Pokharel P K, Kabra S K, Kapoor S K, Pandey R M
Department of Community Medicine, BP Koirala Institute of Health Sciences Dharan, Nepal.
Indian J Pediatr. 2001 Feb;68(2):103-6. doi: 10.1007/BF02722022.
Bronchial asthma is one of the most common illnesses in children. Factors influencing development of asthma have not been studied in rural population. 2000 school going children from five schools of Chhainsa and Dayalpur Primary Health Centre area in Ballabgarh Block of Haryana state were screened for presence of symptoms of asthma using a questionnaire suggested by International Study of Asthma and Allergy in Children (ISSAC). 40 children were identified as cases of bronchial asthma. For each child with asthma two age and sex matched non-asthmatic controls were selected from the study population. History, clinical examination and in-depth interview were carried out for all cases and controls. Factors associated with presence of symptoms of asthma on multivariate analysis were passive smoking (OR 3.33, 95% CI 1.85-7.65), pets at home (OR 5.5, 95% CI 1.04-29.15), and absence of windows in living rooms (OR 4.03, 95% CI 1.17-13.79). Factors such as family history of asthma, history of worm infestation, fuel used for cooking, location of kitchen and food allergy were not significant on statistical analysis. Thus, passive smoking, inadequate ventilation and pets (dogs and cats) at home are significant risk factors associated with presence of symptoms of asthma in rural children.
支气管哮喘是儿童中最常见的疾病之一。尚未对农村人口中影响哮喘发病的因素进行研究。使用国际儿童哮喘和过敏研究(ISSAC)建议的问卷,对哈里亚纳邦巴拉布加尔区Chhainsa和Dayalpur初级卫生中心地区五所学校的2000名学童进行了哮喘症状筛查。40名儿童被确诊为支气管哮喘病例。对于每例哮喘儿童,从研究人群中选择两名年龄和性别匹配的非哮喘对照。对所有病例和对照进行了病史、临床检查和深入访谈。多因素分析显示,与哮喘症状存在相关的因素有被动吸烟(比值比3.33,95%可信区间1.85 - 7.65)、家中饲养宠物(比值比5.5,95%可信区间1.04 - 29.15)以及客厅没有窗户(比值比4.03,95%可信区间1.17 - 13.79)。哮喘家族史、蛔虫感染史、烹饪所用燃料、厨房位置和食物过敏等因素经统计学分析无显著意义。因此,被动吸烟、通风不足以及家中饲养宠物(狗和猫)是农村儿童哮喘症状出现的重要危险因素。