哮喘联盟

   摘要
   背景：近年来，包括玻利维亚在内的发展中国家儿童期哮喘、鼻炎和湿疹症状的患病率大大增加，这可能是由于生活方式、环境、以及家庭因素的改变所致。本研究的目的在于评估玻利维亚奥罗佩萨省学龄期儿童中哮喘、鼻炎和湿疹症状与环境因素的关系。
   方法：在奥罗佩萨省随机选取36所小学五年级的2340名学生参与本次横断面研究。使用儿童期哮喘和过敏的国际研究(ISAAC)调查问卷确定病症的患病率。通过ISAAC环境调查问卷来评估环境因素，该调查问卷内容包括接触宠物、农场动物、室内室外污染物、家里存在的疾病介质以及不稳定家庭因素的相关问题。通过广义线性混合效应模型校正年龄、性别和居住地。
   结果：37%的儿童报告他们的父母中至少有一人在家吸烟。19%的家庭使用木材或煤炭作为烹饪燃料，29%的家庭住在货车运输密集的街道。关于卫生条件，86%儿童与狗有接触，59%与猫有接触，36%定期与农场动物有接触。8%的儿童报告存在超过一个不稳定家庭因素。在校正模型中校正暴露于狗(校正的 OR 1.4; 95% CI:1.0-1.9)、猫(1.2; 1.0-1.5)、农场动物(1.5; 1.2-1.8)后，鼻炎症状与密集的货车运输(1.3; 1.0-1.6)、父母在家吸烟(1.2; 1.0-1.5)、家里的疾病媒介(上四分位数 vs. 下四分位数: 1.6; 1.2-2.3)以及2或3个不稳定家庭因素(1.5; 1.0-2.2)显著相关。哮喘和湿疹症状的关联性相似；但是所有项目均未达到统计学的显著水平。
   结论：本研究结果与在贫困地区特别是拉丁美洲的调查研究一致，提示较低的卫生条件对哮喘、鼻炎以及湿疹症状没有保护效应。
 

（林江涛 审校）
Environ Health. 2013 Nov 5;12(1):95. [Epub ahead of print]

 

Association between environmental factors and current asthma, rhinoconjunctivitis
and eczema symptoms in school-aged children from Oropeza Province -- Bolivia: a
cross-sectional study.
 

Solis-Soto MT, Patiño A, Nowak D, Radon K.
 

Abstract
BACKGROUND: In recent years, the prevalence of asthma, rhinoconjunctivitis and eczema symptoms in childhood has considerably increased in developing countries including Bolivia, possibly due to changes in lifestyle, environmental and domestic factors. This study aimed to assess the association between environmental factors and asthma, rhinoconjuctivitis and eczema symptoms in school-aged children from Oropeza Province in Chuquisaca, Bolivia.
METHODS: A cross-sectional study was performed in 2340 children attending the fifth grade in 36 randomly selected elementary schools in Oropeza province. The prevalence of symptoms was determined using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Environmental factors were assessed by the ISAAC environmental questionnaire including questions related to exposure to pets, farm animals, indoor and outdoor pollution, presence of disease vectors at home and precarious household conditions. Generalized linear mixed-effects models were adjusted for age, sex and place of living.
RESULTS: Thirty seven percent of children reported that at least one of their parents smoked at home. Wood or coal was used as cooking fuel in 19% of the homes and 29% reported intense truck traffic on the street where they lived. With respect to hygiene conditions, 86% reported exposure to dogs, 59% exposure to cats and 36% regular contact to farm animals. More than one precarious household condition was reported by 8% of children. In the adjusted model exposure to dog (adjusted OR 1.4; CI 95% 1.0-1.9), cat (1.2; 1.0-1.5), farm animals (1.5; 1.2-1.8); intense truck traffic (1.3; 1.0-1.6), parents smoking at home (1.2; 1.0-1.5), presence of disease vectors at home (fourth quartile vs. first quartile: 1.6; 1.2-2.3) and two or more precarious household conditions (1.5; 1.0-2.2) were significantly associated with rhinoconjunctivitis symptoms. The associations were similar for asthma and eczema symptoms; however it did not reach the level of statistical significance for all items.
CONCLUSION: Our results support previous findings reported for poor communities especially in Latin America, showing that lower hygiene conditions did not have protective effect against asthma and rhinoconjunctivitis and eczema symptoms.
 

Environ Health. 2013 Nov 5;12(1):95. [Epub ahead of print]