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Asthma
Global Asthma Network Phase I study in Mexico: prevalence of asthma symptoms, risk factors and altitude associations—a cross-sectional study
  1. Blanca Estela Del-Río-Navarro1,
  2. Arturo Berber1,
  3. Nayely Reyes-Noriega1,
  4. Elsy Maureen Navarrete-Rodríguez1,
  5. Roberto García-Almaraz2,
  6. Philippa Ellwood3,
  7. Luis Garcia-Marcos4,
  8. Omar Josué Saucedo-Ramírez1,
  9. Valente Juan Mérida-Palacio5,
  10. Beatriz Del Carmen Ramos-García6,
  11. Alberto José Escalante-Domínguez7,
  12. Francisco Javier Linares-Zapién8,
  13. Héctor Leonardo Moreno-Gardea9,
  14. Georgina Ochoa-López10,
  15. Luis Octavio Hernández-Mondragón11,
  16. José Santos Lozano-Sáenz12,
  17. José Antonio Sacre-Hazouri13,
  18. Ángeles Juan-Pineda14,
  19. Ma Guadalupe Sánchez-Coronel15,
  20. Noel Rodríguez-Pérez15 and
  21. María de Jesús Ambriz-Moreno16
  22. The GAN Phase I group
    1. 1Allergy and Immunology, Hospital Infantil de México Federico Gomez, Mexico City, Mexico
    2. 2Allergy and Immunology, Hospital Infantil de Tamaulipas, Ciudad Victoria, Mexico
    3. 3Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
    4. 4Paediatric Allergy and Pulmonology Units ‘Virgen de la Arrixaca’ University Children’s Hospital, University of Murcia, Universidad de Murcia, Murcia, Spain
    5. 5Allergy and Immunology, Clínica de Asma-Alergia, Mexicali, Mexico
    6. 6Allergy and Immunology, Instituto Mexicano del Seguro Social, San Luis Potosí, San Luis Potosí, Mexico
    7. 7Allergy and Immunology, Hospital General de Tijuana, Tijuana, Mexico
    8. 8Allergy and Immunology, Centro de Investigación, Diagnóstico y Tratamiento de Asma y Alergias, Toluca, Estado de México, Mexico
    9. 9Allergy and Immunology, Hospital Ángeles Chihuahua, Chihuahua, Mexico
    10. 10Allergy and Immunology, Hospital Ángeles Ciudad Juárez, Chihuahua, Mexico
    11. 11Allergy and Immunology, CRIT Michoacán, Morelia, Michoacán, Mexico
    12. 12Allergy and Immunology, Hospital Ángeles Xalapa, Xalapa, Veracruz, Mexico
    13. 13Allergy and Immunology, Universidad Veracruzana, Córdoba, Veracruz, Mexico
    14. 14Allergy and Immunology, Private practice, Puerto Vallarta, Jalisco, Mexico
    15. 15Allergy and Immunology, Benemérita Universidad Autónoma de Aguascalientes, Aguascalientes, Mexico
    16. 16Allergy and Immunology, Hospital General de Matamoros, Matamoros, Mexico
    1. Correspondence to Dr Nayely Reyes-Noriega; naye.rey.nor{at}gmail.com

    Abstract

    Background Global Asthma Network (GAN) was established in 2012 as a development to the International Study of Asthma and Allergies in Childhood to improve asthma care globally.

    Objective To survey asthma, allergic rhinitis and atopic dermatitis in primary and secondary school children and to investigate and evaluate its prevalence, severity, management and risk factors in Mexico.

    Methods GAN Phase I is a cross-sectional, multicentre survey carried out in 15 centres corresponding to 14 Mexican cities throughout 2016–2019 using the validated Spanish language version of the GAN Phase I questionnaires. The questionnaires were completed by parents of 6–7-year-old primary school pupils (school children) and by 13–14-year-old adolescents.

    Results A total of 35 780 school children and 41 399 adolescents participated. Wheezing ever prevalence was 26.2% (95% CI 25.8% to 26.7%) in school children and 23.9% (95% CI 23.4% to 24.3%) in adolescents. The corresponding frequencies for current wheeze were 10.2% (95% CI 9.9% to 10.5%) and 11.6% (95% CI 11.2% to 11.9%). In school children, the risk factors for current wheeze were rhinitis (OR 4.484; 95% CI 3.915% to 5.134%) and rash symptoms (OR 1.735; 95% CI 1.461% to 2.059%). For adolescents, rhinitis symptoms (OR 3.492; 95% CI 3.188% to 3.825%) and allergic rhinitis diagnosis (OR 2.144; 95% CI 1.787% to 2.572%) were the most significant. For both groups, there was a negative relation with centres’ sea level altitude higher than 1500 m above mean sea level (p<0.005).

    Conclusions The most important risk factors for asthma symptoms in both age groups were the presence of rhinitis and rash symptoms or diagnosis. On the other hand, sea level altitude higher than 1500 metres was a protective factor.

    • asthma epidemiology
    • asthma
    • paediatric asthma
    http://creativecommons.org/licenses/by-nc/4.0/

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

    https://doi.org/10.1136/bmjresp-2020-000658

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      Footnotes

      • Collaborators The GAN Phase I group: OJ Saucedo-Ramírez (Mexico City, Mexico), V Merida-Palacio (Mexicali, Mexico), BC Ramos-García (San Luis Potosí, Mexico), AJ Escalante-Dominguez (Tijuana, Mexico), F Linares-Zapien (Toluca, Mexico), HL Moreno-Gardea (Chihuahua, Mexico), G Ochoa-Lopez (Ciudad Juárez, Mexico), LO Hernández-Mondragón (Morelia, Mexico), JS Lozano-Saenz (Xalapa, Mexico), JA Sacre-Hazouri (Córdoba, México), A Juan-Pineda (Puerto Vallarta, Mexico), MG Sánchez Coronel (Aguascalientes, Mexico), N Rodríguez-Pérez (Tamaulipas, Mexico), MJ Ambriz-Moreno (Tamaulipas, Mexico).

      • Contributors BED-R-N, NRN, EMNR, RG-A, PE and LG-M: study conception, design, acquisition of data and drafting the manuscript. AB: statistical analysis. OJSR, VJMP, BDCRG, AJED, FJLZ, LGM, GGOL, LOHM, JSLS, JASH, AJP, MGSC, NRP, MdJAM: data acquisition and drafted the initial version of the article. All authors contributed to data interpretation and read, commented on and approved the final version.

      • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

      • Competing interests None declared.

      • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

      • Patient consent for publication Not required.

      • Ethics approval The present study was approved by the Ethics, Research, and Biosafety committees of the Hospital Infantil de México Federico Gómez (HIMFG, protocol HIM/2016/065) by the guidelines of the institution and according to the Mexican law, was valid to all participant centres.

      • Provenance and peer review Not commissioned; externally peer reviewed.

      • Data availability statement Data are available in a public, open access repository. All data relevant to the study are included in the article or uploaded as supplementary information. Information regarding this article can be requested from Dra Blanca Estela Del Río Navarro at blancadelrionavarro@gmail.com.