Kabir M L, Rahman F, Hassan M Q, Ahamed F, Mridha M A
Institute of Child and Mother Health, Dhaka.
Mymensingh Med J. 2005 Jan;14(1):41-5.
International Study of Asthma and Allergies of Childhood (ISAAC) phase one study had already been completed in two age groups in 156 collaborating centers of 56 countries involving a total of 721601 children. Bangladesh did not participate earlier in this worldwide study. To determine the prevalence of asthma, allergic rhinitis and eczema in school children of Dhaka district using ISAAC protocol. A school based cross sectional study done in 2000 by using both written questionnaires (WQ) and video questionnaires (VQ). Students of class-VIII (13-14 years) filled up both the WQ and VQ and the parents of class I (6-7 years) filled up only the WQ on behalf of the students. Sixty five (6)5 primary schools and 39 high schools were randomly selected from all 19 thanas to cover equally both the urban and rural schools of the entire area of Dhaka district. A total of 6260 written questionnaires were eligible for the analysis (3029 form 6-7 years of class I and 3231 from 13-14 years of class VIII). In addition, the validated international video questionnaires were used for the older age group (3231). The symptoms of atopic diseases in the previous 12 months or ever in all children, both age groups, both sexes and in both urban and rural areas. The life time (ever) and 12-month period (recent) prevalence of three allergic conditions with 95% CI were as follows : wheezing 13.8% (12.9-14.6), 7.6% (6.9-8.2); allergic rhinitis 25.0% (23.9-26.1), 20.0% (19.1-21.1) and eczema 8.7% (CI 8.0-9.4), 6.5% (5.9-7.2). respectively. The prevalence of wheezing and other atopic features in both age groups of 6-7 years and 13-14 years showed higher features of recent wheeze in the younger children than in the older children, recent wheeze 9.1% Vs 6.1%; but the other atopic features were found lower in younger age group, recent rhinitis 16.3% Vs 23.5%, 0.001; conjunctivitis 6.4% Vs 8.3%, 0.001; recent eczema 6.0% Vs 7.1% 0.001. Male children were found to be more suffering from all types allergic conditions than their female peers: recent wheeze 9.0% Vs 5.9%, recent rhinitis 21.9% Vs 17.9%, recent allergic conjunctivitis 8.7% Vs 6.7% and recent eczema 6.8% Vs 6.2%). Though the prevalence of asthma and atopic eczema was lower than those of developed countries but still appeared to be a major health problem for our children. Allergic rhinitis was the commonest of all atopic problems in children. The younger children (6-7 years) were more likely to suffer from wheeze (asthma) but other allergic problems were more in older group of children (13-14 years). Male children were more prone to all types of allergic problems, whether wheeze or other atopic conditions, than the female peers.
国际儿童哮喘和过敏研究(ISAAC)第一阶段研究已经在56个国家的156个合作中心的两个年龄组中完成,共有721601名儿童参与。孟加拉国此前未参与这项全球研究。为了使用ISAAC方案确定达卡地区学童中哮喘、过敏性鼻炎和湿疹的患病率。2000年开展了一项基于学校的横断面研究,使用了书面问卷(WQ)和视频问卷(VQ)。八年级(13 - 14岁)的学生填写了WQ和VQ,一年级(6 - 7岁)学生的家长仅代表学生填写了WQ。从达卡地区所有19个分区中随机选取了65所小学和39所高中,以平等覆盖该地区城乡的学校。共有6260份书面问卷符合分析要求(一年级6 - 7岁的有3029份,八年级13 - 14岁的有3231份)。此外,经过验证的国际视频问卷用于年龄较大的组(3231份)。调查了所有儿童(两个年龄组、男女两性、城乡地区)在前12个月或一生中的特应性疾病症状。三种过敏性疾病的终生(曾经)患病率和12个月期间(近期)患病率及95%置信区间如下:喘息分别为13.8%(12.9 - 14.6)、7.6%(6.9 - 8.2);过敏性鼻炎分别为25.0%(23.9 - 26.1)、20.0%(19.1 - 21.1);湿疹分别为8.7%(置信区间8.0 - 9.4)、6.5%(5.9 - 7.2)。6 - 7岁和13 - 14岁两个年龄组中喘息和其他特应性特征的患病率显示,年幼儿童近期喘息的特征高于年长儿童,近期喘息分别为9.1%对6.1%;但其他特应性特征在年幼儿童组中较低,近期鼻炎分别为16.3%对23.5%,P = 0.001;结膜炎分别为6.4%对8.3%,P = 0.001;近期湿疹分别为6.0%对7.1%,P = 0.001。发现男童比女童更容易患各类过敏性疾病:近期喘息分别为9.0%对5.9%,近期鼻炎分别为21.9%对17.9%,近期过敏性结膜炎分别为8.7%对6.7%,近期湿疹分别为6.8%对6.2%)。虽然哮喘和特应性湿疹的患病率低于发达国家,但对我们的儿童来说似乎仍然是一个主要的健康问题。过敏性鼻炎是儿童所有特应性问题中最常见的。年幼儿童(6 - 7岁)更易患喘息(哮喘),但其他过敏性问题在年长儿童组(13 - 14岁)中更多。男童比女童更容易患各类过敏性问题,无论是喘息还是其他特应性疾病。