Prevalence Rates Of Asthma Research Articles

Respiratory symptoms/diseases prevalence is still increasing: a 25-yr population study

BackgroundFew epidemiological surveys on general population samples estimated changes in prevalence of respiratory symptoms/diseases over a long time interval; our study aims to quantify the temporal changes in the prevalence rates of asthma, allergic rhinitis and Chronic Obstructive Pulmonary Disease (COPD) after 25 years from baseline. MethodsA general population sample participated in 3 cross-sectional surveys carried out in Central Italy (Pisa) in 1985–88 (n = 3865), 1991–93 (n = 2841), 2009–11 (n = 1620). 2276 (47%) subjects participated in at least 1 survey, 1723 (35.5%) in at least 2 surveys and 849 (17.5%) in all the 3 surveys.All subjects filled in a standardized questionnaire about health status and risk factors; a sub-sample performed spirometry.Chi-square test was used to compare adjusted prevalence rates of respiratory symptoms/diseases and descriptive characteristics among the surveys. Generalised estimating equations (GEE) were used to analyze the association between respiratory symptoms/diseases and risk factors. ResultsThere was an increasing trend in prevalence rates of all respiratory symptoms/diseases throughout the surveys: current asthma attacks (1st–3rd survey prevalence: 3.4–7.2%), allergic rhinitis (16.2–37.4%), usual phlegm (8.7–19.5%) and COPD (2.1–6.8%) more than doubled. The GEE model confirmed these increasing trends, indicating higher risk of having respiratory symptoms/diseases in the second and third surveys. ConclusionsWhile asthma and allergic rhinitis increasing trends were confirmed, with respect to other international studies, also a COPD increasing prevalence rates was shown.

Healthcare utilisation by pregnant patients with asthma in South Korea: a cohort study using nationwide claims data

ObjectivesFew nationwide population-based studies have examined the burden of asthma during pregnancy. Here, we investigated the burden and medical treatment of asthma during pregnancy requiring healthcare utilisation in South Korea.DesignCohort...

Is population structure sufficient to generate area-level inequalities in influenza rates? An examination using agent-based models.

BackgroundIn New Haven County, CT (NHC), influenza hospitalization rates have been shown to increase with census tract poverty in multiple influenza seasons. Though multiple factors have been hypothesized to cause these inequalities, including population structure, differential vaccine uptake, and differential access to healthcare, the impact of each in generating observed inequalities remains unknown. We can design interventions targeting factors with the greatest explanatory power if we quantify the proportion of observed inequalities that hypothesized factors are able to generate. Here, we ask if population structure is sufficient to generate the observed area-level inequalities in NHC. To our knowledge, this is the first use of simulation models to examine the causes of differential poverty-related influenza rates.MethodsUsing agent-based models with a census-informed, realistic representation of household size, age-structure, population density in NHC census tracts, and contact rates in workplaces, schools, households, and neighborhoods, we measured poverty-related differential influenza attack rates over the course of an epidemic with a 23 % overall clinical attack rate. We examined the role of asthma prevalence rates as well as individual contact rates and infection susceptibility in generating observed area-level influenza inequalities.ResultsSimulated attack rates (AR) among adults increased with census tract poverty level (F = 30.5; P < 0.001) in an epidemic caused by a virus similar to A (H1N1) pdm09. We detected a steeper, earlier influenza rate increase in high-poverty census tracts—a finding that we corroborate with a temporal analysis of NHC surveillance data during the 2009 H1N1 pandemic. The ratio of the simulated adult AR in the highest- to lowest-poverty tracts was 33 % of the ratio observed in surveillance data. Increasing individual contact rates in the neighborhood did not increase simulated area-level inequalities. When we modified individual susceptibility such that it was inversely proportional to household income, inequalities in AR between high- and low-poverty census tracts were comparable to those observed in reality.DiscussionTo our knowledge, this is the first study to use simulations to probe the causes of observed inequalities in influenza disease patterns. Knowledge of the causes and their relative explanatory power will allow us to design interventions that have the greatest impact on reducing inequalities.ConclusionDifferential exposure due to population structure in our realistic simulation model explains a third of the observed inequality. Differential susceptibility to disease due to prevailing chronic conditions, vaccine uptake, and smoking should be considered in future models in order to quantify the role of additional factors in generating influenza inequalities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2284-2) contains supplementary material, which is available to authorized users.

