ABSTRACT
This is the second report on the continuing efforts of LAGID to increase the recognition and registration of patients with primary immunodeficiency diseases in 12 Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Honduras, Mexico, Panama, Paraguay, Peru, Uruguay, and Venezuela. This report reveals that from a total of 3321 patients registered, the most common form of primary immunodeficiency disease was predominantly antibody deficiency (53.2%) with IgA deficiency reported as the most frequent phenotype. This category was followed by 22.6% other well-defined ID syndromes, 9.5% combined T- and B-cell inmunodeficiency, 8.6% phagocytic disorders, 3.3% diseases of immune dysregulation, and 2.8% complement deficiencies. All countries that participated in the first publication in 1998 reported an increase in registered primary immunodeficiency cases, ranging between 10 and 80%. A comparison of the estimated minimal incidence of X-linked agammaglobulinemia, chronic granulomatous disease, and severe combined immunodeficiency between the first report and the present one shows an increase in the reporting of these diseases in all countries. In this report, the estimated minimal incidence of chronic granulomatous disease was between 0.72 and 1.26 cases per 100,000 births in Argentina, Chile, Costa Rica, and Uruguay and the incidence of severe combined immunodeficiency was 1.28 and 3.79 per 100,000 births in Chile and Costa Rica, respectively. However, these diseases are underreported in other participating countries. In addition to a better diagnosis of primary immunodeficiency diseases, more work on improving the registration of patients by each participating country and by countries that have not yet joined LAGID is still needed.
Subject(s)
Immunologic Deficiency Syndromes/epidemiology , Registries , Birth Rate , Data Collection , Demography , Female , Humans , Immunologic Deficiency Syndromes/classification , Immunologic Deficiency Syndromes/immunology , Latin America/epidemiology , Male , Phenotype , Prevalence , Surveys and QuestionnairesABSTRACT
Es frecuente la falta de adherencia familiar hacia las medidas terapéuticas de las enfermedades alérgicas. La incidencia en el incumplimiento terapéutico de los pacientes asmáticos oscila entre un 20 a un 80 por ciento. En las últimas décadas, la expresión sintomática de las enfermedades atópicas (EA) en la infancia y en la adolescencia de los venezolanos se ha transformado en un problema de salud pública, con un costo terapéutico inaccesible para el estado y la familia. La estructuración del primer programa de prevención de enfermedades atópicas (asma bronquial, rinitis alérgica y dermatitis atópica) predispone hacia un cambio de actitud a través de la educación del grupo familiar de riesgo, basado en los resultados de investigaciones previas y adaptado a las normas y costumbres que rigen nuestra sociedad actual. Se estructura un proyecto de investigación, a través de un equipo multidisciplinario: 1) programa modelo educativo para la prevención de enfermedades alérgicas; 2) población: Grupo A, madres alérgicas venezolanas, embarazadas y sus respectivas parejas de un nivel socieconómico Graffar I,II y III, no parasitadas (n=482). Se seleccionan al azar subgrupos para evaluación prospectiva; A1 (n=20) sin participación en el programa preventivo o grupo control y A2 (n=15) con participación en el programa de prevención de enfermedades alérgicas o grupo intervenido, incluyendo estrategias a ser aplicadas por el núcleo familiar en relación a la adquisición de conocimientos, aplicación de medidas y metas alcanzadas, control inmunológico, pediátrico, y nutricional secuencial; Grupo B control (n=66), para validar las pruebas de laboratorio, y Grupo C control (n=364) para validar los diagnósticos inmunoclínicos; 3) evaluación inmunodiagnóstica in vivo a los padres e hijos (historia clínica, pruebas dérmicas por pinchazo para 6 alergenos: leche de vaca, clara de huevo, trigo, soya, cladosporium y dermatophagoides pteronnysinus), e in vitro (IgE total, Phadiatop y RAST) para los alergenos previamente seleccionados; y 4) análisis estadístico. Los resultados expresan: a) el curso educativo facilitó a las familias el cumplimiento de las normas preventivas en un 73,3 por ciento hasta los 12 meses y su refuerzo incremento a 100 por ciento hasta los 18 meses de edad de los lactantes; b) la prevalencia de EA al final del período experimental evidenció para el grupo A1: 100 por ciento y para el grupo intervenido A2: 6,6 por ciento. Los lactantes con antecedentes...
Subject(s)
Child , Humans , Male , Female , Allergy and Immunology/classification , Education , Family , Hypersensitivity/prevention & controlABSTRACT
The point prevalence of bronchial asthma and the influence of environmental conditions among 100 individuals chosen from two Venezuelan regions, i.e., rural and urban, were investigated by history, routine laboratory test, determination of total and specific IgE antibody to common allergens ans spirometric test. The point prevalence of bronchial asthma was 3,0% in rural subjects who were also highly parasitized by helmints and 3,6% in subjects from the urban region. A significative difference in skin responses to Dermatophagoides pteronnysinus was observed in urban asthmatics when compared with rural astmatics. A similar response to selected allergens was found among both populations. The prevalence of infestation by Ascaris in rural asthmatics was high compared with that of rural controls. Total IgE levels were elevated for both populations, but significatively higher (p<0.05) for rural individuals. Results suggest a significative point prevalence of bronchial asthma in both regions despite the helmint infestation of rural subjects. The effects of environmental factors, their concentrations and time of exposure are considered as main factors responsible for allergic reactivity observed in the Venezuelan regions studied
