Zaman Khalequz, Takeuchi Haruko, El Arifeen Shams, Chowdhury Hafizur R, Baqui Abdullah H, Wakai Susmu, Iwata Tsutomu
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Indian J Pediatr. 2007 Jun;74(6):539-43. doi: 10.1007/s12098-007-0104-0.
Although bronchial asthma causes a great deal of morbidity among children in Bangladesh, few epidemiological studies addressed this problem. The study aims to determine the prevalence of wheezing and its association with environmental and host factors.
A total of 1587 children aged 60-71 mth living in 50 villages in rural Bangladesh at Matlab was studied. Trained field workers interviewed caretakers of these children to diagnose wheezing using an adopted questionnaire of the International Studies of Asthma and Allergies in Childhood (ISAAC). History of pneumonia among wheezing and non-wheezing children during their childhood was obtained from the surveillance records.
The prevalence of wheezing in the last 12 mth prior to survey was 16.1% (95% CI: 14.3%, 18.0%), significantly higher among children who had attacks of pneumonia during their infancy compared to children who did not (23.0% vs 14.6%, p< 0.0001). Risk factors associated with wheezing were pneumonia at ages 0-12 m (OR= 1.50, 95% CI 1.08, 2.10) and 13-24 m (OR= 2.12, 1.46, 3.08), maternal asthma (OR=3.01, 95% CI 2.02, 4.47), paternal asthma (OR= 3.12, 95% CI 1.85, 5.26), maternal eczema (OR=1.81, 95% CI 1.14, 2.87) and family income 100 pounds US$ (OR for US$ 51-99= 1.63, 95% CI 1.05, 2.53; OR for US$ 50 pounds = 2.12, 95% CI 1.31, 3.44).
Our results suggest that wheezing is a significant cause of morbidity among children in rural Bangladesh. Greater efforts are needed to prevent pneumonia among children during their infancy to reduce the chances of subsequent development of wheezing.
尽管支气管哮喘在孟加拉国儿童中造成了大量发病情况，但很少有流行病学研究涉及这一问题。本研究旨在确定喘息的患病率及其与环境和宿主因素的关联。
对生活在孟加拉国农村Matlab地区50个村庄的1587名年龄在60 - 71个月的儿童进行了研究。训练有素的现场工作人员通过采用儿童哮喘和过敏国际研究（ISAAC）的问卷对这些儿童的照料者进行访谈以诊断喘息。喘息儿童和非喘息儿童童年时期的肺炎病史从监测记录中获取。
调查前最后12个月内喘息的患病率为16.1%（95%可信区间：14.3%，18.0%），与未患肺炎的儿童相比，婴儿期患过肺炎的儿童中喘息患病率显著更高（23.0%对14.6%，p < 0.0001）。与喘息相关的危险因素包括0 - 12个月（比值比= 1.50，95%可信区间1.08，2.10）和13 - 24个月（比值比= 2.12，1.46，3.08）时患肺炎、母亲患哮喘（比值比= 3.01，95%可信区间2.02，4.47）、父亲患哮喘（比值比= 3.12，95%可信区间1.85，5.26）、母亲患湿疹（比值比= 1.81，95%可信区间1.14，2.87）以及家庭收入低于100美元（51 - 99美元的比值比= 1.63，95%可信区间1.05，2.53；低于50美元的比值比= 2.12，95%可信区间1.31，3.44）。
我们的结果表明，喘息是孟加拉国农村儿童发病的一个重要原因。需要做出更大努力预防儿童婴儿期的肺炎，以减少随后发生喘息的几率。
