Preschool Children In Shanghai Research Articles

Epidemiological characterization and risk factors of rhinitis and rhinoconjunctivitis among preschool children in Shanghai, China

BackgroundPrevious studies have reported an increasing prevalence of childhood allergic rhinitis in developing countries. There is still a lack of the recent epidemiology of allergic rhinitis among Chinese preschool children. Therefore, this study explored the prevalence of rhinitis symptoms and identified their associations with potential risk factors among children at the age of 3–6 in Shanghai, China. MethodsValidated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was adopted to collect information about rhinitis symptoms and potential risk factors. Univariate and multivariate logistic regression analyses were used to assess associations between risk factors and allergic rhinitis and rhinoconjunctivitis. ResultsA total of 6183 questionnaires were included in our study. The prevalence of rhinitis ever, current rhinitis, and physician-diagnosed rhinitis were 32.6%, 29.2%, and 14.3%, respectively, while the prevalence of current rhinoconjunctivitis was 11.3%. The higher prevalence was observed in boys than in girls in terms of rhinitis ever, current rhinitis, current rhinoconjunctivitis and doctor-diagnosed rhinitis. Autumn had the highest prevalence among four seasons. In our multivariate logistic regression analyses, history of allergic diseases and paracetamol use in the last year showed positive associations with the increased risk of both current rhinitis and rhinoconjunctivitis, and antibiotic use was an independent significant risk factor only for current rhinitis. Genetic factors, including maternal and paternal rhinitis, asthma, and eczema, were significantly associated with the prevalence of current rhinitis. Similar associations were seen between these factors and current rhinoconjunctivitis, except for paternal eczema. Among environmental factors, smoking exposure at home, heavy truck traffic in home's street, floor heating system were independent risk factors for both current rhinitis and rhinoconjunctivitis in the adjusted model, while cleaning the house less than once a week was only associated with current rhinitis. ConclusionThe prevalence of current rhinitis was 29.2% among children aged 3–6 in Shanghai, China. Sex differences and seasonal variations were observed in the prevalence of rhinitis symptoms. The identified risk factors would provide a basis for policy makers and medical experts to take intervention measures to prevent allergic rhinitis and rhinoconjunctivitis.

Effects of 12-week aerobic exercise with different frequencies on executive function in preschool children: a cluster randomized controlled trial

Objective To explore the effects of a 12-week aerobic exercise program with different frequencies on executive functions (EFs) in preschool children. Method Four kindergartens, comprising 126 preschool children in Shanghai, were enrolled in this 12-week cluster randomized controlled trial with a 12-week follow-up period. Kindergartens were allocated to high-frequency (three times a week) or low-frequency (once a week) exercise groups using stratified block randomization. Three core sub-EFs, including inhibition, working memory, and cognitive flexibility, were assessed at baseline, post-intervention, and the 12-week follow-up. Results Compared to baseline, both groups showed significant improvements in inhibition and working memory after the intervention and at the 12-week follow-up. However, only the high-frequency exercise group demonstrated a significant improvement in cognitive flexibility after the follow-up period. Nonetheless, there were no significant differences in the core sub-functions of EFs between the two groups at the end of the intervention or the follow-up periods. Conclusion A 12-week aerobic exercise of three times a week was insufficient to significantly improve EFs in preschool children compared to once a week. Future studies are needed to examine the dose-response relationship of aerobic exercise on EFs and to verify the effects of different exercise modalities on EFs in preschool children.

Iodine status and associated dietary factors among preschool children in Shanghai.

Children aged 3-6 years undergo a critical stage of growth and development and are irreversibly affected by their iodine status. In order to reveal iodine status in preschool children, we detected iodine concentrations in urine samples from 1382 children aged 3-6 years based on a cross-sectional study. The median urinary iodine concentration (UIC) of children was 193.36 μg/L and was 336.96 μg/g·Cr corrected for creatinine. The study developed a link between dietary habits and iodine status, revealing that regular calcium supplement (OR: 1.79, (95% CI: 1.03, 3.12)) increased deficiency risk, while moderate seafood consumption (OR: 0.60, (95% CI: 0.38, 0.95)) decreased it. Additionally, modest intake of shellfish (OR: 0.58, (95% CI: 0.33, 1.00)), vegetables (OR: 0.61, (95% CI: 0.38, 0.97)), and eggs (OR: 0.53, (95% CI: 0.30, 0.95)) was found to protect against excess iodine. The findings underline the importance of balanced diets and various nutrients' roles in preschoolers' iodine status.

