Centre for Population Health Sciences, University of Edinburgh, UK.
Allergy. 2010 Feb;65(2):152-67. doi: 10.1111/j.1398-9995.2009.02244.x. Epub 2009 Nov 12.
Asthma prevalence has increased very considerably in recent decades such that it is now one of the commonest chronic disorders in the world. Recent evidence from epidemiological studies, however, suggests that the prevalence of asthma may now be declining in many parts of the world, which, if true is important for health service planning and also because this offers the possibility of generating and testing new aetiological hypotheses. Our objective was to determine whether the prevalence of asthma is declining worldwide. We undertook a systematic search of EMBASE, Medline, Web of Science and Google Scholar, for high quality reports of cohort studies, repeat cross-sectional studies and analyses of routine healthcare datasets to examine international trends in asthma prevalence in children and adults for the period 1990-2008. There were 48 full reports of studies that satisfied our inclusion criteria. The large volume of data identified clearly indicate that there are, at present, no overall signs of a declining trend in asthma prevalence; on the contrary, asthma prevalence is in many parts of the world still increasing. The reductions in emergency healthcare utilization being reported in some economically developed countries most probably reflect improvements in quality of care. There remain major gaps in the literature on asthma trends in relation to Africa and parts of Asia. There is no overall global downward trend in the prevalence of asthma. Healthcare planners will for the foreseeable future, therefore, need to continue with high levels of anticipated expenditure in relation to provision of asthma care.
在过去的几十年中，哮喘的患病率显著增加，现已成为世界上最常见的慢性疾病之一。然而，最近的流行病学研究证据表明，哮喘的患病率在世界许多地区可能正在下降，如果这一事实属实，那么这对卫生服务规划很重要，因为这为生成和测试新的病因假设提供了可能性。我们的目的是确定哮喘的患病率是否在全球范围内呈下降趋势。我们系统地检索了 EMBASE、Medline、Web of Science 和 Google Scholar，以获取高质量的队列研究、重复横断面研究和常规医疗保健数据集分析报告，以研究 1990 年至 2008 年期间儿童和成人哮喘患病率的国际趋势。有 48 份符合我们纳入标准的研究的完整报告。大量确定的数据清楚地表明，目前没有哮喘患病率下降趋势的总体迹象；相反，哮喘在世界许多地区的患病率仍在上升。一些经济发达国家报告的急诊医疗利用率的降低很可能反映了护理质量的提高。在与非洲和亚洲部分地区的哮喘趋势相关的文献中仍存在重大空白。哮喘的患病率没有总体的全球下降趋势。因此，在可预见的未来，医疗保健规划者将需要继续为哮喘护理提供高预期支出。
