Onazi S O, Orogade A A, Yakubu A M
Department of Paediatrics, Ahmadu Bello University Teaching Hospital Shika, Zaria, Nigeria.
West Afr J Med. 2012 Apr-Jun;31(2):76-80.
Childhood asthma was said to be rare in Northern Nigeria three decades ago. However, since then, there has been rapid industrial development with increase in especially textile and quarry factories. Hyperresponsiveness of the bronchi of asthmatic children to various challenge tests differentiate them from non-asthmatic children. One of these, the Exercise-Induced Bronchospasm (EIB) which is a reduction in post exercise Peak Expiratory Flow Rate (PEFR), is widely used to define childhood asthma in epidemiological studies. To determine the current prevalence of asthma in childhood in a Northwestern Nigerian town, pupils aged 5-14 years were enrolled in the study.
A modified ISAAC questionnaire was administered and the subjects trained to use the peak flow meter. Pre exercise PEFR was obtained thereafter they were subjected to a six minute free running exercise challenge test and the best of three post exercise PEFR taken at intervals was obtained. EIB was taken as 15% reduction or more in post-exercise compared to pre-exercise PEFR.
The prevalence of EIB was 6.0% (64/1067 subjects) while 12.7% (136/1067) had a history of wheeze. History of wheeze was found to be a sensitive (96.3%) but nonspecific (22.2%) indicator of childhood asthma. The highest prevalence of EIB was among children aged 10-14 years with male: female ratio 1.9:1. The location of the residence of the pupils did not significantly affect the prevalence of EIB.
The prevalence of childhood asthma in this region is on the increase compared to earlier studies and there should be a high index of suspicion in children with suggestive symptoms who should then undergo further screening tests.
三十年前,据说尼日利亚北部儿童哮喘病例罕见。然而,自那时以来,工业迅速发展,特别是纺织厂和采石厂不断增加。哮喘儿童的支气管对各种激发试验的高反应性使其有别于非哮喘儿童。其中之一,运动诱发性支气管痉挛(EIB),即运动后呼气峰值流速(PEFR)降低,在流行病学研究中被广泛用于定义儿童哮喘。为了确定尼日利亚西北部一个城镇儿童哮喘的当前患病率,研究纳入了5至14岁的学生。
采用改良的国际儿童哮喘和过敏研究(ISAAC)问卷,并对受试者进行使用峰值流量计的培训。之后获取运动前的PEFR,然后让他们接受6分钟的自由跑步运动激发试验,并获取三次运动后间隔测量的最佳PEFR值。若运动后的PEFR较运动前降低15%或更多,则判定为EIB。
EIB的患病率为6.0%(64/1067名受试者),而有喘息病史的患病率为12.7%(136/1067)。喘息病史被发现是儿童哮喘的一个敏感(96.3%)但非特异性(22.2%)指标。EIB患病率最高的是10至14岁的儿童,男女比例为1.9:1。学生居住地点对EIB患病率没有显著影响。
与早期研究相比,该地区儿童哮喘的患病率在上升,对于有提示性症状的儿童应高度怀疑,然后进行进一步的筛查测试。