Bryant-Stephens Tyra, West Caroline, Dirl Cannae, Banks Tinesha, Briggs Vanessa, Rosenthal Michael
Community Asthma Prevention Program, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
J Asthma. 2012 Aug;49(6):581-5. doi: 10.3109/02770903.2012.690476. Epub 2012 Jul 3.
Local asthma prevalence, especially in high-risk areas, may vary greatly from those estimated by national or regional data and targeted, community-specific approaches may be needed to assess the burden of childhood asthma. The Philadelphia Merck Childhood Asthma Network project sought to understand the local prevalence of asthma in Philadelphia communities and schools of low-income, disadvantaged children utilizing a grassroots approach that would access traditionally hard-to-reach families.
Two asthma-screening methodologies were implemented using the Brief Pediatric Asthma Screen. Door-to-door screening was conducted in disadvantaged neighborhoods by community health workers. School screening was implemented in each class through partnership with the school principals and teachers in disadvantaged neighborhoods within the same target area.
A total of 2368 children were screened through door-to-door methodology and 5563 children were screened in the schools. Door-to-door screening revealed asthma prevalence of 21.7%, with an additional 4.9% reporting symptoms consistent with asthma. School screening results revealed a higher prevalence with more than a quarter (27.5%) of the students screened positive for asthma. An additional 16.7% had symptoms indicative of asthma.
Both methods were able to successfully identify children with asthma in hard-to-reach populations. These methods can easily be replicated in other cities and the results can be used to inform programs, services, and policy developments.
局部地区哮喘患病率，尤其是在高危地区，可能与国家或地区数据所估计的有很大差异，可能需要针对特定社区的方法来评估儿童哮喘负担。费城默克儿童哮喘网络项目旨在利用一种能接触到传统上难以触及家庭的基层方法，了解费城低收入弱势儿童社区和学校中哮喘的局部患病率。
采用简易儿童哮喘筛查工具实施两种哮喘筛查方法。社区卫生工作者在弱势社区进行挨家挨户的筛查。通过与同一目标区域内弱势社区的学校校长和教师合作，在每个班级实施学校筛查。
通过挨家挨户的方法共筛查了2368名儿童，在学校筛查了5563名儿童。挨家挨户筛查显示哮喘患病率为21.7%，另有4.9%报告有与哮喘相符的症状。学校筛查结果显示患病率更高，超过四分之一（27.5%）的学生哮喘筛查呈阳性。另有16.7%有哮喘指征性症状。
两种方法都能够成功识别难以触及人群中的哮喘儿童。这些方法可以很容易地在其他城市复制，其结果可用于为项目、服务和政策制定提供信息。
