RESUMO
SETTING AND OBJECTIVE: The International Study of Asthma and Allergies in Childhood (ISAAC) reported asthma prevalence in Peru to be among the highest in the world. We assessed the prevalence and morbidity of self-reported asthma in an underserved, peri-urban area of Lima, Peru, with limited medical access. DESIGN: The study was conducted in the outskirts of Lima from March to May 2011. Five hundred children aged 6-18 years were selected through cluster sampling. Parents completed a modified version of the ISAAC questionnaire. Children underwent spirometry testing. Those with a forced expiratory volume in one second (FEV1% predicted) îº80% were tested for reversibility using salbutamol. RESULTS: Of the 500 children selected, 71% participated. The prevalence of asthma was 16.7%. Asthma symptoms were associated with self-reported asthma (P < 0.001); 52.5% of children with asthma had ever used an inhaler (P < 0.001), and 27.1% had never been to the doctor for respiratory problems (P < 0.001). CONCLUSION: We found a high prevalence of self-reported asthma and high morbidity related to asthma symptoms in the previous 12 months among the study cohort. Symptoms were poorly controlled due to limited availability of medication and access to medical services.
Assuntos
Asma/epidemiologia , Acessibilidade aos Serviços de Saúde , Estudantes/estatística & dados numéricos , Adolescente , Asma/diagnóstico , Criança , Estudos de Coortes , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Pais , Peru/epidemiologia , Prevalência , Autorrelato , Espirometria , Inquéritos e Questionários , População UrbanaRESUMO
Herpes simplex virus (HSV) is one of the most commonly identified infectious aetiologies of encephalitis in North America and Europe. The epidemiology of encephalitis beyond these regions, however, is poorly defined. During 2009-2012 we enrolled 313 patients in a multicentre prospective study of encephalitis in Peru, 45 (14·4%) of whom had confirmed HSV infection. Of 38 patients with known HSV type, 84% had HSV-1 and 16% had HSV-2. Patients with HSV infection were significantly more likely to present in the summer months (44·4% vs. 20·0%, P = 0·003) and have nausea (60·0% vs. 39·8%, P = 0·01) and rash (15·6% vs. 5·3%, P = 0·01) compared to patients without HSV infection. These findings highlight differences in the epidemiology and clinical presentation of HSV encephalitis outside of the Northern Hemisphere that warrant further investigation. Furthermore, there is an urgent need for improved HSV diagnostic capacity and availability of intravenous acyclovir in Peru.