Determinants affecting the blood mercury levels of preschool children in Shanghai, China: A cross-sectional study.

Infants and children are vulnerable to mercury (Hg)-induced toxicity, which has detrimental effects on their neurological development. This study measured blood Hg levels (BMLs) and identified potential factors influencing BMLs, including demographic and socioeconomic factors, lifestyle, and daily dietary habits, among 0 to 7-year-old children in Shanghai. Our study recruited 1474 participants, comprising 784 boys and 690 girls. Basic demographic and lifestyle information were obtained and blood Hg were analyzed using the Direct Mercury Analyzer 80. The blood Hg concentrations of children in Shanghai ranged from 0.01 to 17.20 μg/L, with a median concentration of 1.34 μg/L. Older age, higher familial socioeconomic status, higher residential floors, and a higher frequency of consuming aquatic products, rice, vegetables, and formula milk were identified as risk factors. Other potential influencing factors including the mother's reproductive history (gravidity and parity), smoking (passive smoking), supplementation of fish oil and calcium need to be further investigated. These findings can be useful in establishing appropriate interventions to prevent children's high blood Hg concentrations in Shanghai and other similar metropolitan cities.

Improved ambient air quality is associated with decreased prevalence of childhood asthma and infancy shortly after weaning is a sensitive exposure window.

The urban ambient air quality has been largely improved in the past decade. It is unknown whether childhood asthma prevalence is still increasing in ever top-ranking city of Shanghai, whether the improved air quality is beneficial for children's asthma and what time window of exposure plays critical roles. Using a repeat cross-sectional design, we analyzed the association between early life exposure to particles and wheezing/asthma in each individual and combined surveys in 2011 and 2019, respectively, in 11,825 preschool children in Shanghai. A significantly lower prevalence of doctor-diagnosed asthma (DDA) (6.6% vs. 10.5%, p < 0.001) and wheezing (10.5% vs. 23.2%, p < 0.001) was observed in 2019 compared to 2011. Exposure to fine particulate matter (PM2.5), coarse particles (PM2.5-10) and inhalable particles (PM10) was decreased in 2019 by 6.3%, 35.4%, and 44.7% in uterus and 24.3%, 20.2%, and 31.8% in infancy, respectively. Multilevel log-binomial regression analysis showed exposure in infancy had independent association with wheezing/DDA adjusting for exposure in uterus. For each interquartile range (IQR) increase of infancy PM2.5, PM2.5-10 and PM10 exposure, the odds ratios were 1.39 (95% confidence interval (CI): 1.24-1.56), 1.51 (95% CI:1.15-1.98) and 1.53 (95% CI:1.27-1.85) for DDA, respectively. The distributed lag non-linear model showed the sensitive exposure window (SEW) was 5.5-11 months after birth. Stratified analysis showed the SEWs were at or shortly after weaning, but only in those with <6 months of exclusive breastfeeding. Improved ambient PM benefits in decreasing childhood asthma prevalence. We firstly reported the finding of SEW to PM at or closely after weaning on childhood asthma.

The Impact of Learning English on Chinese Pre-schoolers’ Identity Aspirations

The promotion of the English language continues to be instrumental in helping China to engage with the world, but it has caused identity anxiety and cultural uncertainty among language learners. In this paper, we analyze data from a favorite-character-presentation task and an oral survey conducted with 82 preschool children in Shanghai. We found that Chinese remains the most important language for the participants in expressing their transcultural identity aspirations, but the influences of English can be observed in their language practice when presenting their favorite characters. These findings suggest that the participants’ identity aspirations can be understood in the context of their translanguaging practices, which unfold in their use of linguistic and pictorial resources. The paper concludes with a discussion of how language educators and policymakers should consider children’s exposure to informal language learning beyond the classroom in teaching.

Mental health problems of preschool children during the COVID-19 home quarantine: A cross-sectional study in Shanghai, China.

