Why despite the lower prevalence, is asthma more severe in the semiarid region?

Introduction and objectives: Asthma is a chronic inflammatory disease which is very prevalent throughout the world, and climatic factors, especially air humidity, have been considered fundamental to its development. This study aims to evaluate the relationship between the climate factor and the severity of asthma episodes in the semiarid region, comparing it to the coast and an intermediate climate region, considering the use of medication as an intervening factor. Materials and methods: Ecological study in cities with different climatic conditions (semiarid, intermediate region and Coast). Prevailing data was obtained from the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. We evaluated the temperature, humidity and use of drugs for asthma/100,000 inhabitants. Results: The prevalence of asthma was lower in the semiarid (14%; 95% CI = 12.1-15.7) than the intermediate region (19.1%; 95% CI = 17.7-20.6) and coast (17.9%; 95% CI = 16.6-19.2). Episodes of severe asthma attacks were surprisingly higher in semiarid (10.4%; 95% CI=8.9-11.9) when compared to coast (4.1%; 95% CI = 3.4-4.9) and intermediate region (5.0%; 95% CI = 4.3-5.8). In the semiarid region, the humidity was lower and the temperature higher than the other cities evaluated. The dispensing of medications was lower in the semiarid region. Conclusions: Temperature and humidity may have contributed to a lower prevalence and greater severity of asthma in the semiarid region. The dispensing of medications was lower in the semiarid region, indicating that access to both relief and control drugs was lower in this city. The possibility of lack of health care in the semiarid region can also be another explanatory factor associated

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Sensitisation to aeroallergens among asthmatic and non-asthmatic adolescents living in a poor region in the Northeast of Brazil

Objectives: To assess the kind and frequency of sensitisation to aeroallergens (skin prick test - SPT) of asthmatic and non-asthmatic adolescents (13–14 years old) living in the city of Caruaru, Northeast of Brazil, and to analyse their exposure to some environmental factors. Method: A case-control study was conducted with asthmatic (50) and non-asthmatic (150) adolescents diagnosed by the International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire. All were submitted to SPT with aeroallergens (house dust mites, cat and dog epithelium, cockroaches, moulds and grass) and completed a questionnaire to evaluate their environmental exposure. Results: There were no significant differences between groups regarding gender, age, number of siblings and environmental exposure. Asthmatic subjects exhibited a higher frequency of positive SPTs than non-asthmatic subjects (54.0% vs 33.3%, p=0.009) mainly due to Periplaneta americana (34.0% vs 12.7%, p=0.0007 respectively) and Canis familiaris (20.0% vs 8.7%, p=0.029). Conclusion: Although sensitisation to aeroallergens was high among non-asthmatic adolescents, asthma was associated with parental history of atopic disease and sensitisation to P. americana and Canis familiaris but not to D. pteronyssinus showing that local studies are mandatory for the tailoring of appropriate management of allergic diseases (AU)

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