Higgins Pamela Sangeloty, Wakefield Dorothy, Cloutier Michelle M
Asthma Center, Connecticut Children's Medical Center, 282 Washington St, Hartford, CT 06106, USA.
Chest. 2005 Dec;128(6):3846-53. doi: 10.1378/chest.128.6.3846.
To examine asthma diagnosis, asthma severity, and the presence of established asthma risk factors in children who reside in nonurban communities.
A cross-sectional study was conducted of 19,076 children (6 months to 18 years of age) who lived in 146 nonurban communities in the greater Hartford, CT, region and who were enrolled in a disease-management program (Easy Breathing II; Michelle Cloutier, MD; Hartford, CT) designed to improve asthma diagnosis and treatment.
The overall frequency of physician-confirmed asthma in children seeking health care was 18%. Asthma frequency was related to low socioeconomic status (SES), non-Caucasian ethnicity, male gender, age > or = 5 years, and exposure to tobacco smoke, dust, or cockroaches in the multivariate analysis. When controlling for SES, African-American children were 1.33 times more likely (95% confidence interval [CI], 1.15 to 1.53) and Hispanic children were 1.60 times as likely (95% CI, 1.38 to 1.85) as Caucasian children to have asthma. In contrast, asthma severity was related to dust exposure, a family history of asthma, non-Caucasian ethnicity, and age < or = 4 years in the multivariate analysis. African-American children (odds ratio, 1.31; 95% CI, 1.03 to 1.67) had more severe asthma diagnosed as compared to Caucasian children. Hispanic ethnicity was not associated with an increase in asthma severity.
Risk factors for asthma in nonurban children are similar to risk factors in urban children. Ethnicity is a risk factor for asthma regardless of SES. Even in nonurban environments, African-American and Hispanic children have more asthma, and African-American children have more severe disease than their Caucasian counterparts.
调查居住在非城市社区儿童的哮喘诊断情况、哮喘严重程度以及已确定的哮喘风险因素的存在情况。
对居住在康涅狄格州大哈特福德地区146个非城市社区、年龄在6个月至18岁之间且参加了旨在改善哮喘诊断和治疗的疾病管理项目（轻松呼吸II；医学博士米歇尔·克劳蒂尔；康涅狄格州哈特福德）的19,076名儿童进行了横断面研究。
寻求医疗保健的儿童中，医生确诊哮喘的总体发生率为18%。在多变量分析中，哮喘发生率与低社会经济地位（SES）、非白种人种族、男性、年龄≥5岁以及接触烟草烟雾、灰尘或蟑螂有关。在控制SES后，非裔美国儿童患哮喘的可能性是白种儿童的1.33倍（95%置信区间[CI]，1.15至1.53），西班牙裔儿童患哮喘的可能性是白种儿童的1.60倍（95%CI，1.38至1.85）。相比之下，在多变量分析中，哮喘严重程度与接触灰尘、哮喘家族史、非白种人种族以及年龄≤4岁有关。与白种儿童相比，非裔美国儿童（优势比，1.31；95%CI，1.03至1.67）被诊断出的哮喘更严重。西班牙裔种族与哮喘严重程度增加无关。
非城市儿童哮喘的风险因素与城市儿童相似。无论SES如何，种族都是哮喘的一个风险因素。即使在非城市环境中，非裔美国儿童和西班牙裔儿童患哮喘的情况更多，且非裔美国儿童的病情比白种儿童更严重。
