Understanding and controlling asthma in Latin America: A review of recent research informed by the SCAALA programme

Author:

Cooper Philip J.12ORCID,Figueiredo Camila A.3,Rodriguez Alejandro1ORCID,dos Santos Leticia Marques4,Ribeiro‐Silva Rita C.5,Carneiro Valdirene Leao6,Costa Gustavo78,Magalhães Thiago9ORCID,dos Santos de Jesus Talita3,Rios Raimon3,da Silva Hugo Bernardino F.3,Costa Ryan3,Chico Martha E.10,Vaca Maritza910,Alcantara‐Neves Neuza3,Rodrigues Laura C11,Cruz Alvaro A.12,Barreto Mauricio L.79

Affiliation:

1. Escuela de Medicina Universidad Internacional del Ecuador Quito Ecuador

2. Institute of Infection and Immunity St George's University of London London UK

3. Instituto de Ciências da Saúde Universidade Federal da Bahia Salvador Brazil

4. Departamento de Saúde Coletiva Universidade Federal da Bahia Salvador Brazil

5. Escola de Nutrição Universidade Federal da Bahia Salvador Brazil

6. Departamento de Ciências da Vida Universidade do Estado da Bahia Salvador Brazil

7. Center for Data Knowledge and Integration for Health (CIDACS) Fundação Oswaldo Cruz Bahia Salvador Brazil

8. Universidade Salvador (UNIFACS) Salvador Bahia Brazil

9. Instituto de Saúde Coletiva Universidade Federal da Bahia Salvador Brazil

10. Fundacion Ecuatoriana para la Investigacion en Salud (FEPIS) Esmeraldas Ecuador

11. Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London UK

12. Universidade Federal da Bahia and Fundação ProAR Salvador Brazil

Abstract

AbstractAsthma is an important health concern in Latin America (LA) where it is associated with variable prevalence and disease burden between countries. High prevalence and morbidity have been observed in some regions, particularly marginalized urban populations. Research over the past 10 years from LA has shown that childhood disease is primarily non‐atopic. The attenuation of atopy may be explained by enhanced immune regulation induced by intense exposures to environmental factors such as childhood infections and poor environmental conditions of the urban poor. Non‐atopic symptoms are associated with environmental and lifestyle factors including poor living conditions, respiratory infections, psychosocial stress, obesity, and a diet of highly processed foods. Ancestry (particularly African) and genetic factors increase asthma risk, and some of these factors may be specific to LA settings. Asthma in LA tends to be poorly controlled and depends on access to health care and medications. There is a need to improve management and access to medication through primary health care. Future research should consider the heterogeneity of asthma to identify relevant endotypes and underlying causes. The outcome of such research will need to focus on implementable strategies relevant to populations living in resource‐poor settings where the disease burden is greatest.

Funder

Wellcome Trust

Publisher

Wiley

Subject

Immunology and Allergy,Immunology,Pulmonary and Respiratory Medicine

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