVE: Determine whether the parents' quality of life predicts medium-term asthma control in children. METHODS: Longitudinal study of children between 4 and 14 years of age, with active asthma. The parents' quality of life was evaluated using the specific IFABI-R instrument, in which scores were higher for poorer quality of life. Its association with asthma control measures in the child 16 weeks later was analyzed using multivariate methods, adjusting the effect for disease, child and family factors. RESULTS: The data from 452 children were analyzed (median age 9.6 years, 63.3% males). The parents' quality of life was predictive for asthma control; each point increase on the initial IFABI-R score was associated with an adjusted odds ratio (95% confidence interval) of 0.56 (0.37-0.86) for good control of asthma on the second visit, 2.58 (1.62-4.12) for asthma exacerbation, 2.12 (1.33-3.38) for an unscheduled visit to the doctor, and 2.46 (1.18-5.13) for going to the emergency room. The highest quartile for the IFABI-R score had a sensitivity of 34.5% and a specificity of 82.2% to predict poorly controlled asthma. CONCLUSIONS: Parents' poorer quality of life is related to poor, medium-term asthma control in children. Assessing the parents' quality of life could aid disease management decisions. Pediatr Pulmonol. 2016;51:670-677. © 2015 Wiley Periodicals, Inc.
Subject(s)
Asthma/epidemiology , Parents , Quality of Life , Adolescent , Child , Child, Preschool , Female , Humans , Longitudinal Studies , Male , Spain/epidemiology , Surveys and QuestionnairesABSTRACT
OBJECTIVE: Describe the association between parents' quality of life and the two components of asthma control in children: impairment and risk. METHODS: Cross-sectional study with children between 4 and 14 years of age with active asthma recruited at primary care centers in Spain. Asthma control was assessed according to the Third National Asthma Expert Panel Report, classifying "impairment" in three levels (well-controlled asthma, partially controlled, and poorly controlled), and "risk" as high or low. The parents' quality of life was evaluated using the specific Family Impact of Childhood Bronchial Asthma Questionnaire instrument (IFABI-R). The association between asthma control and the parents' quality of life was analyzed using multivariate regression models adjusted for other social and family variables. RESULTS: Data from 408 children were analyzed. The parents' quality of life was affected in the partially controlled asthma group when compared with well-controlled asthma, as showed by an increase in IFABI-R scores in all dimensions: functional 17.2% (p < 0.001), emotional 10.4% (p = 0.021), and socio-occupational 6.8% (p = 0.056). The differences were higher in poorly controlled asthma compared with well-controlled asthma: functional 24.3% (p = 0.001), emotional 18.9% (p = 0.008), and socio-occupational 11.5% (p = 0.036). The "risk" component was independently associated with the parents' quality of life. Of all the elements used to assess the control, the only one independently associated with the parents' quality of life was recurrent asthma crisis. CONCLUSIONS: In asthma control, both "impairment" and "risk" in children are gradually associated with the parents' quality of life. The global assessment of the control surpasses the importance of each individual element used in this assessment.
Subject(s)
Asthma/physiopathology , Asthma/psychology , Parents/psychology , Adolescent , Asthma/prevention & control , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Quality of Life , Spain , Statistics, Nonparametric , Surveys and QuestionnairesABSTRACT
OBJECTIVES: To study the frequency, characteristics, and complications of non-therapeutic male circumcision on immigrant children from Africa in Spain. METHODS: This descriptive study focused on primary care consultations conducted at 21 Aragon health centres during 2010 and 2011. The data were gathered through interviewer-administered questionnaires to the parents of African children. Sociodemographic variables were studied, along with others related to the practice of circumcision. RESULTS: 283 questionnaires were obtained. 98.93 % of the children had undergone or were planning to undergo circumcision. 68.2 % were circumcised. Circumcisions were most frequently performed during a vacation to the country of origin (67.04 %), especially so for the Maghreb population. The remaining circumcisions had been performed in Spain. Half of the circumcisions practiced in Spain were performed at home, and 84 % of these were performed on Gambian children. CONCLUSIONS: The current study demonstrates that, in Aragon, Spain, almost all immigrant children from Africa have been or will be circumcised and that a considerable proportion has been circumcised at home by unqualified individuals. Gambians are particularly at risk of performing unsafe circumcision.
