title: The Program for the Prevention of Childhood Asthma: a specialized care program for children with wheezing or asthma in Brazil.
abstract: OBJECTIVE
  To present the Programa Infantil de Prevenção de Asma (PIPA, Program for the Prevention of Childhood Asthma) and the characteristics of the patients followed in this program.
  
  
  METHODS
  Implemented in the city of Uruguaiana, Brazil, PIPA has as its target population children and adolescents (< 18 years of age) with asthma or suspected asthma. Patients either enroll in PIPA spontaneously or are referred by pediatricians or primary care physicians. In this retrospective study, we use a standardized protocol to assess PIPA patients.
  
  
  RESULTS
  By the end of the study period, 646 patients were being followed. Of those, 298 (46.1%) were ≤ 3 years of age. In this group of patients, recurrent wheezing was identified in 60.7%, and the first episode of wheezing occurred in the first six months of life in 86.0%. Severe wheezing was identified in 29.5% and 45.4% in the children ≤ 3 and > 3 years of age, respectively. Physician-diagnosed asthma was reported in 26.5% and 82.2%, respectively. In the sample as a whole, the prevalence of passive smoking was high (> 36%), occurring during pregnancy in > 15%; > 40% of the patients had been born by cesarean section; and 30% had a mother who had had < 8 years of schooling.
  
  
  CONCLUSIONS
  A prevention program for children with asthma is an effective strategy for controlling the disease. Knowledge of local epidemiological and environmental characteristics is essential to reducing the prevalence of the severe forms of asthma, to improving the use of health resources, and to preventing pulmonary changes that could lead to COPD in adulthood.
authors.affiliation: Secretaria Municipal de Saúde, Prefeitura Municipal de Uruguaiana, Uruguaiana, RS, Brasil.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Urrutia-Pereira
authors.affiliation: Secretaria Municipal de Saúde, Prefeitura Municipal de Uruguaiana, Uruguaiana, RS, Brasil.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Avila
authors.affiliation: Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: Dirceu
authors.initials: D
authors.lastname: Solé
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000517:prevention & control*; D001938:Brazil; D002648:Child; D002654:Child Care; D002675:Child, Preschool; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015397:Program Evaluation; D015203:Reproducibility of Results; D012135:Respiratory Sounds / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires