Glasgow N J, Goodchild E A, Yates R, Ponsonby A-L
Academic Unit of General Practice and Community Care, Canberra Clinical School of the University of Sydney, Canberra, Australia.
J Paediatr Child Health. 2003 Sep-Oct;39(7):534-9. doi: 10.1046/j.1440-1754.2003.00209.x.
To measure the prevalence of respiratory symptoms and atopic disease in Aboriginal and Torres Strait Islander (indigenous) and non-indigenous children in the Australian Capital Territory (ACT).
A two-stage questionnaire survey of children in the ACT with stage two completed for children identified by parents as having respiratory symptoms or asthma in the first stage cross-sectional survey. Participants in the study were: (i) all new entrant primary schoolchildren aged 4-6 years in 1999, 2000 and 2001, 217 being indigenous children and 10 604 being non-indigenous children (80% of eligible); and (ii) Year 1-6 primary schoolchildren in 2000, with 216 being indigenous children and 14 202 being non-indigenous children (52% of eligible). Respiratory symptoms (including recent wheeze and parent-reported asthma) and other factors were measured by parental questionnaire.
Indigenous kindergarten children had more recent wheeze (21%, odds ratio (OR) 1.4 95% confidence interval (CI) 1.0-2.0)) and parent-reported asthma (24%, OR 1.8 95% CI 1.3-2.5) than non-indigenous children (both 15%). However, indigenous children had less eczema (25%, OR 0.7 95% CI 0.5-0.9) and hayfever (14%, OR 0.7 95% CI 0.5-1.0) than non-indigenous children (32% and 19%, respectively). Among children with respiratory symptoms, the symptom severity did not differ between groups, but indigenous children were exposed to more environmental tobacco smoke (ETS) (63%, OR 3.5 95% CI 2.1-5.9) than non-indigenous children (32%).
Indigenous children in the ACT have more respiratory morbidity but less of the atopic diseases of hayfever and eczema than non-indigenous children. Whether the respiratory morbidity represents 'asthma' or results from increased ETS exposure is unclear and needs to be further explored.
测量澳大利亚首都地区（ACT）原住民和托雷斯海峡岛民（土著）儿童以及非土著儿童的呼吸道症状和特应性疾病患病率。
对ACT地区儿童进行两阶段问卷调查，在第一阶段横断面调查中，父母确定有呼吸道症状或哮喘的儿童完成第二阶段调查。研究参与者包括：（i）1999年、2000年和2001年所有4至6岁的新入学小学生，其中217名是土著儿童，10604名是非土著儿童（占符合条件者的80%）；（ii）2000年1至6年级的小学生，其中216名是土著儿童，14202名是非土著儿童（占符合条件者的52%）。通过家长问卷测量呼吸道症状（包括近期喘息和家长报告的哮喘）及其他因素。
与非土著儿童（均为15%）相比，土著幼儿园儿童近期喘息（21%，优势比（OR）1.4，95%置信区间（CI）1.0 - 2.0）和家长报告的哮喘（24%，OR 1.8，95% CI 1.3 - 2.5）更多。然而，与非土著儿童（分别为32%和19%）相比，土著儿童湿疹（25%，OR 0.7，95% CI 0.5 - 0.9）和花粉症（14%，OR 0.7，95% CI 0.5 - 1.0）更少。在有呼吸道症状的儿童中，两组症状严重程度无差异，但与非土著儿童（32%）相比，土著儿童接触环境烟草烟雾（ETS）更多（63%，OR 3.5，95% CI 2.1 - 5.9）。
ACT地区的土著儿童呼吸道发病率更高，但花粉症和湿疹等特应性疾病比非土著儿童少。尚不清楚呼吸道发病率是代表“哮喘”还是因接触ETS增加所致，需要进一步探究。