Risk factors associated with asthma, atopic dermatitis and rhinoconjunctivitis in a rural Senegalese cohort.

BackgroundThe World Allergy Organization estimates that 40 % of the world’s population is affected by allergic diseases. The International Study of Asthma and Allergies in Childhood has completed Phase III and it has now become clear that these diseases have increased in developing countries, especially Africa, where prevalence rates were formerly low. Despite an increase in studies in Africa, few sub-Saharan West African countries are represented; the focus has remained on urban populations and little attention has been paid to rural sub-Saharan Africa.MethodsWe performed an allergy survey in a birth cohort of children aged less than 15 years in rural Senegal and implemented an ISAAC questionnaire. We carried out a complete blood count and serological analyses for IgE levels against common allergens and mosquito saliva.ResultsThe prevalence rates of asthma, rhinoconjunctivitis (RC) and atopic dermatitis (AD) were 12.8, 12.5 and 12.2 % respectively. Specific IgE (sIgE) levels against mosquito spp. salivary gland antigens were significantly associated with AD; sIgE levels against selected true grasses (Poaceae) were significantly associated with RC. sIgE levels against house dust mite spp. were not associated with asthma, but were significantly correlated with mosquito IgE levels. Such cross-reactivity may blur the association between HDM sIgE and asthma. Consumption of seafood, storing whey cream, using plant fibre bedding and presence of carpet were significantly associated with increased risk of RC. The association of seafood may be the result of histamine intoxication from molluscs prepared by putrefaction. Cat presence and dog contact were associated with increased risk of asthma. Cow contact was associated with increased risk of AD.ConclusionsOur allergy study in rural West Africa revealed lower prevalence rates than the majority of African urban settings. Although several associated known risk factors were identified, there were associations specific to the region. The identification of probable artefactual dietary phenomena is a challenge for robust diagnosis of allergic disease. The association AD with mosquito saliva, a common allergen in rural settings, warrants specific attention. Further studies in rural Africa are needed to address the aetiology of allergy in a non-urban environment.Electronic supplementary materialThe online version of this article (doi:10.1186/s13223-015-0090-0) contains supplementary material, which is available to authorized users.

Allergic Disease In Relation To Phthalates In House Dust And Urine

In recent years, increasing prevalence rate of asthma and allergies has been great concern world-wide. Because people spend much of their time indoors in modern society, one of the risk factors to ...

Sleep-disordered breathing and asthma: evidence from a large multicentric epidemiological study in China.

BackgroundPrevious studies have postulated that sleep-disordered breathing (SDB) may be associated with the occurrence and exacerbation of asthma. However, there was limited quantitative evidence on the topic. This study aimed at investigating the prevalence and predisposing factors of asthma, and quantifying the association between SDB and asthma among school-aged children in China. In addition, a comprehensive meta-analysis of the published evidences and our findings were further conducted.MethodsTo test the hypothesis, we conducted a multicentric cross-sectional study involving 22,478 children aged 5–12 years recruited from eight cities in China. Furthermore, a meta-analysis based on both previously published studies and our cross-sectional study was performed.ResultsThe prevalence rate of SDB and asthma was 12.0% and 3.5% among our cross-sectional study sample. It was demonstrated that symptoms of SDB, such as habitual snoring (OR = 1.28, 95%CI: 1.01-1.62), and obstructive sleep apnea (OSA) (OR = 1.92, 95%CI: 1.34-2.76), were significantly associated with asthma, after adjusting for potential confounding factors. In the meta-analysis, SDB was correlated with the prevalence of asthma in both children (OR = 1.58, 95%CI: 1.35-1.80) and adults (OR = 1.55, 95%CI: 1.42-1.67).ConclusionsOur results provide further evidence for the independent association between SDB and asthma. The clinical significance of our findings lies in the emphasis that children undergoing examination or treatment for asthma should be routinely screened for sleep problems. Further systematic study is required to illuminate the underlying mechanism.

The use of behavior change theory in Internet-based asthma self-management interventions: a systematic review.

