CAN IMMUNOTHERAPY BE HELPFUL IN PUBLIC HEALTH?

Seção, Destaque Gaúcho, Nascimento Do, E Ferreira, Pizarro, Do, Nascimento Machado, Bittencourt De Oliveira, Costa, Wein-Berger
unpublished
O resumo em destaque nesta edição foi submetido para apresentação em pôster no 29 o Congresso da Acade-mia Europeia de Alergia e Imunologia Clínica (European Academy of Allergy and Clinical Immunology), realizado em Londres no período de 5 a 9 de junho deste ano, e a Comissão Científica, ao avaliar os trabalhos submetidos, determinou que o mesmo fosse classificado para apresenta-ção oral na Seção de Discussão de Pôster. Este resumo está publicado sob o numero 259 na ALLERGY, vol. 65, Suppl 92,
more » ... vol. 65, Suppl 92, pag 111, June 2010. O trabalho aqui destacado foi realizado longe dos gran-des centros universitários dotados de tecnologia sofistica-da, numa demonstração cabal de que com boas ideias, cri-atividade e disposição é possível fazer ciência e contribuir para a construção do conhecimento. Os nossos parabéns aos autores e a nossa palavra de estímulo para que continuem em sua busca e produção de conhecimento. Background: There have been an increasing prevalence of respiratory allergies among general population. There is a lack of specialists for assisting impoverished patients at public health settings. Pediatricians and General Practitioners have been using immunotherapy (IT) under the supervision of an specialist in Allergy and Clinical Immuno-logy, in south Brazil at a public health setting for asthma/ wheeze and/or allergic rhinitis patients. A signifi cant reduction of associated respiratory infections, hospital admissions and medicines consumption among treated children has been reached. The objective of this study is to evaluate the effi cacy of IT in a group of patients (n=46) and compare with a control group (n=48). Methods: Patients were allocated by clinical parameters which suggest respiratory allergic disease to common inhaled environmental allergens (mites and mold) accordingly to medical doctors experience. IT was taken for 12 months with a mixture of those allergens prepared in a weight/volume basis accordingly to an empirical established method which have been used in more than a thousand patients for the last 15 years at public health department of Santo Angelo county, RS. Besides asthma/wheeze and/or allergic rhinitis, respiratory infections considered were pneumonia , tonsilitis/pharingitis, bronchiolitis, sinusitis and otitis. Data were analyzed by chi-squared test with a significance level of 0.05. Results: There were 208 respiratory infections in the control group and 24 in IT group (p < 0,001) with a number needed to treat (NNT) of 3.1 and relative risk reduction (RRR) of 88%. The consumption of medicines by controls and treated patients were as follow in number of events: antibiotics (208 and 24) (p<0.001), oral steroids (53 and 11) (p<0.001), antihistamines (52 and 5) (p<0.001), oral broncodilators (31 and 11) (p=0.003) and nebulizations with beta-agonists (66 and 27) (p<0.001). There was also a signifi cant reduction in hospital admissions (21 and 7), RRR of 65% (p = 0.022). Conclusion: Our results suggest that immunotherapy with a mixture of inhaled common environmental aller-gens might be used in treatment and prevention of asthma/ wheeze, allergic rhinitis and respiratory infections in public health. Pediatricians and General Practitioners may allocate and treat patients under the supervision of an specialist in Allergy and Clinical Immunology.
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