Browsing by Author "Taborda-Barata, Luis"
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- Allergic sensitisation and relationship with asthma and other allergic diseases in children in the province of Bengo, AngolaPublication . Arrais, Margarete; Lulua, Ofélia; Quifica, Francisca; Gama, Jorge; Taborda-Barata, Luis; Brito, MiguelBackground: In recent decades, the prevalence of allergies has increased, especially in children. In Africa, few studies have evaluated allergic sensitization and in Angola, none. The aim of this study was to evaluate the profile of allergic sensitization in children with asthma and other allergic diseases. Method: This was a cross-sectional study, using the methodology of the International Study of Asthma and Allergic Diseases in Children (ISAAC), conducted from September to November 2017 in 5 to 14-year-old children in the Bengo Province, Angola. Out of a total of 33 public schools, 5 (15%) were randomly selected, 3 in urban and 2 in rural areas. Allergic sensitization was defined by positive skin prick tests (SPT) and/or positive inhalant Phadiatop. Data were analyzed with SPSS Statistics v25.0. Results: The sample consisted of 1023 children, 48% girls, 58% 10-14-year-old, 61% living in urban areas. Of these children, 8% had positive SPT with the most frequent sensitization being to mites (B.tropicalis, D.farinae, D.pteronyssinus) and cockroach mix, without statistically significant differences between sexes, age, and urban or rural area residents. About 56% of children were monosensitized, 44% were polysensitized, and most sensitized children (55%) were asymptomatic. No significant differences in allergen sensitization patterns were observed among atopic children who were asymptomatic, had asthma, rhinitis, or eczema. Conclusion: Allergic sensitization to dust mites, cockroach mix, and fungi is the most frequent pattern observed in 5-14-year-old Angolan children in Bengo but this was not different between sensitized children with and without allergic diseases.
- Factors associated with poor asthma symptom control in adult Angolan regularly seen at an outpatient respiratory clinicPublication . Arrais, Margarete L.; Maricoto, Tiago; Lulua, Ofélia M.; Quifica, Francisca G.; Gama, Jorge M.; Brito, Miguel; Taborda-Barata, LuisBackground: Asthma is one of the most common chronic respiratory diseases and one of the most frequent causes of hospital care. Objectives: To describe the clinical characteristics of asthma and factors associated with its control. Methods: A cross-sectional study was conducted at the Military Hospital in Luanda, from April 2018 to March 2019. Data collection was performed using questionnaires on asthma symptoms and treatment, socio-demographic and environmental questions, and a Global Initiative for Asthma (GINA) questionnaire to assess the level of asthma control. Ordinal logistic regression analyses were performed. We estimated odds ratios, for higher categories of asthma control. P<0.05 was considered significant. Results: The sample consisted of 305 asthmatics ≥18-years-old, 56% women, with a mean age of 41.3 years. About 28% of patients had controlled asthma, 36% partially controlled and 35% uncontrolled. Poor asthma control was associated with frequent use of short-acting beta-2 agonists [OR 5.70 (95%CI 2.37;13.7)], oral corticosteroids [OR 3.68 (95%CI 2.24;6.04)], and incorrect inhaler technique [OR 4.08 (95%CI 1.25;13.3)]. Conclusions: A significant number of adults living in Luanda have uncontrolled asthma due to the under-use of inhaled corticosteroid therapy. It is necessary to develop strategic management and prevention plans to improve Angolan asthmatics' medical care.
- Helminth infections and allergic diseases: systematic review and meta-analysis of the global literaturePublication . Arrais, Margarete; Maricoto, Tiago; Nwaru, Bright I.; Cooper, Philip J.; Gama, Jorge M.R.; Brito, Miguel; Taborda-Barata, LuisBackground: There is considerable research interest in the role of helminth infections in the development of allergic diseases. However, findings from previous studies are mixed. Existing systematic reviews of these studies are outdated. We performed a systematic review of the global literature on the association between helminth infections and development and clinical outcomes of allergic diseases. Methods: We searched Cochrane Library, MEDLINE, EMBASE, ISI Web of Science, PubMed, Global Index Medicus, Scielo, KoreaMed, Google Scholar, and Lilacs for studies published up to January 2020. We included observational epidemiological studies (cohort, case-control, and cross-sectional studies) of children and adults reporting associations between helminth infections and asthma, allergic rhinitis, eczema, and atopy. We performed a random-effects meta-analysis to summarize the effect estimates. Results: We included 80 studies with 99,967 participants. In the meta-analyses, we did not observe an overall association between helminth infections and allergic diseases. There was, however, evidence that Ascaris lumbricoides infections were associated with an increased risk of bronchial hyperreactivity in children (risk ratio, 1.41; 95% CI, 1.17-1.70; I2 = 50; P for I2 = .09), and were associated with an increased risk of atopy among helminth-infected adults (risk ratio, 1.37; 95% CI, 1.18-1.61; I2 = 52; P for I2 = .02). We found no study that addressed the association between helminth infection and clinical outcomes of allergic diseases. The overall strength of the underlying evidence was low to moderate. Conclusions: Helminth infections may increase the risk of bronchial hyperreactivity in children and atopy in adults. Well-designed longitudinal cohorts may help clarify potential causal associations between chronic helminth infections and allergic diseases.