BackgroundThe high prevalence rate of asthma represents a major societal burden. Advancements in information technology continue to affect the delivery of patient care in all areas of medicine. Internet-based solutions, social media, and mobile technology could address some of the problems associated with increasing asthma prevalence.ObjectiveThis review evaluates Internet-based asthma interventions that were published between 2004 and October 2014 with respect to the use of behavioral change theoretical frameworks, applied clinical guidelines, and assessment tools.MethodsThe search term (Asthma AND [Online or Internet or Mobile or Application or eHealth or App]) was applied to six bibliographic databases (Ovid MEDLINE, PubMed, BioMed Central, ProQuest Computing, Web of Knowledge, and ACM Digital Library) including only English-language articles published between 2004 and October 2014. In total, 3932 articles matched the priori search terms and were reviewed by the primary reviewer based on their titles, index terms, and abstracts. The matching articles were then screened by the primary reviewer for inclusion or exclusion based on their abstract, study type, and intervention objectives with respect to the full set of priori inclusion and exclusion criteria; 331 duplicates were identified and removed. A total of 85 articles were included for in-depth review and the remaining 3516 articles were excluded. The primary and secondary reviewer independently reviewed the complete content of the 85 included articles to identify the applied behavioral change theories, clinical guidelines, and assessment tools. Findings and any disagreement between reviewers were resolved by in-depth discussion and through a consolidation process for each of the included articles.ResultsThe reviewers identified 17 out of 85 interventions (20%) where at least one model, framework, and/or construct of a behavioral change theory were applied. The review identified six clinical guidelines that were applied across 30 of the 85 interventions (35%) as well as a total of 21 assessment tools that were applied across 32 of the 85 interventions (38%).ConclusionsThe findings of this literature review indicate that the majority of published Internet-based interventions do not use any documented behavioral change theory, clinical guidelines, and/or assessment tools to inform their design. Further, it was found that the application of clinical guidelines and assessment tools were more salient across the reviewed interventions. A consequence, as such, is that many Internet-based asthma interventions are designed in an ad hoc manner, without the use of any notable evidence-based theoretical frameworks, clinical guidelines, and/or assessment tools.

International prevalence rates of asthma and allergy are associated with income inequality

The global burden of asthma and allergic diseases is rising, and decades of research on causal pathways has had limited impact on the development of effective prevention strategies.1 It remains unclear what causes variations in prevalence rates between countries, and evidence on the role of poverty is mixed. Data from the World Health Survey show a U-shaped pattern, with the highest prevalence rates of asthma reported in low-income and high-income countries.2 The International Study for Asthma and Allergy in Childhood survey data show some positive associations between per capita gross national product and atopy, depending on the age group, world region, and health outcome studied.

Polycyclic aromatic hydrocarbons and childhood asthma.

Asthma is the most common chronic illness in children living in developed countries and the leading cause of childhood hospitalization and school absenteeism. Prevalence rates of asthma are increasing and show disparities across gender, geographic regions, and ethnic/racial groups. Common risk factors for developing childhood asthma include exposure to tobacco smoke, previous allergic reactions, a family history of asthma, allergic rhinitis or eczema, living in an urban environment, obesity and lack of physical exercise, severe lower respiratory tract infections, and male gender. Asthma exacerbation in children can be triggered by a variety of factors, including allergens (e.g., pollen, dust mites, and animal dander), viral and bacterial infections, exercise, and exposure to airway irritants. Recent studies have shown that exposure to polycyclic aromatic hydrocarbons (PAHs), a major component of fine particulate matter from combustion sources, is also associated with onset of asthma, and increasing asthmatic symptoms. In this paper, we review sources of childhood PAH exposure and the association between airborne PAH exposure and childhood asthma prevalence and exacerbation.

