Division of Allergy Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Asian Pac J Allergy Immunol. 2011 Jun;29(2):120-6.
Traditional asthma prevalence surveys were based on the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, which focuses on children aged 6-7 and 13-14. However, asthma-like symptoms usually commence in preschool aged children, in whom it is difficult to make a definite diagnosis of asthma. It is worth determining the prevalence rate of asthma or asthma-like symptoms and analyzing the risk factors for this phenomenon among preschool aged children.
Children aged 3-6 years were recruited from kindergartens in Keelung City, northern Taiwan. The questionnaire used was based on the ISAAC phase III core and environmental questionnaires and included questions on asthma, rhino-conjunctivitis, and eczema, along with questions to elicit common and early presentations of asthma, as well as other demographic and environmental data. The questionnaires were delivered and completed by parents.
2395 questionnaires were delivered to parents with children at 50 kindergartens, of which 2170 questionnaires were returned (return rate 90.6%). 9.9% of these preschool children had physician-diagnosed asthma. However, 20.4% of them experienced asthma like symptoms while attending kindergarten. Both the physician-diagnosed asthma and asthma-like symptoms groups had more clinical symptoms in all seasons except summer, compared to children without asthma. It was significant that the asthma-like symptoms commenced after joining a kindergarten (p < 0.001), and 66.5% of the children started to experience the symptoms within one month of beginning kindergarten. Using antibiotics or antipyretics in young infancy and mothers having asthma were the risk factors for developing asthma and asthma-like symptoms (p < 0.001), but parental smoking was not contributory to asthma development in preschool children. More frequent use of antipyretics in a year had a higher risk for the development of asthma and asthma-like symptoms.
Asthma and asthma-like symptoms were common in preschool children. Early infection of the respiratory tract and use of antibiotics were associated with presentation of symptoms. Attending a kindergarten is also a risk factor for early presentation of asthma among preschool children.
传统的哮喘患病率调查基于国际儿童哮喘和过敏研究（ISAAC）问卷，该问卷侧重于 6-7 岁和 13-14 岁的儿童。然而，哮喘样症状通常在学龄前儿童中开始出现，在这些儿童中很难明确诊断哮喘。值得确定学龄前儿童哮喘或哮喘样症状的患病率，并分析其发病的危险因素。
从台湾北部基隆市的幼儿园招募 3-6 岁的儿童。使用的问卷基于 ISAAC 第三阶段核心和环境问卷，包括哮喘、鼻结膜炎和湿疹问题，以及引出哮喘常见和早期表现的问题，以及其他人口统计学和环境数据。问卷由家长完成。
向 50 家幼儿园的 2395 名家长发放了问卷，其中 2170 份问卷（回收率 90.6%）返还。这些学龄前儿童中有 9.9%被诊断患有哮喘。然而，20.4%的儿童在幼儿园时出现哮喘样症状。与没有哮喘的儿童相比，所有季节（除夏季外）均有更多的临床症状，包括医生诊断的哮喘和哮喘样症状组。值得注意的是，哮喘样症状在进入幼儿园后开始出现（p < 0.001），66.5%的儿童在进入幼儿园一个月内开始出现症状。幼儿期使用抗生素或退烧药以及母亲患有哮喘是发展为哮喘和哮喘样症状的危险因素（p < 0.001），但父母吸烟对学龄前儿童哮喘的发展没有影响。一年内更频繁地使用退烧药与哮喘和哮喘样症状的发展风险更高有关。
哮喘和哮喘样症状在学龄前儿童中很常见。呼吸道早期感染和使用抗生素与症状表现有关。上幼儿园也是学龄前儿童早期出现哮喘的危险因素。