- Lack of association between asthma, atopy and helminthic infection in school-age children in the province of Bengo, AngolaPublication . Arrais, Margarete; Sachicola, Ofélia; Quifica, Francisca; Gama, Jorge; Taborda-Barata, Luis; Brito, MiguelBackground: Epidemiological studies conducted in several countries worldwide and in some African countries have shown that there is controversy in the relationship between asthma, atopy, and helminthic infection. The aim of this study was to fully evaluate such a relationship in children living in areas of high and moderate helminthic prevalence. Method: Cross-sectional study using the methodology of the International Study of Asthma and Allergies in Childhood (ISAAC), conducted from September to November 2017, in the Province of Bengo, Angola. From a total of 33 schools, five (15%), three in urban and two in rural areas were randomly selected. Atopy was defined by positive skin prick tests and/or specific IgE to aeroallergens (Phadiatop), and helminthic infection was defined by the presence of helminths in feces. Data were obtained regarding the helminthic load, types of helminths, previous infections, and anti-helminthic treatments, and were analyzed with SPSS Statistics v25.0. Results: The sample consisted of 1023 children, 48% female, 58% 10 to 14 years old, and 61% living in urban areas. About 9% had asthma, 22% had rhinitis, 16% had eczema, 8% were atopic and 36% were infected by helminths. The most frequently detected helminths were Ascaris lumbricoides (23% of children), Hymenolepsis nana (6%), and Trichuris trichiuria (4%). No relationship was detected between the prevalence of asthma, rhinitis, or atopy and parameters of helminthic infection. Conclusion: No relationship was apparent between the prevalence of asthma, atopy, and helminth infection. Further studies are warranted, namely, cohort studies with long follow-up monitoring since birth.
- Lack of consistent association between asthma, allergic diseases, and intestinal helminth infection in school-aged children in the Province of Bengo, AngolaPublication . Arrais, Margarete; Lulua, Ofélia; Quifica, Francisca; Rosado-Pinto, José; Gama, Jorge M.; Cooper, Philip J.; Taborda-Barata, Luis; Brito, MiguelEpidemiological studies have shown conflicting findings on the relationship between asthma, atopy, and intestinal helminth infections. There are no such studies from Angola; therefore, we aimed to evaluate the relationship between asthma, allergic diseases, atopy, and intestinal helminth infection in Angolan schoolchildren. We performed a cross-sectional study of schoolchildren between September and November 2017. Five schools (three urban, two rural) were randomly selected. Asthma, rhinoconjunctivitis, and eczema were defined by appropriate symptoms in the previous 12 months: atopy was defined by positive skin prick tests (SPT) or aeroallergen-specific IgE; intestinal helminths were detected by fecal sample microscopy. In total, 1023 children were evaluated (48.4% female; 57.6% aged 10–14 years; 60.5% urban). Asthma, rhinoconjunctivitis, or eczema were present in 9%, 6%, and 16% of the studied children, respectively. Only 8% of children had positive SPT, but 64% had positive sIgE. Additionally, 40% were infected with any intestinal helminth (A. lumbricoides 25.9%, T. trichiura 7.6%, and H. nana 6.3%). There were no consistent associations between intestinal helminth infections and asthma, allergic diseases, or atopy, except for A. lumbricoides, which was inversely associated with rhinoconjunctivitis and directly associated with aeroallergen-specific IgE. We concluded that, overall, intestinal helminth infections were not consistently associated with allergic symptoms or atopy. Future, preferably longitudinal, studies should collect more detailed information on helminth infections as part of clusters of environmental determinants of allergies.
- Sensitisation to aeroallergens in relation to asthma and other allergic diseases in Angolan children: a cross-sectional studyPublication . Arrais, Margarete; Lulua, Ofélia; Quifica, Francisca; Rosado-Pinto, José; Gama, Jorge; Brito, Miguel; Taborda-Barata, LuisIntroduction and Objectives: In Africa, few studies of sensitization profiles have been performed in children or adolescents and, in Angola, there are none. The objectives of the present study were to assess the sensitization profile of Angolan schoolchildren and to determine the relationship between that pattern, sociodemographic factors, asthma, and other allergic diseases. Materials and Methods: Cross-sectional, observational study in 5-14-year-old children, performed between September and November 2017, in the Province of Bengo, Angola. Five schools (15%) were randomly selected in the geographical area of the study: three from an urban area, and two from a rural area. Data were collected using the Portuguese versions of the ISAAC questionnaires for children and adolescents, regarding asthma, rhinitis, and eczema. Skin prick tests (SPT) were performed with a battery of 12 aeroallergens. Stools were assessed for the presence of helminths. Descriptive statistics were used, as well as a univariate calculation of odds ratios. Results: Sensitisation to aeroallergens was low (8%) and most sensitized children were asymptomatic. Most frequent sensitizations involved house dust mites, cockroaches, or fungi, and a high proportion of children (78.1%) were monosensitized. No relationship was detected between sensitizations and asthma, rhinitis or eczema. Place of residence, gender, age or helminthic infection did not affect the probability of having positive SPTs. Conclusions: The most frequent sensitizations in children from Bengo Province in Angola involve house dust mites, followed by cockroaches and fungi. No relationship was found between atopic sensitization and asthma or other allergic diseases.