The prevalence of asthma and its related risk factors among the children in Taif area, Kingdom of Saudi Arabia

Background: The prevalence of asthma has increased considerably in the last few years. Aims: The aim of this study was to assess the prevalence of asthma and its related risk factors among children in Taif, Saudi Arabia. Materials and Methods: A cross-sectional prospective study was carried out. Pretested well-designed questionnaires were distributed during the period from May to October 2014. Results: Parents of 1700 children out of 4000 have completed the questionnaire with a response rate of 42.5%, 1082 (63.6%) of them were male. Asthma prevalence among girls (14.4%) was higher than boys (12.4%), but this was insignificant. Asthma prevalence was significantly higher among Saudi participants (14.4%) than non-Saudi (5.9%). Nature of residency, the presence of a plant or presence of pets at home had no significant effect on asthma prevalence. A smoking of family member and a history of asthma in the family had an important association on asthma prevalence rate. The highest prevalence of asthma (29.7%) was among the younger children ( Conclusion: The asthma prevalence rate among children was 13.1%, whereas smoking and a history of asthma in the family increased this rate. Future studies are recommended to investigate asthma prevalence based on clinical and laboratory diagnosis to explore the link between asthma and obesity.

Dampness Problem in Dwellings at Tianjin and its Association with Asthma and Allergy among Children

In China, the prevalence rates of asthma and allergies have been increasing in past 50 years. Several epidemiological investigations have indicated that dampness is associated with health effects such as respiratory infections, asthma and allergy. This study aims to find the associations between home dampness and asthma, rhinitis and eczema among children. A cross-sectional study on dampness and asthma and allergy at Tianjin was launched in 2013. Questionnaires were used to survey indoor dampness and health outcomes of occupants. 3.5% parents reported that they have noticed visible mildew/mold in child's rooms. The association between water leakage and asthma among children was seemingly strong (AOR: 3.29, 95% CI: 1.75-6.19). The dampness in home may have influence on asthma, rhinitis and eczema among children.

Genetic, familial and environmental correlates of asthma among early adolescents in Sri Lanka: a case control study

Background Despite advances in management, the mortality and morbidity due to asthma are increasing globally. Identification of specific correlates in the local context is useful in disease management. The objective of this study was to estimate the prevalence and to describe selected correlates of asthma among12-14 year old school children in a district in Sri Lanka.Method A school based cross-sectional study was conducted using a self administered questionnaire. Multi-staged stratified cluster sampling was used to select 42 classes in grades 7, 8 and 9. “Current asthma” (CA)(case) was defined as ‘having Physician Diagnosed Asthma (PDA) and having had wheezing during the previous 12 months’. For each case, two healthy controls were selected from the same class to assess correlates. Information on correlates was collected by trained field midwives during home visits. Backward stepwise logistic regression model was used for analysis of correlates. Skin Prick Testing was carried out among asthmatics together with their healthy siblings using standard extracts of House Dust Mite (HDM), cockroach and Blomia. Ethical clearance was obtained from Ethical Review Committee, Faculty of Medicine, Colombo.Results Out of 1483 subjects participated, 753 were females (50.8%). The prevalence rates for current wheezing (CW), ever wheezing (EW), current asthma (CA), and physician diagnosed asthma (PDA) were 16.7%, 19.4%, 10.7% and 14.5% respectively. A total of 158 CA cases were identified. Information on correlates of asthma was collected for 145 CA cases (97.9%) and for 285 controls (96.6%). The unconfounded predictors of having CA among adolescents in the present sample were; only child in the family (OR = 4.2, 95% CI: 1.7-9.9); first born of the family (OR = 2.6 95% CI: 1.3-5.2); presence of allergic rhinitis (OR = 2.7, 95% CI: 1.6-4.6); family history of asthma (OR = 1.8, 95% CI: 1.1-3.2); family history of allergic rhinitis (OR = 1.9, 95% CI: 1.1-3.2); family history of eczema (OR = 1.8, 95% CI: 1.0-3.2). Higher risk of sensitization to cockroach, HDM and Blomia was seen among asthmatics compared to healthy siblings.Conclusion A significant proportion of students reported to have asthma. Atopy and other genetic and environmental correlates should be considered as important correlates in asthma management among early adolescents in Sri Lanka.