As the coronavirus disease 2019 (COVID-19) pandemic spread across Shanghai, China, in late February 2022 and protective measures to mitigate its impact were enacted, this study aimed to estimate how home quarantine affected the mental health of preschool children in Shanghai, China and explore the association between lifestyle factors and mental health during this special period. A cross-sectional online survey of 2,110 preschool students from Shanghai, China, was conducted during May 20-25,2022. Preschooler' mental health (Strengths and Difficulties Questionnaire, SDQ) and daily activities were reported by parents. The sample involved 2,110 children with a mean age of 4.65 years [standard deviation (SD): 0.91, range: 3-6 years]. Boys and children whose mother's education level were college and high school had higher rate of mental health problems. Boys had significantly higher rates of peer problems and prosocial behaviors than girls. The 3-year-old group had significantly higher rates of prosocial behaviors than other groups. As compared to the Shanghai norm and the SDQ results of preschool children in Shanghai in 2019 (SH2019), there were a significant decrease in emotional symptoms score, as well as a significant increase in conduct problems score. Additionally, peer problems score significantly increased compared to SH2019. Decreased time spent on daily sleep was associated with the increased risk for preschoolers' mental health problems. There was an increase in the frequency of emotional and behavioral problems, especially regarding conduct problems and peer problems, in preschool children during the COVID-19 home quarantine in Shanghai, China. Boys, younger preschool children and children whose mother's education level were college and high school may be especially vulnerable to emotional and behavioral problems. It was also found that decreased time spent on sleep may aggravate preschool children's mental health problems. It may be beneficial to differentiate and focus on conducting psychoeducation and implementing psycho-behavioral interventions to solve these issues.

Prevalence and Risk Factors of Asthma in Preschool Children in Shanghai, China: A Cross-Sectional Study.

BackgroundPrevious studies have shown the increasing prevalence of childhood asthma around the world as well as in China. Nevertheless, little is known about the epidemiology of asthma in preschool children. Thus, the present study investigated the prevalence and severity of asthma in Shanghai, China, and identified related risk factors for asthma in children at the age of 3–6.MethodsInformation was obtained through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Risk factor analysis was carried out using univariate and multivariate logistic regression. The odds ratio (OR)/adjusted odds ratio (aOR) and the 95% confidence interval (CI) were determined.ResultsA total of 6,183 children (3,165 boys and 3,018 girls) covering 12 communities were included in our study, with an average age of 4.2 ± 0.7 years. The prevalence of ever asthma, current asthma, and physician-diagnosed asthma was 16.0, 11.2, and 5.3%, respectively. Parental allergic history, including rhinitis and asthma, was significantly associated with asthma symptoms. The strongest association with current asthma was paternal asthma (aOR = 5.91, 95% CI 3.87–9.01), and maternal asthma had the second strongest association with current asthma (3.85; 2.40–6.17). Among personal factors, allergic rhinitis history, eczema history, food allergy history, and antibiotic use in the first year of life were significantly associated with current asthma (aOR = 1.89, 95% CI 1.52–2.34; aOR = 1.34, 95% CI 1.09–1.64; aOR = 1.68, 95% CI 1.37–2.06; aOR = 1.53, 95% CI 1.25–1.87, respectively). More than once paracetamol use per year and per month were associated with current asthma in a dose–response manner. Additionally, female sex was an independent protective factor for ever asthma (0.82; 0.70–0.96). Among environmental factors, dampness or mildew at home was an independent risk factor for ever asthma (1.50; 1.15–1.97) and current asthma (1.63; 1.21–2.19). Floor heating system was significantly associated with ever asthma (1.57; 1.25–1.98) and current asthma (1.36; 1.04–1.78). Furthermore, dampness or mildew, infrequent house cleaning, and truck traffic in residential streets were significantly associated with asthma symptoms only in old communities, while paracetamol use in the first year of life and flooring materials were significant factors only in new communities.ConclusionThe prevalence of asthma has increased among preschool children in Shanghai over the past three decades. The identified risk factors indicated the combined effects of genetic, personal, and environmental factors on asthma symptoms. Differentiated strategies should be taken for preventing asthma in old and new communities.

