Incidencia y factores asociados al síndrome sibilante del lactante, Área Metropolitana de Bucaramanga, Colombia

RESUMEN Introduccion: Los cuadros bronco obstructivos en lactantes son causa frecuente de consulta a servicios ambulatorios, acudir a urgencias u hospitalizacion. Se presentan en forma recurrente o recidivante, con secuelas a largo plazo. Objetivo : Establecer la incidencia y los factores asociados para desarrollar sindrome sibilante (SS) y su recurrencia durante los dos primeros anos de vida. Metodologia : Estudio retrospectivo de cohorte. Se indago sobre presencia de sibilancias, edad de la primera crisis, eventos en los primeros dos anos de vida, y aspectos reconocidos previamente como factores de riesgo. Se estimotasa de incidencia y probabilidad de estar libre de SS a los dos anos, asi como los factores asociados con la presencia de SS recurrente y no recurrente. Resultados : Se estudiaron 139 varones y 159 ninas residentes en el Area Metropolitana de Bucaramanga, Colombia. La tasa de incidencia a dos anos es de 1,22 episodios/100 meses-persona (IC95% 0,97-1,47), con probabilidad de llegar al segundo cumpleanos sin SS es 67,0% (IC95% 60,7 a 72,4%). Los factores asociados con SS no recurrente fueron historia familiar de rinitis (RR 2,56) o asma (RR 2,11), y convivir con fumadores (RR 2,00); SS recurrente fueron historia familiar de rinitis (RR 8,79) o asma (RR 3,43), consumo de alimentos alergenicos (RR6,82), asfixia perinatal (RR 6,36), asistir al jardin infantil (RR 3,37) y convivir con menores de 10 anos(RR 1,63). Discusion: La incidencia de SS es similar a la encontrada en paises desarrollados. Muchos factores asociados son prevenibles, que de intervenirse ayudaria a disminuir el riesgo de que los lactantes enfermen o que recurran. Salud UIS 2011; 43 (2): 131-140 Palabras clave: Sibilancias, sindrome broncobstructivo, bronquiolitis, asma, tabaquismo,contaminacion ambiental, asfixia perinatal ABSTRACT Introduction: Bronchoobstructive disease in infants is frequent cause of assistance to primary and emergency services, and hospitalization, too. These are recurrent or non-recurrent, with long-term sequelae. Objective :To establish the incidence and associated factors for developing wheezing syndrome (WS) and its recurrence during the first two years of life. Methodology: A retrospective cohort. A survey was conducted to determine wheezing incidence, age at first crisis, event number in the first two years of life, and aspects previously recognized as risk factors. It was estimated incidence rate and likelihood of being free of WS at two years, as well as the associated factors with recurrent and non-recurrent WS. Results : We studied 139 boys and 159 girls dwelling in the Bucaramanga Metropolitan Area, Colombia. The incidence rate for two years is 1.22 events/100 person-months(95%CI 0,97-1,47), with a potential to reach the second birthday without WS of 67.0% (95%CI 60.7 to 72.4%).Associated factors with non-recurrent WS were family history of recurrent rhinitis (RR 2.56) or asthma (RR 2.11),and live with smokers (RR 2.00); for recurrent WS were a family history of rhinitis (RR 8.79 ) or asthma (RR 3.43),consumption of allergenic food (RR 6.82), perinatal asphyxia (RR 6.36), to attend kindergarten (RR 3.37), and tobe living with children under 10 years (RR 1,63). Discussion : The incidence of WS is similar to others found in developed countries. Many risk factors are preventable, and their intervention would help to reduce the risk to suffer WS. Salud UIS 2011; 43 (2): 131-140 Keywords: Wheezing, asthma, smoking, environmental contamination, perinatal asphyxia, bronchiolitis