An observational study of bronchial asthma in 6-12 years school going children of Agra District

Background: The present epidemiological study was planned and conducted to determine the prevalence of bronchial asthma in school going children of Agra, and to assess the precipitating factors in the causation of bronchial asthma mainly on the basis of the questionnaire and spirometry wherever possible. Methods: A total of 2175 school children in the age group 6-12 years from the two schools located in Agra were surveyed. These schools were selected on the basis of the surrounding environment and the socioeconomic status of their students. A detailed history was taken from students using a validated questionnaire. A total 153 cases of bronchial asthma were identified on the basis of the questionnaire. Out of which only 79 cases were subjected to spirometry. Spirometry could not be done in 74 students as their parents did not give consent. Results: The prevalence of bronchial asthma was found to be 7%. There were 61.4% male and 38.6% female patients having the disease. The study revealed that the upper classes had the largest number of students suffering from bronchial asthma. There is a higher prevalence of bronchial asthma in nonvegetarian children. Conclusion: This survey shows that the prevalence rates of bronchial asthma in school population (6-12 years) of Agra are almost similar to those seen in other parts of Northern India.

English

Asthma is one of the most common respiratory disorders. There have not been any studies assessing the prevalence rate for asthma based on spirometry in an adult population in the west of Iran. The aim of this study was to assess the prevalence of asthma in an adult population in Khorramabad, in the west of Iran. This prospective cross-sectional study was done on adult residents in Khorramabad between 2009 and 2010. The samples were selected by cluster and systematic sampling methods. The interviewers went to the selected homes and evaluated the samples by the standard questionnaire of the European Community Respiratory Health Survey. The individuals who were susceptible to asthma were evaluated using a hand-held spirometer (ZAN 100, Obertulba, Germany). Also, in the patients whose first spirometry had been normal, a more than 10% reduction in forced expiratory volume in one second (FEV1) after the exercise and more than 12% rise in FEV1 after the salbutamol spray inhalation was considered as having asthma. Finally, the data were summarized using means and percentages. Eight hundred and fifty-seven adults were evaluated by the questionnaire and 450 were referred to the pulmonologist office. The frequency of spirometry-diagnosed asthma in the adult residents of Khorramabad was 9.45%. The prevalence of asthma in Khorramabad in our study was more than in similar studies in Iran and other countries. Doing analytical studies on the prevalence of asthma and its risk factors is recommended.

Prevalence of bronchial asthma and respiratory symptoms in a group of students from grodno. An example of standardized epidemiological survey

Introduction: Due to an insufficient knowledge of the real asthma prevalence rate among children and adults in Belarus, we conducted a population-based respiratory health survey.Aim of the study: The study aimed at estimating the prevalence rate of asthma and major respiratory symptoms among students of the Grodno Region (Western Belarus).Material and methods: The cross-sectional study was conducted in 2014 and included 833 students aged 20-40 (young adults). Physician-diagnosed respiratory diseases and symptoms were ascertained using electronic version of the ISAAC questionnaire (web LimeSurvey).Results: The prevalence of asthma was 2.88% (physician-diagnosed). The obstructive (asthmatic) bronchitis (without established diagnosis of asthma) was found in 5.04% of the respondents. A chronic respiratory symptom occurring in the past 12 months and suggestive of asthma included attacks of dyspnea at rest, cough (5.88%) or in previous periods (8.88%), and wheezing in the chest (one of the most characteristic symptoms of asthma) - 8.04%, which may indicate a higher prevalence of asthma among patients. Wheezing and wheeze without diagnosed asthma, colds or infections were reported in a small number of cases (about 1.0%). 32 respondents (3.84%) can be attributed to the group of risk for asthma due to the presence of specific respiratory symptoms.Conclusions: The findings show a low prevalence of physician-diagnosed asthma among students of Western Belarus. Relatively low prevalence of allergic disorders among respondents of Belarus suggest underdiagnosis of allergic diseases, in particular of asthma. Presumably, cases of asthma might be diagnosed as spastic bronchitis, “obstructive bronchitis”, “asthmatic bronchitis”, a traditional label for clinical manifestation of asthma in medical practice in the region.