Thermal comfort in residences related to respiratory diseases among preschool children in Shanghai

ObjectiveThis study aimed to explore the thermal comfort situation in children's bedrooms and its association with the prevalence of respiratory diseases among children. MethodOn basis of field measurements in 454 families conducted by CCHH (China, Children, Home, Health) study group in Shanghai during 2013–2014, 167 samples inspected in transition season were selected to study the thermal sensation and thermal comfort of children in residential environments. Pearson χ2 test and multiple logistic regression were employed to examine the thermal comfort and respiratory diseases among children. ResultsIn the transition season, 24% of the residents had the predicted percentage of dissatisfied (PPD) higher than 40%. The prevalence of children with asthma, dry cough, and pneumonia were 37.7%, 31.1%, and 31.7%, respectively, where boys had a higher prevalence than girls. Children's thermal discomfort (indicators: PMV, PPD, SET) had a dose–response relationship with respiratory diseases. Compared with the neutral thermal environment (PMV[-1, 0, +1]), cold environment (PMV [-3, −2]) was associated with a higher risk of asthma, dry cough and pneumonia in children for odds ratio (95%CI, P < 0.05) of 1.19 (1.07–1.32), 1.15 (1.03–1.29) and 1.89 (1.16–3.09) respectively. After adjusting for confounders, the significant associations were also found between children in cold environment and asthma, dry cough and pneumonia (AOR is 1.34, 1.11, 1.23, P < 0.05). ConclusionsIn transition season, the thermal conditions in children's bedrooms in Shanghai were worse than expected, where PMV presented as cool to cold and high PPD. The risk of asthma and pneumonia increased significantly with the thermal discomfort and showing the sensitivity to “gender” and “weight” of children. The dose–response relationship suggested paying more attention to thermal comfort and adverse health outcomes caused by relative cold environment in transition season.

Measuring early childhood development with The Early Human Capability Index (eHCI): a reliability and validity study in China

BackgroundWith the importance of early childhood development more recognized by the international society, low-cost and cross-culturally comparable measures of early childhood development is in great demand, both in China and worldwide. In this study, we aim to test the psychometrics of the Chinese version of The Early Human Capability Index (eHCI), which is designed as a measurement for school readiness in large population.MethodsWe evaluated the internal consistency, test-retest reliability, inter-rater reliability, factor structure, criterion-related validity, and discriminant validity of the eHCI in 20,324 preschool children in Shanghai. We also compared eHCI scores with test result of ASQ in 815 children in Yexian and EAP-ECDS in 6947 children in Daming.ResultsThe ICC between parents and teachers were 0.83 and 0.63 for Literacy Numeracy and Overall Development. The confirmatory factor analyses showed good model fit (χ2 = 509,323, p < 0.001; CFI = 0.901; RMSEA = 0.038). The correlations between the scores of eHCI and other ECD metrics ranged between r = − 0.42 and r = 0.53. The scale discriminated between children’s developmental level based on sex, parental education, family income, family assets, and nutrition status.ConclusionsResults from Chinese population suggested that eHCI is valid and reliable for measuring early childhood development in children aged 3–6 years. The eHCI can be applied to map the global distribution of early childhood development for allocating scarce resources to help those in greatest demand. Longitudinal studies are warranted to test its predictive validity for later outcomes.

Are preschool children active enough in Shanghai: an accelerometer-based cross-sectional study

ObjectiveEngaging in physical activity (PA) plays an important role in promoting physical and mental health, but the PA data for Chinese preschool children are lacking. This study aims to objectively...

PIH7 - A Cost-Benefit Analysis of A Kindergarten-Based Fluoride Varnish Program Among 3-Year Old Children: Some Preliminary Results

