Centro de Ciências Biológicas e da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil.
PLoS One. 2012;7(5):e37050. doi: 10.1371/journal.pone.0037050. Epub 2012 May 31.
Asthma constitutes a serious public health problem in many regions of the world, including the city of Salvador, State of Bahia-Brazil. The purpose of this study was to analyse the factors associated with poor asthma control.
METHODOLOGY/PRINCIPAL FINDINGS: Two definitions were used for asthma: 1) wheezing in the last 12 months; 2) wheezing in the last 12 months plus other asthma symptoms or asthma diagnosis ever. The definition of poorly controlled asthma was: at least one reported hospitalisation due to asthma and/or high frequency of symptoms, in the last year. Children with poorly controlled asthma (N = 187/374) were compared with wheezing children with controlled asthma regarding age, gender, atopy, parental asthma, rhinitis, eczema, exposure to second hand tobacco smoke, presence of moulds, pets and pests in the house, helminth infections and body mass index. Crude and logistic regression adjusted odds ratios were used as measures of association. There was a higher proportion of poorly controlled asthma among children with eczema (OR = 1.55; 95% CI 1.02; 2.37). The strength of the association was greater among children with eczema and rhinitis (42.6%, 53.4% and 57.7%, respectively, in children who had no rhinitis nor eczema, had only one of those, and had both (p = 0.02 for trend test). The presence of mould in the houses was inversely associated with poorly controlled asthma (OR = 0.54; 95% CI 0.34; 0.87).
CONCLUSIONS/SIGNIFICANCE: Our results indicate an association between eczema and poor asthma control in this environment, but emphasize the role of various other individual and environmental factors as determinants of poor control.
哮喘在世界许多地区，包括巴西巴伊亚州萨尔瓦多市，构成了一个严重的公共卫生问题。本研究旨在分析与哮喘控制不佳相关的因素。
方法/主要发现：我们使用了两种哮喘定义：1）过去 12 个月内喘息；2）过去 12 个月内喘息加上其他哮喘症状或曾被诊断为哮喘。哮喘控制不佳的定义为：过去 1 年内至少因哮喘住院 1 次，或症状频繁发作。我们将哮喘控制不佳的儿童（N=187/374）与喘息但哮喘控制良好的儿童进行比较，比较因素包括年龄、性别、特应性、父母哮喘、鼻炎、湿疹、二手烟暴露、霉菌、宠物和害虫在房屋中的存在、寄生虫感染和体重指数。使用粗比值比和逻辑回归调整比值比作为关联的度量。患有湿疹的儿童中哮喘控制不佳的比例较高（比值比=1.55；95%可信区间 1.02；2.37）。在患有鼻炎和湿疹的儿童中，这种关联的强度更大（在没有鼻炎和湿疹、只有一种、同时患有两种疾病的儿童中，分别为 42.6%、53.4%和 57.7%，p=0.02 趋势检验）。房屋中存在霉菌与哮喘控制不佳呈负相关（比值比=0.54；95%可信区间 0.34；0.87）。
结论/意义：我们的研究结果表明，在这种环境下，湿疹与哮喘控制不佳之间存在关联，但也强调了各种其他个体和环境因素作为控制不佳的决定因素的作用。