Geographic and racial variation in asthma prevalence and emergency department use among Medicaid-enrolled children in 14 southern states

Background: Despite evidence-based prevention and practice guidelines, asthma prevalence, treatment, and outcomes vary widely at individual and community levels. Asthma disproportionate/ly affects low-income and minority children, who comprise a large segment of the Medicaid population. Methods: 2007 Medicaid claims data from 14 southern states was mapped for 556 counties to describe the local area variation in 1-year asthma prevalence rates, emergency department (ED) visit rates, and racial disparity rate ratios. Results: One-year period prevalence of asthma ranged from 2.8% in Florida to 6.4% in Alabama, with a median prevalence rate of 4.1%. At the county level, the prevalence was higher for Black children and ranged from 1.03% in Manatee County, FL, to 21.0% in Hockley County, TX. Black–White rate ratios of prevalence ranged from 0.49 in LeFlore County, MS, to 3.87 in Flagler County, FL. Adjusted asthma ED visit rates ranged from 2.2 per 1000 children in Maryland to 16.5 in Alabama, with a median Black–White ED-visit rate ratio of 2.4. Rates were higher for Black children, ranging from 0.80 per 1000 in Wicomico County, MD, to 70 per 1000 in DeSoto County, FL. Rate ratios of ED visits ranged from 0.25 in Vernon Parish, LA, to 25.28 in Nelson County, KY. Conclusions and relevance: Low-income children with Medicaid coverage still experience substantial variation in asthma prevalence and outcomes from one community to another. The pattern of worse outcomes for Black children also varies widely across counties. Eliminating this variation could substantially improve overall outcomes and eliminate asthma disparities.

Prevalence of common allergies in children and adolescents in Germany: results of the KiGGS study: first follow-up (KiGGS Wave 1)

The first follow-up of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 1) was conducted from 2009 to 2012 as a combined cross-sectional and longitudinal study and provides, among other things, data on allergic diseases. Data collection was carried out by telephone interviews. In total, 6,093 girls and 6,275 boys were included, among them 4,455 newly recruited 0- to 6-year-olds (response 38.8%) and 7,913 KiGGS follow-up participants aged 7-17 years (response 72.9%). Based on parent reports, 15.6% (95% confidence interval 14.7-16.5) of children and adolescents aged 0-17 years were currently affected by at least one atopic disease. The 12-month prevalence rates of hay fever, atopic dermatitis, and asthma were 9.1% (8.4-9.8), 6.0% (5.4-6.6), and 4.1% (3.6-4.6), respectively. In all, 2.2% (1.9-2.6) of the children and adolescents were currently suffering from contact dermatitis. Compared with the baseline KiGGS survey from 2003 to 2006, a higher percentage of participants reported the occurrence of asthma within the past 12 months in the recent KiGGS Wave 1 (4.1 vs. 3.2%; p = 0.0034). The total increase is mainly due to higher prevalence rates among 0- to 6-year-olds, especially in girls. Higher 12-month prevalence rates can be also observed for hay fever among 0- to 6-year-olds, especially in girls, although the total increase is not statistically significant (9.1 vs. 8.3%; p = 0.08). There was a declining trend for atopic dermatitis: 6.8% (2003-2006) vs. 5.4% (2009-2012); p = 0.0015.

Asthma prevalence, knowledge, and perceptions among secondary school pupils in rural and urban coastal districts in Tanzania.

BackgroundAsthma is a common chronic disease of childhood that is associated with significant morbidity and mortality. We aimed to estimate the prevalence of asthma among secondary school pupils in urban and rural areas of coast districts of Tanzania. The study also aimed to describe pupils’ perception towards asthma, and to assess their knowledge on symptoms, triggers, and treatment of asthma.MethodsA total of 610 pupils from Ilala district and 619 pupils from Bagamoyo district formed the urban and rural groups, respectively. Using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, a history of “diagnosed” asthma or the presence of a wheeze in the previous 12 months was obtained from all the studied pupils, along with documentation of their perceptions regarding asthma. Pupils without asthma or wheeze in the prior 12 months were subsequently selected and underwent a free running exercise testing. A ≥ 20% decrease in the post-exercise Peak Expiratory Flow Rate (PEFR) values was the criterion for diagnosing exercise-induced asthma.ResultsThe mean age of participants was 16.8 (±1.8) years. The prevalence of wheeze in the past 12 months was 12.1% in Bagamoyo district and 23.1% in Ilala district (p < 0.001). Self-reported asthma was found in 17.6% and 6.4% of pupils in Ilala and Bagamoyo districts, respectively (p < 0.001). The prevalence of exercise-induced asthma was 2.4% in Bagamoyo, and 26.3% in Ilala (P < 0.002). In both districts, most information on asthma came from parents, and there was variation in symptoms and triggers of asthma reported by the pupils. Non-asthmatic pupils feared sleeping, playing, and eating with their asthmatic peers.ConclusionThe prevalence rates of self-reported asthma, wheezing in the past 12 months, and exercise-induced asthma were significantly higher among urban than rural pupils. Although bronchial asthma is a common disease, pupils’ perceptions about asthma were associated with fear of contact with their asthmatic peers in both rural and urban schools.

