Rural Santa Maria Centre

Personnel

• Dr Vitor Emanuel Cassol
• Dr Thiago Moraes Rizzato
• Professor Dirceu Solé
• Dr Stefania Teche

When ISAAC phase 1 had begun, in the middle of the 1990’s, the standard written questionnaire (WQ) had not yet been validated for Portuguese language (Brazilian culture). After been validated (1,2,3) the ISAAC WQ was used by several investigators, independently to be involved with ISAAC Project.

In phase 1 had participated 7 Brazilian centers including São Paulo (4), five of them had participated in both phases 1 and 3 (5,6). São Paulo is the largest city in Brazil. More than 12 million of people live in São Paulo, so obtain homogeneous sample of schoolchildren as recommended by the ISAAC protocol, was not possible. Therefore, we limited the study to two parts of the city: southern and western. In the southern region lies second airport of Brazil in terms of traffic and in the western region there are several roads with jam traffic. In São Paulo we could analyze the influence of exposure to photochemical pollutants on the prevalence of asthma and allergic diseases (7). In part of the students evaluated we applied the complementary questionnaire and risk factors associated with the expression of asthma and allergic diseases were analyzed (8). The comparison between the prevalence of asthma and allergic diseases obtained in phase 1 and phase 3 showed to be constant (6). Other interesting issue was the genetic background impact on the expression of asthma and atopic diseases. Although we have evaluated schoolchildren with asthma and similar socio-economic level, there were differences according to risk factors for presentation of asthma in children born from exclusively Japanese progeny and native Brazilian children. These data reinforces the idea that asthma in Brazilian children is more than a single disease.

The ISAAC study in Santa Maria (Rio Grande do Sul, Brazil) was performed by Dr Victor E. Cassol and when the data collection was finished, several investigations were carried out. Considering that population of Santa Maria was theoretically homogeneous and with few miscegenation, the prevalence of asthma and allergic diseases was evaluated according to local characteristics like living in urban or rural areas, which allowed a more appropriate comparison of the environment influence on the expression of asthma and allergic diseases. Other interesting study was about the relationship between obesity and prevalence and severity of asthma among adolescents. Both studies were published (9,10,11) in peer reviewed journals and after the decease of Dr Cassol, I assumed the coordination of the centers in Santa Maria.

References

1. Solé D, Vanna AT, Yamada E, Rizzo MC, Naspitz CK. International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire: validation of the asthma component among Brazilian children. J Investig Allergol Clin Immunol. 1998;8(6):376-82.
2. Vanna AT, Yamada E, Arruda LK, Naspitz CK, Solé D. International Study of Asthma and Allergies in Childhood: validation of the rhinitis symptom questionnaire and prevalence of rhinitis in schoolchildren in São Paulo, Brazil. Pediatr Allergy Immunol. 2001;12(2):95-101.
3. Yamada E, Vanna AT, Naspitz CK, Solé D. International Study of Asthma and Allergies in Childhood (ISAAC): validation of the written questionnaire (eczema component) and prevalence of atopic eczema among Brazilian children.J Investig Allergol Clin Immunol. 2002;12(1):34-41.
4. Solé D, Yamada E, Vana AT, Werneck G, Solano de Freitas L, Sologuren MJ, et al. International Study of Asthma and Allergies in Childhood (ISAAC): prevalence of asthma and asthma-related symptoms among Brazilian schoolchildren. J Investig Allergol Clin Immunol. 2001;11(2):123-8.
5. Solé D, Camelo-Nunes IC, Wandalsen GF, Sarinho E, Sarinho S, Britto M, et al. Ecological correlation among prevalence of asthma symptoms, rhinoconjunctivitis and atopic eczema with notifications of tuberculosis and measles in the Brazilian population. Pediatr Allergy Immunol. 2005;16(7):582-6.
6. Solé D, Melo KC, Camelo-Nunes IC, Freitas LS, Britto M, Rosário NA, et al. Changes in the prevalence of asthma and allergic diseases among Brazilian schoolchildren (13-14 years old): comparison between ISAAC Phases One and Three. J Trop Pediatr. 2007;53(1):13-21.
7. Solé D, Camelo-Nunes IC, Wandalsen GF, Pastorino AC, Jacob CM, Gonzalez C, et al. Prevalence of symptoms of asthma, rhinitis, and atopic eczema in Brazilian adolescents related to exposure to gaseous air pollutants and socioeconomic status. J Investig Allergol Clin Immunol. 2007;17(1):6-13.
8. Pastorino AC, Rimazza RD, Leone C, Castro AP, Solé D, Jacob CM. Risk factors for asthma in adolescents in a large urban region of Brazil. J Asthma. 2006;43(9):695-700.
9. Cassol VE, Rizzato TM, Teche SP, Basso DF, Hirakata VN, Maldonado M, et al. Prevalence and severity of asthma among adolescents and their relationship with the body mass index. J Pediatr (Rio J). 2005;81(4):305-9.
10. Cassol VE, Rizzato TM, Teche SP, Basso DF, Centenaro DF, Maldonado M, et al. - Obesity and its relationship with asthma prevalence and severity in adolescents from southern Brazil. J Asthma. 2006;43(1):57-60.
11. Solé D, Cassol VE, Silva AR, Teche SP, Rizzato TM, Bandim LC, et al. - Prevalence of symptoms of asthma, rhinitis, and atopic eczema among adolescents living in urban and rural areas in different regions of Brazil. Allergol Immunopathol (Madr). 2007;35(6):248-53.