Warman Karen, Silver Ellen Johnson, Wood Pamela R
Department of Pediatrics, Children's Hospital at Montefiore/Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Ann Allergy Asthma Immunol. 2006 Jul;97(1 Suppl 1):S11-5. doi: 10.1016/s1081-1206(10)60779-x.
A complex array of risk factors contributes to sustained high levels of asthma morbidity in inner-city children.
To describe risk factors for asthma morbidity in a national sample of inner-city children with persistent asthma.
This study examined baseline questionnaire results from 1,772 children ages 5 to 11 years old with moderate to severe persistent asthma who enrolled in the Centers for Disease Control and Prevention-funded Inner-City Asthma Intervention between April 2001 and March 2004. Risk for asthma morbidity was assessed in 9 domains using the Child Asthma Risk Assessment Tool. The domains included environmental exposures, parental stress, medication adherence, pessimistic asthma beliefs, smoke exposure, aeroallergen exposure, child psychological well-being, responsibility for medication administration, and medical care.
A total of 51% of families demonstrated high risk of asthma morbidity in 3 or more domains. High risk of asthma morbidity was suggested based on household environmental exposures (47.7%), high parental stress (38.5%), poor medication adherence (38.3%), pessimistic asthma beliefs (31.8%), environmental tobacco smoke (24.4%), sensitization to aeroallergens in the home (24.8%), child behavioral or emotional concerns (22.9%), child assigned responsibility for medication administration (21.2%), and poor medical care (20.7%). Allergy testing was completed for 40% of the participating children. Of these children, 61% were exposed to aeroallergens in their home to which they were sensitized.
In this national sample of inner-city children, multiple risk factors for asthma morbidity were identified. Asthma programs that provide multilevel support and intervention are needed to reduce the burden of asthma on inner-city families.
一系列复杂的风险因素导致城市内儿童哮喘发病率持续居高不下。
描述全国范围内患有持续性哮喘的城市内儿童哮喘发病的风险因素。
本研究调查了2001年4月至2004年3月期间参与美国疾病控制与预防中心资助的城市内哮喘干预项目的1772名5至11岁患有中度至重度持续性哮喘儿童的基线调查问卷结果。使用儿童哮喘风险评估工具在9个领域评估哮喘发病风险。这些领域包括环境暴露、父母压力、药物依从性、对哮喘的悲观信念、烟雾暴露、气传变应原暴露、儿童心理健康、药物管理责任和医疗护理。
共有51%的家庭在3个或更多领域表现出哮喘发病的高风险。基于家庭环境暴露（47.7%）、父母压力大（38.5%）、药物依从性差（38.3%）、对哮喘的悲观信念（31.8%）、环境烟草烟雾（24.4%）、家中对气传变应原过敏（24.8%）、儿童行为或情绪问题（22.9%）、儿童负责药物管理（21.2%）和医疗护理差（20.7%），提示哮喘发病风险高。40%的参与儿童完成了过敏测试。在这些儿童中，61%在家中接触到了他们过敏的气传变应原。
在这个全国性的城市内儿童样本中，确定了哮喘发病的多种风险因素。需要提供多层次支持和干预的哮喘项目，以减轻哮喘对城市内家庭的负担。