Effect of a home intervention program on pediatric asthma in an environmental justice community.

Asthma prevalence rates are at an all-time high in the United States with over 25 million persons diagnosed with asthma. African Americans and other minorities have higher asthma prevalence and higher exposure to environmental factors that worsen asthma as compared to Caucasians. This article describes the evaluation of an inner-city home-based asthma education and environmental remediation program that addressed both indoor and outdoor triggers through collaboration between a health system and local environmental justice organization. The program enrolled 132 children older than 2.5 years and centers on a 4- to 6-week intervention with peer counselors using the U.S. Environmental Protection Agency Asthma Home Environment Checklist and the You Can Control Asthma curriculum. Families receive asthma-friendly environmental home kits. Peer counselors reinforce key asthma management messages and facilitate the completion of Asthma Action Plans. The environmental justice community partner organized block cleanups to reduce outdoor triggers. The evaluation used a pretest-posttest design to assess changes in client behavior and asthma symptoms. Data were collected at baseline and during a 6-month postintervention period. Participants saw enhanced conditions on asthma severity and control. The improvement was greatest for children whose asthma was considered "severe" based on the validated Asthma Control Test. Other positive results include the following: greater completion of Asthma Action Plans, significant reduction in the number of emergency room visits (p = .006), and substantial decreases in school absenteeism (p = .008) and use of rescue medications (p = .049). The evaluation suggests that the program was effective in improving asthma self-management in a high-risk population living within an environmental justice community.

Epidemiological investigation and risk factor analysis of childhood asthma in Dongguan area

Objective To investigate the prevalence rate of asthma and explore the risk factors of asthma in children of Dongguan, and to provide epidemiological evidence for prevention and treatment of childhood asthma. Methods A cluster random sampling survey of 8 680 children aged 0 to 14 years from Dongguan was conducted to finish the standardized screening questionnaire for diagnosis of suspicious objects.Asthmatic patients and suspect cases were screened out for further examination.Case-control study and Logistic regression analysis were performed to analyze the association of asthma and risk factors. Results The total prevalence rate of asthma in children aged 0 to 14 from Dongguan was 3.27%, while prevalence ratio between male and female was 1.43︰1.00.Among asthmatic children, those aged 0 to 3 years and aged 6 to 11 years had the highest prevalence rates with 4.57% and 3.96%, respectively.Of the 284 cases, 141(49.6%) had their first asthma attack before the age of 3 years, 110(38.86%) suffered from asthma during periods of seasonal change, while 109(38.45%) had attacks with no obvious regularity of time, and 264(62.96%) suffered from asthma caused by respiratory tract infection.The case-control study and Logistic regression analysis of the 284 asthma cases and 284 healthy children showed that independent risk factors for asthma in children were as follows: family history of allergy(OR=0.586, 95%CI: 0.353-0.927), history of food allergies(OR=0.508, 95%CI: 0.306-0.843), eczema(OR=0.302, 95%CI: 0.163-0.561), urticarial(OR=0.292, 95%CI: 0.141-0.607), use of antibiotics during infants and young children periods(OR=0.377, 95%CI: 0.169-0.841), and the differences were all statistically significant(all P<0.001). Conclusions The total prevalence rate of asthma in children aged 0 to 14 from Dongguan was 3.27%, which was higher than the national level.Increasing children's resistance and preventing respiratory infection actively is an important way for the prevention and cure of asthma. Key words: Asthma; Epidemiological investigation; Risk factor; Child