The use of anti-asthmatic drugs in children in northeast Brazil

Background: Several studies have found underuse of the long control medications. However, few of these studies examined medication use within the general population, outside a health care setting, mainly in Brazil.
Objectives: To describe the use of anti-asthmatic drugs in children in the general population and in children with current asthma in Salvador, Brazil.
Methods: A follow up study is on going in Salvador, involving a sample of 1445 children of 4 to 11 years old. At baseline an extensive questionnaire was applied, including questions on use of anti-asthmatic in the last 12 months, between february and may 2006. Drugs were classified according to the Anatomical Therapeutic Chemical (ATC) Classification system. Categoric relationsships were examined with analysis. A P value < 0.05 was considered statiscally significant.
Results: In all children (n=1382), oral b₂-agonists were most frequently during the last 12 months (9.8%), followed by inhaled b₂-agonists (4.3%) and systemic steroids (1.6%). Anti-asthmatic use was higher among male than female and significantly decreased with increasing age of 4-5 to 9-11 years in both genders (À²_t=15.4; p<0.001); from17.2% to 8.0% in females (À²_t=8.0; p=0.005) and from 20.3% to 8.8% in males (À²_t=10.6; p=0.001). From an overall sample of 1382 children, 312 with current asthma were included in this analysis. A considerable percentage (62%) of children with current asthma were not being treated with anti-asthmatic therapy. Twenty percent used oral oral b₂-agonists alone, 6.1% inhaled b₂-agonists alone, 4.8% a combination of oral b₂-agonists and inhaled b₂-agonists. Anti-asthmatic use did not differ according to socio-economic status except for the use inhaled b₂-agonists and systemic steroids, which were reported more frequently among children higher socio-economic status (p<0.05).      
Conclusions: Anti-asthmatic drugs are underused in Salvador, Brazil. Among anti-asthma drugs, agents used for symptomatic relief were the most frequently reported being oral b₂-agonists is used more often.