Ponsonby Anne-Louise, Glasgow Nicholas, Pezic Angela, Dwyer Terence, Ciszek Karen, Kljakovic Marjan
Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia.
Int J Epidemiol. 2008 Jun;37(3):559-69. doi: 10.1093/ije/dyn029. Epub 2008 Feb 14.
Asthma prevalence has declined in some countries over the past 10 years. Most reports have been based on population surveys conducted at two points of time in a given location. Comparisons across countries and time periods can be limited by differences in study methodology or disease diagnostics in different communities. Here, we examined trends in asthma prevalence using serial annual data and further examine the importance of country of birth.
The source population has children aged 4-6 commencing school in the Australian Capital Territory from 2000 to 2005 inclusive. Over 80% of these children and their families completed a health questionnaire on asthma, other atopic disease and respiratory symptoms using some questions from the International Study of Asthma and Allergies in Childhood (n = 22 882). Current asthma has been previously validated against physician assessment in this setting.
The prevalence of current asthma declined (P < 0.001) but eczema ever increased (P < 0.001) from 2000 to 2005. The asthma decline was predominantly linear in form, and accompanied by a reduction in night cough and shortness of breath but not recent wheeze. Compared with Australian-born children, children from New Zealand and the United Kingdom had a similar prevalence of asthma, hay fever and eczema history. However, children born in other countries, such as Asia, generally had a lower prevalence of these disorders. The temporal trends for atopic disorders or respiratory symptoms did not differ for overseas-born compared with Australian-born children.
The decline in current asthma prevalence from 2000 to 2005 was linear in form and appeared uncoupled from trends in child eczema. Country of birth was associated with marked variation in atopic disorder prevalence. The similar temporal trends for Australian vs overseas-born children indicate that the factors underlying the asthma prevalence decline are unlikely to be only in the pre-natal period.
在过去10年中，一些国家的哮喘患病率有所下降。大多数报告基于在特定地点两个时间点进行的人群调查。不同国家和时间段之间的比较可能会受到不同社区研究方法或疾病诊断差异的限制。在此，我们使用连续年度数据研究哮喘患病率的趋势，并进一步探讨出生国家的重要性。
研究对象为2000年至2005年（含）在澳大利亚首都地区开始上学的4至6岁儿童。超过80%的这些儿童及其家庭使用儿童哮喘和过敏国际研究中的一些问题完成了一份关于哮喘、其他特应性疾病和呼吸道症状的健康问卷（n = 22882）。在这种情况下，目前哮喘已通过与医生评估进行过验证。
从2000年到2005年，目前哮喘的患病率下降（P < 0.001），但湿疹患病率有所上升（P < 0.001）。哮喘患病率的下降主要呈线性，同时夜间咳嗽和呼吸急促有所减少，但近期喘息情况未变。与澳大利亚出生的儿童相比，来自新西兰和英国的儿童哮喘、花粉热和湿疹病史的患病率相似。然而，出生在其他国家（如亚洲）的儿童，这些疾病的患病率通常较低。与澳大利亚出生的儿童相比，海外出生儿童的特应性疾病或呼吸道症状的时间趋势没有差异。
2000年至2005年期间目前哮喘患病率的下降呈线性，且似乎与儿童湿疹的趋势无关。出生国家与特应性疾病患病率的显著差异有关。澳大利亚出生儿童与海外出生儿童相似的时间趋势表明，哮喘患病率下降的潜在因素不太可能仅存在于产前阶段。
