Escolares com sintomas de asma em uma comunidade carente de Salvador: o olhar da família

Abstract

Asthma is a chronic inflammatory disease, most common in childhood and with high prevalence around the world. Genetics factors alone do not explain the increase of its prevalence, and psychological, social, and environmental conditions have been considered. First of all, the assessment of the prevalence of asthma symptoms in schoolchildren in Bairro da Paz, in the city of Salvador, Bahia, was made, in order to evaluate the relationship between sociodemografic characteristics and symptoms. Later, the objective was to identify, to investigate, and to analyze the family influence on the perception, on the treatment, on the management and on the onset of asthma symptoms. At the first phase, a cross-sectional study was carried out among schoolchildren in Bairro da Paz. The International Study of Asthma and Allergies in Childhood (ISAAC) was used and applied to those responsible for the children with the asthma symptoms. Two hundred and forty-two schoolchildren with low socioeconomic characteristics and low level of schooling were studied. Cumulative asthma was identified in 38,4%, active asthma in 31,1%, wheezing upon physical exertion in 36,6%, and diagnostic asthma in 16,6%, without any differences between genders and race groups. Active asthma was more prevalent in boys under 10 years old. (CI=0,19-0,91). A high prevalence of asthma in the neighborhood of Bairro da Paz was identified in children of families with higher levels of schooling and younger age. The findings related to places with warmer average temperatures can be associated with increased asthma prevalence and poverty. At the second moment, a qualitative study was carried out with 10 (ten) families of schoolchildren, previously analyzed and classified as sufferers of severe asthma, who were interviewed using a semi-structured questionnaire. The data were analyzed through the technique of interpretative phenomenological analysis, considering the moment before the first fit of asthma (maternal feelings at the moment of birth, socioeconomicdemografic characteristics, genetic factors), the moment before the fit of asthma (death or separation in the family, emotional factors immediately after the fit, exposure to allergens), and the moment after the fit of asthma (the family’s look, sacrifices and renunciation, health assistance). The findings showed a genetic, environmental and emotional influence on the onset of asthma and the presence of a particular event or fact that makes the child unique and special, in a way that favors both the onset and the perpetuation of the crisis.