Browsing by Author "Cooper , Philip John"

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    Impact of COVID-19 pandemic on asthmasymptoms and management: a prospectiveanalysis of asthmatic children in Ecuador
    (2021) Rodríguez, Alejandro; Romero Sandoval, Natalia Cristina; Cruz, Alvaro A.; Cooper , Philip John; Arteaga Vaca, Karen Alexandra; Maldonado G., Augusto; Maestre Calderón, Manolo Patricio; Chis Ster, Irina; Rodas Espinoza, Claudia Rosana; Molina Cando, María José; Morillo Argudo, Diana Alexandra; Ochoa Avilés, María Cristina; Ochoa Avilés, Angélica María
    ackground:Asthma affects up to 33% of children in Latin American settings. The ongoingCOVID-19 pandemic has had a significant impact on access to and use of health services. Weaimed to evaluate the impact of the COVID-19 lockdown on asthma exacerbations, medical facilityvisits, and use of asthma medications in children.Methods:We used data from a prospective cohort of 213 children aged 5–17 years in 3 Ecua-dorian cities and analysed the impact of the COVID-19 lockdown on asthma. Outcomes (asthmaexacerbations, emergency room [ER] visits, planned and unplanned outpatient visits, and use ofinhaled corticosteroids and Beta-2 agonists) were analysed using repeated Poisson counts (ie,number of events per participant before and during the COVID-19 lockdown).Results:During compared to before lockdown: a) the number of asthma exacerbations remainedconstant (IRR, 0.87; 95% CI: 0.72–1.05; p¼0.152); b) outpatient visits (IRR 0.26, 95% CI 0.14–0.47,p<0.001) declined 74% while ER visits declined 89% (IRR 0.11, 95% CI 0.04–0.32, p<0.001); andc) there was no change in inhaled corticosteroids use (IRR 1.03, 95% CI 0.90–1.16, P¼0.699) whileBeta-2 agonist use increased (IRR 1.32, 95% CI 1.10–1.58, P¼0.003).Conclusions:In a cohort of Ecuadorian children with asthma, health services attendancedecreased dramatically after COVID-19 lockdown, but asthma exacerbations and use of inhaledcorticosteroids were unchanged. Future analyses will address the question of the effect of SARS-CoV-2 infection on asthma exacerbations and control in this paediatric population.
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    Prevalence and risk factors for asthma, rhinitis, eczema, and atopy among preschool children in an andean city
    (2020) Ochoa Avilés, María Cristina; Morillo Argudo, Diana Alexandra; Rodriguez, Alejandro; Cooper , Philip John; Andrade Tenesaca, Dolores Susana; Molina Cando, Maria Jose; Parra Ullauri, Mayra Alejandra; Parra Ullauri, Andrea; Mejía Coronel, Julio Danilo; Neira Molina, Vivian Alejandra; Rodas Espinoza, Claudia Rosana; Ochoa Avilés, Angélica María
    Background: Limited data are available on prevalence and associated risk factors for atopy and allergic diseases from high-altitude urban settings in Latin America. Objective: To estimate the prevalence of atopy, asthma, rhinitis, and eczema, and associations with relevant risk factors in preschool children in the Andean city of Cuenca. Methods: A cross-sectional study was undertaken using a representative sample of 535 children aged 3-5 years attending 30 nursery schools in the city of Cuenca, Ecuador. Data on allergic diseases and risk factors were collected by parental questionnaire. Atopy was measured by skin prick test (SPT) reactivity to a panel of relevant aeroallergens. Associations between risk factors and the prevalence of atopy and allergic diseases were estimated using multivariable logistic regression. Results: Asthma symptoms were reported for 18% of children, rhinitis for 48%, and eczema for 28%, while SPT reactivity was present in 33%. Population fractions of asthma, rhinitis, and eczema attributable to SPT were 3.4%, 7.9%, and 2.9%, respectively. In multivariable models, an increased risk of asthma was observed among children with a maternal history of rhinitis (OR 1.85); rhinitis was significantly increased in children of high compared to low socioeconomic level (OR 2.09), among children with a maternal history of rhinitis (OR 2.29) or paternal history of eczema (OR 2.07), but reduced among children attending daycare (OR 0.64); eczema was associated with a paternal history of eczema (OR 3.73), and SPT was associated with having a dog inside the house (OR 1.67). Conclusions: A high prevalence of asthma, rhinitis, and eczema symptoms were observed among preschool children in a high-altitude Andean setting. Despite a high prevalence of atopy, only a small fraction of symptoms was associated with atopy. Parental history of allergic diseases was the most consistent risk factor for symptoms in preschool children.