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Prevalence and risk factors for wheeze, decreased forced expiratory volume in 1 s and bronchoconstriction in young children living in Havana, Cuba: a population-based cohort study

Suárez-Medina, Ramón; Venero-Fernández, Silvia; Alvarez-Valdés, Vilma; Sardiñas-Baez, Nieves; Cristina, Carmona; Loinaz-Gonzalez, Maria; Verdecia-Pérez, Zunilda; Corona-Tamayo, Barbara; Betancourt-López, Maria; Britton, John; Fogarty, Andrew W

Authors

Ramón Suárez-Medina

Silvia Venero-Fernández

Vilma Alvarez-Valdés

Nieves Sardiñas-Baez

Carmona Cristina

Maria Loinaz-Gonzalez

Zunilda Verdecia-Pérez

Barbara Corona-Tamayo

Maria Betancourt-López

John Britton

ANDREW FOGARTY andrew.fogarty@nottingham.ac.uk
Clinical Associate Professor & Reader in Clinical Epidemiology



Abstract

Objectives: Asthma has not been extensively studied in low-income and middle-income countries, where risk factors and access to treatment may differ from more affluent countries. We aimed to identify the prevalence of asthma and local risk factors in Havana, Cuba.

Setting: Four municipalities in Havana, Cuba.

Participants: A population-based cohort study design of young children living in Havana, Cuba. Children were recruited from primary care centres at age 12–15 months.

Primary and secondary outcome measures: Data on wheeze in the past 12 months, asthma treatment and environmental exposures collected regularly until the age of 6 years, when forced expiratory volume in 1 s (FEV1) and reversibility to aerosolised salbutamol were also measured.

Results: 1106 children provided data at the age of 6 years old. The prevalence of wheeze in the previous 12 months was 422 (38%), and 294 (33%) of the study population had bronchodilatation of 12% or more in FEV1 after administration of inhaled salbutamol. In the previous 12 months, 182 (16%) of the children had received inhaled corticosteroids, 416 (38%) salbutamol inhalers and 283 (26%) a course of systemic steroids.

Wheeze in the first year and a family history of asthma were both positively associated with bronchodilatation to inhaled salbutamol (1.94%; 95% CI 0.81 to 3.08 and 1.85%; CI 0.14 to 3.57, respectively), while paracetamol use in the first year was associated with wheeze at 6 years (OR 1.64, 95% CI 1.14 to 2.35). There were large differences in FEV1, bronchodilatation and risk of wheeze across different geographical areas.

Conclusions: Asthma is common in young children living in Havana, and the high prevalence of systemic steroids administrated is likely to reflect the underuse of regular inhaled corticosteroids. If replicated in other comparable low-income and middle-income countries, this represents an important global public health issue.

Citation

Suárez-Medina, R., Venero-Fernández, S., Alvarez-Valdés, V., Sardiñas-Baez, N., Cristina, C., Loinaz-Gonzalez, M., …Fogarty, A. W. (2020). Prevalence and risk factors for wheeze, decreased forced expiratory volume in 1 s and bronchoconstriction in young children living in Havana, Cuba: a population-based cohort study. BMJ Open, 10(4), https://doi.org/10.1136/bmjopen-2019-034192

Journal Article Type Article
Acceptance Date Mar 6, 2020
Online Publication Date Apr 22, 2020
Publication Date 2020-04
Deposit Date Apr 29, 2020
Publicly Available Date Apr 29, 2020
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 10
Issue 4
Article Number e034192
DOI https://doi.org/10.1136/bmjopen-2019-034192
Keywords General Medicine
Public URL https://nottingham-repository.worktribe.com/output/4341957
Publisher URL https://bmjopen.bmj.com/content/10/4/e034192

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e034192.full (409 Kb)
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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0/





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