do Rosário Dias de Oliveira Latorre Maria, Medeiros da Silva Aline, Chinzon Décio, Eisig Jaime N, Dias-Bastos Telma R P
Maria do Rosário Dias de Oliveira Latorre, Aline Medeiros da Silva, Department of Epidemiology, Faculty of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
World J Gastroenterol. 2014 Dec 14;20(46):17388-98. doi: 10.3748/wjg.v20.i46.17388.
To determine the prevalences of symptoms consistent with gastroesophageal reflux disease (GERD) and dyspepsia in South America.
A telephone survey was conducted among adult owners of land-based telephones in São Paulo, Brazil, using previously validated computer-assisted sampling and survey protocols. The Portuguese-language survey included (1) sociodemographic characteristics (e.g., weight, height, smoking) and comorbidities; (2) dietary habits; (3) presence of symptoms consistent with GERD or dyspepsia within the prior 3 mo; and (4) use of medications and other therapies to manage symptoms. Data were stratified post-hoc into three homogeneous geographical regions of São Paulo according to the Social Exclusion Indices of the districts and postal codes. Survey response data from each respondent were weighted by the numbers of adults and landline telephones in each household. The analyses were weighted to account for sampling design and to be representative of the São Paulo population according to city census data.
Among 4570 households contacted, an adult from 3050 (66.7%) agreed to participate. The nonresponse rate was 33.3%. The mean (SE) respondent age was 42.6 (16.0) years. More than half of all respondents were women (53.1%), aged 18 through 49 years (66.7%), married or cohabitating (52.5%), and/or above normal-weight standards (i.e., 35.3% overweight and 16.3% obese). A total of 26.5% of women were perimenopausal. More than 20% of respondents reported highly frequent symptoms consistent with GERD (e.g., gastric burning sensation = 20.8%) or dyspepsia (e.g., abdominal swelling/distension = 20.9%) at least once per month. Prevalences of these symptoms were significantly (approximately 1.5- to 2.0-fold) higher among women than men but did not vary significantly as a function of advancing age. For instance, 14.1% of women reported that they experienced stomach burning (symptom of GERD) at least twice per week, compared to 8.4% of men (P = 0.012 by χ(2) test). A total of 15.7% of women reported that they experienced abdominal swelling (symptom of dyspepsia) at least twice per week, compared to 6.4% of men (P < 0.001 by χ(2) test). Despite frequent manifestations of GERD or dyspepsia, most (≥ 90%) respondents reported that they neither received prescription medications from physicians, nor took behavioral measures (e.g., dietary modifications), to manage symptoms.
Symptoms consistent with dyspepsia and GERD are prevalent in Brazil and represent major public-health and clinical challenges.
确定南美洲符合胃食管反流病（GERD）和消化不良症状的患病率。
在巴西圣保罗对拥有陆基电话的成年人进行电话调查，采用先前验证的计算机辅助抽样和调查方案。葡萄牙语调查问卷包括：（1）社会人口统计学特征（如体重、身高、吸烟情况）和合并症；（2）饮食习惯；（3）过去3个月内符合GERD或消化不良的症状；（4）使用药物和其他疗法来控制症状。根据地区和邮政编码的社会排斥指数，事后将数据分层为圣保罗的三个同质地理区域。每个受访者的调查回复数据根据每个家庭中的成年人数量和固定电话数量进行加权。分析进行了加权，以考虑抽样设计，并根据城市人口普查数据代表圣保罗人群。
在联系的4570户家庭中，3050户（66.7%）的一名成年人同意参与。无应答率为33.3%。受访者的平均（SE）年龄为42.6（16.0）岁。所有受访者中超过一半为女性（53.1%），年龄在18至49岁之间（66.7%），已婚或同居（52.5%），和/或高于正常体重标准（即35.3%超重，16.3%肥胖）。共有26.5%的女性处于围绝经期。超过20%的受访者报告每月至少出现一次符合GERD的频繁症状（如胃烧灼感=20.8%）或消化不良症状（如腹部肿胀/胀满=20.9%）。这些症状在女性中的患病率显著高于男性（约1.5至2.0倍），但并未随年龄增长而有显著变化。例如，14.1%的女性报告每周至少经历两次胃烧灼感（GERD症状），而男性为8.4%（χ(2)检验，P = 0.012）。共有15.7%的女性报告每周至少经历两次腹部肿胀（消化不良症状），而男性为6.4%（χ(2)检验，P < 0.001）。尽管GERD或消化不良症状频繁出现，但大多数（≥90%）受访者报告他们既未从医生处获得处方药，也未采取行为措施（如饮食调整）来控制症状。
符合消化不良和GERD的症状在巴西很普遍，是主要的公共卫生和临床挑战。
