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新西兰儿童哮喘症状的患病率和严重程度有变化吗?国际儿童哮喘和过敏研究(ISAAC)第三阶段。

Has the prevalence and severity of symptoms of asthma changed among children in New Zealand? ISAAC Phase Three.

作者信息

Asher M Innes, Stewart Alistair W, Clayton Tadd, Crane Julian, Ellwood Philippa Innes, Mackay Richard, Mitchell Ed, Moyes Chris, Pattemore Philip K, Pearce Neil

机构信息

Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand.

出版信息

N Z Med J. 2008 Oct 17;121(1284):52-63.

Abstract

AIM

To investigate time trends in prevalence of symptoms of asthma by repeating, during 2001-3 (Phase Three), the International Study of Asthma and Allergies in Childhood (ISAAC) Phase One study that was conducted in New Zealand in 1992-3.

METHODS

ISAAC Phase Three involved repeating the cross-sectional questionnaire survey of two age groups of school children (6-7 years and 13-14 years, children and adolescents respectively) using the same methodology as Phase One. In New Zealand it was conducted in Auckland, Bay of Plenty, Christchurch, Nelson, and Wellington.

RESULTS

After 9 years, reported asthma ever increased from 24.6% to 30.2% in children and from 24.1% to 32.4% in adolescents (p<0.001). Current wheeze (written questionnaire) significantly decreased in children from 23.6% to 22.2% (p=0.002) and in adolescents from 29.7% to 26.7% (p=0.047), and for the video questionnaire from 18.1% to 11.1% (p<0.001). There was a significant reduction in wheezing limiting speech from 5.0% to 3.7% in children, and 7.9% to 6.2% in adolescents. Little regional variation was found. A higher proportion of children with asthma symptoms now report having ever had asthma.

CONCLUSIONS

The decrease in prevalence and severity of symptoms of asthma is encouraging, but the reasons for these trends are currently unclear. Increases in asthma labelling are likely to be due to greater awareness of asthma. A trend of decreasing prevalence of asthma symptoms, if maintained, has positive implications for lessened burden of disease among asthmatics and lowered cost of treatment.

摘要

目的

通过在2001 - 2003年(第三阶段)重复1992 - 1993年在新西兰进行的儿童哮喘和过敏国际研究(ISAAC)第一阶段研究,调查哮喘症状患病率的时间趋势。

方法

ISAAC第三阶段采用与第一阶段相同的方法,对两个年龄组的学童(分别为6 - 7岁儿童和13 - 14岁青少年)进行横断面问卷调查。在新西兰,该研究在奥克兰、丰盛湾、克赖斯特彻奇、纳尔逊和惠灵顿进行。

结果

9年后,报告曾患哮喘的儿童比例从24.6%增至30.2%,青少年从24.1%增至32.4%(p<0.001)。当前喘息(书面问卷)在儿童中从23.6%显著降至22.2%(p = 0.002),在青少年中从29.7%降至26.7%(p = 0.047),视频问卷中从18.1%降至11.1%(p<0.001)。喘息致言语受限在儿童中从5.0%显著降至3.7%,在青少年中从7.9%降至6.2%。未发现明显的地区差异。现在有哮喘症状的儿童中,报告曾患哮喘的比例更高。

结论

哮喘症状患病率和严重程度的下降令人鼓舞,但这些趋势的原因目前尚不清楚。哮喘诊断增加可能是由于对哮喘的认识提高。哮喘症状患病率下降的趋势若能持续,对减轻哮喘患者的疾病负担和降低治疗成本具有积极意义。

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