We aimed to evaluate the cost-effectiveness of a kindergarten-based fluoride varnish (FV) program for caries prevention among 3-year old children. The program was part of a larger public health project from 2015-2017 to improve oral health of pre-school children in Shanghai, China. Specifically, from January 2016, FV (50 mg/ml Sodium Fluoride, Duraphat, Colgate-Palmolive, USA) was applied every 6 months to all primary teeth of every 3-year old child (with parental/guardian’s consent) in all public kindergartens in Shanghai. A cost-benefit analysis was conducted from the perspective of the municipal healthcare system to compare with a historic cohort before the program launched. The effectiveness outcomes (proportion of children having caries, mean number of decayed, missing, or filled teeth surfaces (dmfs)) were measured at end of 2017 as part of a routine yearly dental screening from a representative sample of all 5-year old children attending public kindergartens in Shanghai. The mean cumulative cost of the program over the 3-year implementation was calculated for one FV application. Cost-benefit ratio (CBR) was estimated by using treatment cost per carious surface for monetary valuation of effectiveness. The prevalence of caries among 5-year old children in Shanghai was 62.82% in 2017, 2.36 percent points lower than that in 2015. The mean dmfs was 2.64 in 2017 vs 3.14 in 2015. Incremental cost-effectiveness ratios (ICERs) were CNY 2833 per child remaining caries free, and CNY 134 per carious surface avoided. Given that the mean treatment cost was estimated at CNY 127 per carious surface, the CBR was 0.95. The sensitivity analysis indicated that CBR would reach 1.0 if the mean dmfs was improved to 2.61, or the cost per FV application was cut by 5%. With a high CBR, the program seemed to be value for money. Further analysis was warranted to evaluate uncertainties.

Excessive Screen Time and Psychosocial Well-Being: The Mediating Role of Body Mass Index, Sleep Duration, and Parent-Child Interaction

To examine the relationship between excessive screen time and psychosocial well-being in preschool children, and the potential mediating role of body mass index, sleep duration, and parent-child interaction. A cross-sectional survey was conducted in Shanghai, China using stratified random sampling design. A representative sample of 20 324 children aged 3-4 years old from 191 kindergartens participated in this study. Parents completed the Strengths and Difficulties Questionnaire and reported the child's time spent on screen exposure, sleep duration, height, weight, and parent-child interactive activities. Preschool children in Shanghai were exposed to 2.8 (95% CI 2.7, 2.9) hours/day of screen time, with 78.6% (95% CI 77.8,79.3) exceeding 1 hour/day and 53% (95% CI 52.0,53.9) exceeding 2 hours/day. Every additional hour of screen time was associated with increased risk for poor psychosocial well-being. Body mass index, sleep duration, and parent-child interaction mediated the effect of excessive screen time on children's psychosocial well-being, among which parent-child interaction contributed most. Parent-child interaction could explain 28.1% of the effect on total difficulties and 58.6% on prosocial behavior. Excessive screen time during early childhood exists in Shanghai preschool children. Excessive screen exposure was associated with poor psychosocial well-being in preschool children via a number of mediators, mostly by reducing parent-child interaction.

Refraction and Ocular Biometry of Preschool Children in Shanghai, China.

Purpose To investigate the refraction and ocular biometry characteristics and to examine the prevalence of refractive errors in preschool children aged 3 to 6 years in Shanghai, China. Methods A school-based cross-sectional study was conducted in Jiading and Xuhui District, Shanghai, in 2013. We randomly selected 7 kindergartens in Jiading District and 10 kindergartens in Xuhui District, with a probability proportionate to size. The children underwent comprehensive eye examinations, including cycloplegic refraction and biometric measurements. Myopia, hyperopia, astigmatism were defined as spherical equivalent (SE) ≤ −0.50 D, SE ≥ +2.00 D, and cylindrical diopters ≤ −1.00 D. Results The mean SE for 3- to 6-year-old children was +1.20 D (standard deviation [SD] 1.05), and the mean axial length (AL) was 22.29 mm (SD 0.73). The overall prevalence of myopia and astigmatism was 3.7% and 18.3%, respectively. No difference in prevalence of astigmatism was found across age groups. There was a statistically significant association between lower cylindrical diopters and higher spherical diopters (Spearman's correlation: −0.21, P < 0.001). Conclusion Chinese children aged 3 to 6 years in the Shanghai area were mostly mildly hyperopic, with a low prevalence of myopia. Refractive astigmatism for children may be relatively stable throughout the preschool stage. Astigmatism was significantly associated with refractive error.