Subject(s)
Circumcision, Male/ethnology , Emigrants and Immigrants , Adolescent , Africa/ethnology , Child , Child, Preschool , Circumcision, Male/statistics & numerical data , Humans , Infant , Male , Spain , Surveys and QuestionnairesABSTRACT
Fundamento y objetivo: Tras la introducción de la vacuna neumocócica conjugada heptavalente (VNC-7v) se plantea investigar en nuestro medio las características que influyen en la colonización por serotipos de neumococo en niños preescolares sanos, la distribución de serotipos y su sensibilidad a antimicrobianos.Sujetos y método: Entre febrero de 2008 y enero de 2009 se recogieron muestras nasofaríngeas a niños de entre 2 meses y 5 años de edad que acudían a revisiones del niño sano en 4 centros de atención primaria de la provincia de Zaragoza (España) para cultivo y serotipado. Mediante regresión logística se estudiaron diferentes variables relacionadas con el estado de portador y las resistencias.Resultados: De los 371 niños estudiados, un 30,7% portaban neumococo en la nasofaringe. Con una cobertura de VNC-7v del 66%, factores relacionados con el hecho de ser portador fueron el número de hermanos (odds ratio [OR] 1,44; intervalo de confianza del 95% [IC 95%] 1,05 a 1,97 por cada hermano), estar escolarizado o asistir a guardería (OR 3,99; IC 95% 2,00 a 7,96), y padecer afección leve de vías respiratorias altas en el momento de la toma (OR 1,72; IC 95% 1,02 a 2,90). Solamente correspondían a serotipos incluidos en la vacuna (STV) un 8,7%. Los serotipos no vacunales más frecuentemente aislados fueron 19A, 6A, 15B, 11 y 15A. Se detectaron significativamente más resistencias a antibióticos entre los STV. Conclusiones: Los niños menores de 6 años de nuestro medio portan neumococos más frecuentemente cuando tienen hermanos, están escolarizados o padecen afecciones leves de vías respiratorias altas. Tras la introducción de la vacuna VNC-7v, los STV son casi anecdóticos (8,7%) y los serotipos emergentes presentan mejor sensibilidad a antibióticos (AU)
Background and objective: To determine the characteristics influencing pneumococcal serotype colonization in healthy pre-school aged children, the distribution of serotypes and their antimicrobial susceptibility, after the introduction of pneumococcal 7-valent conjugate vaccine (VNC-7v). Sujetos and methods: Nasopharyngeal samples were collected from children under 6years of age attending well-child examinations in the province of Zaragoza (Spain). Logistic regression was used to study different variables related to the status of the carriers. Results:Of the 371 children studied 30.7% were found to be carriers. With a vaccine coverage rate of 66%, factors related with presence of pneumococcal carriage were found to be the number of siblings (OR 1.44; CI 95% 1.05-1.97 for each sibling), attending a school or child day care centre (OR 3.99; CI 95% 2.00-7.96) and suffering from a minor upper respiratory tract infection (URTI) (OR 1.72; CI 95% 1.02-2.90). Only 8.7% corresponded to VNC-7v serotypes. The most common non VNC-7v serotypes isolated were 19A, 6A, 15B, 11, and 15A. Significantly greater resistance was detected among VNC-7v serotypes. Conclusion: Children in the setting of this study carried pneumococci more commonly when they have siblings, attend school or day care, or suffer from minor URTI. In the VNC-7v vaccine era, VNC-7v serotypes have become rare occurrences (8.7%) and emerging serotypes present better susceptibility to antibiotics (AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Streptococcus pneumoniae/isolation & purification , Nasopharynx/microbiology , Pneumococcal Infections/epidemiology , Drug Resistance, Microbial , Vaccines, Conjugate/analysis , Pneumococcal Vaccines/analysisABSTRACT
BACKGROUND AND OBJECTIVE: To determine the characteristics influencing pneumococcal serotype colonization in healthy pre-school aged children, the distribution of serotypes and their antimicrobial susceptibility, after the introduction of pneumococcal 7-valent conjugate vaccine (VNC-7 v). SUJETOS AND METHODS: Nasopharyngeal samples were collected from children under 6 years of age attending well-child examinations in the province of Zaragoza (Spain). Logistic regression was used to study different variables related to the status of the carriers. RESULTS: Of the 371 children studied 30.7% were found to be carriers. With a vaccine coverage rate of 66%, factors related with presence of pneumococcal carriage were found to be the number of siblings (OR 1.44; CI 95% 1.05-1.97 for each sibling), attending a school or child day care centre (OR 3.99; CI 95% 2.00-7.96) and suffering from a minor upper respiratory tract infection (URTI) (OR 1.72; CI 95% 1.02-2.90). Only 8.7% corresponded to VNC-7 v serotypes. The most common non VNC-7 v serotypes isolated were 19A, 6A, 15B, 11, and 15A. Significantly greater resistance was detected among VNC-7 v serotypes. CONCLUSION: Children in the setting of this study carried pneumococci more commonly when they have siblings, attend school or day care, or suffer from minor URTI. In the VNC-7 v vaccine era, VNC-7 v serotypes have become rare occurrences (8.7%) and emerging serotypes present better susceptibility to antibiotics.