Risk factors for wheezing in infants born in Cuba

1. Silvia Josefina Venero Fernández*, 
2. Ramón Suárez Medina*, 
3. Esperanza de la C. Mora Faife*,
4. Gladys García García*, 
5. Ileana del Valle Infante*, 
6. Liem Gómez Marrero*,
7. Gladys Abreu Suárez**, 
8. José González Valdez**, 
9. Dania Fabré Ortiz⁺,
10. Hermes Fundora Hernández*, 
11. Andrea Venn PhD^{^}, 
12. John Britton FRCP^{^},
13. Andrew W Fogarty DM^{^} and 
14. the HINASIC (Historia Natural de la Sibilancia en Cuba/National History of Wheezing in Cuba) Study Group⁺⁺

+Author Affiliations

1. * Instituto Nacional de Higiene, Epidemiología y Microbiología, Infanta No 1158 e/ Llinás y Clavel, Código Postal 10300, La Habana, Cuba.
2. ** Hospital Universitario Pediátrico Docente Centro Habana, La Habana, Cuba.
3. ⁺ Hospital Pediátrico Docente “Juan Manuel Márquez”. La Habana, Cuba.
4. ^{^} Nottingham Biomedical Research Unit, Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK
5. ⁺⁺ full list of collaborating researchers at the end of the manuscript

1. To whom correspondence should be addressed. Correspondence and requests for reprints to MSc.Silvia Josefina Venero Fernández: Address: Infanta No 1158 e/ Llinás y Clavel, Código Postal 10300, La Habana, Cuba. Office phone: (537) 878 8479, Email: silviavf@inhem.sld.cu

• Received May 9, 2013.
• Revision received May 30, 2013.
• Accepted June 7, 2013.

Abstract

Background: Cuba is a unique country, and despite limited economic development has an excellent health system. However, the prevalence of asthma symptoms in children in Havana, Cuba, is unusually high.

Aim: Since early life exposures are critical to the aetiology of asthma, we have studied environmental influences on the risk of wheeze in Cuban infants.

Design: Cross-sectional study.

Methods: A random sample of 2032 children aged 12-15 months living in Havana was selected for inclusion in the cohort. Data were collected using questionnaires administered by researchers.

Results: Of 2032 infants invited to participate, 1956 (96%) infants provided data. The prevalence of any wheeze was 45%, severe wheeze requiring use of the emergency services was 30%, and recurrent wheeze on three or more occasions was 20%. The largest adjusted risk factors for any wheeze were presence of eczema (odds ratio OR 2.09; 95% confidence intervals 95% CI: 1.48-2.94), family history of asthma (OR 2.05; 95% CI: 1.60-2.62), poor ventilation in the home (OR 1.99; 95% CI: 1.48-2.67), attendance at nursery (OR 1.78; 95%CI: 1.24-2.57), male sex (OR1.52; 95% CI: 1.19-1.96) and the number of smokers in the house (p<0 .03="" 1.17-2.31="" 1.64="" compared="" for="" home="" household.="" in="" more="" no="" or="" p="" smokers="" the="" three="" to="" trend="">

Conclusion: We have identified several risk factors for any wheeze in young infants living in modern day Cuba. As the prevalence of smoking in the home is high (51%), intervention studies are required to determine effective strategies to improve infant health.

Keywords

• wheeze
 
• infants
 
• recurrent wheeze
 
• risk factor
 
• Cuba

• © The Author(s) 2013. Published by Oxford University Press on behalf of the Association of Physicians.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

This Article

1. QJM (2013)doi: 10.1093/qjmed/hct143First published online: July 3, 2013

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