Home dampness-related exposures increase the risk of common colds among preschool children in Shanghai, China: Modified by household ventilation

Few studies have estimated the effects of dampness-related exposures and its interaction effects with poor household ventilation on common colds of preschool children. During April 2011–April 2012, we conducted a cross-sectional survey on home environment and childhood health and collected 13,335 parents-reported questionnaires of 4–6 year-old children in Shanghai, China. In this paper, we investigated associations between the incidence and duration of common colds among these children during the past 12 months before the survey and frequency of opening windows, as well as household dampness-related exposures (indicated by six dampness indicators). Significantly higher incidence (≥3 times) and longer duration (≥2 weeks) of common cold were found among children with than without these dampness exposures (p-value <0.01 for mold spots and p-value <0.001 for all other indicators). The number of dampness-related indicators had a positive and strong dose-response relationship with common colds (p-trend <0.01). Low frequency of ventilation was also a risk factor for children common colds. After adjusted for the potential confounders in the multiple logistic regression analyses, all dampness-related indicators were significantly associated with the increased odds of common colds and the highest odds ratios was 1.21 (95% CI: 1.16–1.27). We also found that dampness-related exposures and household ventilation habits (p-value for interaction <0.001) had a strong interaction effect on the incidence and duration of common cold. The stratified analysis of ventilation condition displays that the influence of dampness-related exposures has been modified by ventilation. Therefore, good household ventilation habits may have an effect of modification for dampness-related exposures.

Prevalence of Malocclusion in 3- to 5-Year-Old Children in Shanghai, China.

The aim of the present study was to obtain the prevalence of malocclusions in preschool children in Shanghai, China. A cross-sectional survey was conducted among 2335 children aged 3–5 years from kindergartens. Several occlusal parameters were clinically assessed, including second deciduous molar terminal plane, canine relationship, degree of overjet and overbite, anterior and posterior crossbite, and the presence or absence of physiologic spaces and crowding. All parents of subjects were asked to fill in the oral health knowledge questionnaires. The prevalence of malocclusion in primary dentition in Shanghai was 83.9%, and no significant differences were found in genders. Data showed that the prevalence of deep overbite (63.7%) was the highest in children with malocclusion, followed by deep overjet (33.9%), midline deviation (26.6%), anterior crossbite (8.0%) and anterior crowding (6.5%). The results revealed a high prevalence of malocclusion in primary dentition in children aged 3–5 years old of Shanghai, especially in vertical anomalies. The need for preventive orthodontic therapy is extremely desired and oral health education about malocclusion should be strengthened.

Residential Risk Factors for Atopic Dermatitis in 3- to 6-Year Old Children: A Cross-Sectional Study in Shanghai, China

Background: Atopic dermatitis (AD) is common among pre-school children in Shanghai. This study aimed to identify the risk factors for childhood AD from the perspectives of home environment, demographics and parents-grandparents’ atopic disease. Methods: A cross-sectional study was conducted in Shanghai in April–June, 2010. Preschool children’s parents or guardians were invited to participate a questionnaire survey in six districts (two urban and four suburban/rural) and 6624 children were finally recruited (51.3% boys). AD diagnosis was based on the U.K. Working Party’s (UKWP) criteria. Adjusted odds ratios (AOR) with 95% confidence intervals (95% CI) were calculated by multiple logistic regression. Results: A total of 8.5% of children ever had AD. Around 10.2% of the mothers had lived in newly renovated/decorated homes (NRDH) during the prenatal period (one year before or during pregnancy) and 9.5% got new home furniture (NHF) during the same period. AD was more common in children when mothers had lived in NRDH homes during the prenatal period (AOR = 1.41; 95% CI 1.03–1.93), the current home had indoor mold (2.00, 1.48–2.70), parents-grandparents’ had atopic diseases (3.85, 3.05–4.87), the children had food allergy (3.40, 2.63–4.40) or children lived in urban area (1.52, 1.18–1.96). Associations between AD and NRDH, NHF and indoor molds were only significant in children without parents-grandparents’ atopic diseases. There was an interaction effect between parents-grandparents’ atopic diseases and NRDH (p < 0.05). Conclusions: Home renovation/ redecoration, new furniture and indoor mold, urban residency, heredity disposition and food allergy can be risk factors for childhood AD in Shanghai.

Associations between home dampness-related exposures and childhood eczema among 13,335 preschool children in Shanghai, China: A cross-sectional study

From April 2011 to April 2012, we conducted a cross-sectional study in Shanghai, China. A total of 13,335 modified ISAAC questionnaires (response rate: 85.3%) were returned by parents or guardians for 4–6 year-old children. Six dampness-related indicators (visible mold spots, visible damp stains, damp bed clothing, water damage, window pane condensation, and moldy odor) were used to evaluate home dampness-related exposures. In the present study, we applied logistic regression model to reveal associations, dose–response relationships, and statistical interaction effects of these dampness-related exposures, with childhood eczema, during lifetime since birth (ever) and in the last 12 months before the questionnaire. The dampness-related indicators were frequently reported in the perinatal and current residences. Prevalences of eczema ever and in the last 12 months were 22.9% and 13.2%, respectively. The dampness-related indicators were robustly associated and dose–response related with increased risk of eczema ever and in the last 12 months in the logistic regression analyses, with adjusted for potential confounders. Specifically, in the perinatal residence, visible mold spots or damp stains could increase 46% (OR, 95% CI: 1.46, 1.29–1.66) odds of childhood eczema (ever); in the current residence, visible mold spots and visible damp stains could increase 34% (1.34, 1.14–1.58) and 38% (1.38, 1.22–1.56) odds of childhood eczema (ever), respectively. Associations were not appreciably different between boys and girls, nor were they different between children with and without parental history of atopy. In conclusion, perinatal and current dampness-related exposures in the residence perhaps are risk factors for childhood eczema.

Epidemiological investigation on autism spectrum disorders among preschool children in Shanghai

To investigate the prevalence of autism spectrum disorders (ASD) of children aged 4-6 years in public kindergartens in Shanghai. Songjiang district and Xuhui district were selected randomly as the representative sample. By means of "Clancy Autism Behavior Scale", "Social Communication Questionnaire" and "high-functioning Autism Spectrum Screening Questionnaire", all of the 33 public kindergartens in chosen area, which contained 10 385 children aged 4-6 years, were surveyed. Those who were screened as suspected cases would be further diagnosed by "Autism Diagnostic Interview-Revised" and "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition". Among 9 665 valid questionnaires, 9 children were diagnosed with ASD. The ratio of male to female was 8:1, the point prevalence rate was 0.93‰. The results of ADI-R corresponded with that of DSM-5. There were two children who never had medical records. For others, "language" problem was the most likely reason for their parents to seek medical help, while "deficits in social communication" was the main symptom of patients. The prevalence of ASD was lower than those recorded in literature, home and abroad which might be related to some patients not going to public kindergartens.

Updated prevalences of asthma, allergy, and airway symptoms, and a systematic review of trends over time for childhood asthma in Shanghai, China.

BackgroundThe prevalence of asthma among Shanghai children has increased over time. This increase might be associated with changes in environmental exposures. Investigation of the time-trend of asthma and current prevalences is essential to understanding the causes.ObjectiveTo estimate the current prevalences of asthma, allergies and other respiratory symptoms among Shanghai preschool children, and to investigate the time-trend of childhood asthma prevalence of from 1990 to 2011.MethodsFrom April 2011 to April 2012, the CCHH (China, Children, Homes, Health) cross-sectional study was conducted in Shanghai. Questionnaires were distributed to 17,898 parents or guardians of preschool children from 72 kindergartens in 5 districts. Previous similar studies were also summarized by a systematic literature review.ResultsFrom a total of 14,884 questionnaires for 3–7 year old children, prevalences of the following diseases and symptoms were calculated: asthma 10.2%, wheeze (ever) 28.1%, pneumonia (ever) 33.5%, otitis media 11.0%, rhinitis (ever) 54.1%, hay fever 12.2%, eczema (ever) 22.7%, and food allergy 15.7%. Urban children had higher prevalences of most symptoms than suburban children. The prevalence of asthma has increased significantly, almost five-fold, from 2.1% in 1990 to 10.2% in the present study. The prevalence of asthma in boys was higher than in girls in the present study and in all reviewed studies.ConclusionsAsthma, allergy and airway symptoms are common among preschool children in Shanghai. The prevalence of childhood asthma in Shanghai has increased rapidly from 1990 to 2011.