Solis-Soto María Teresa, Patiño Armando, Nowak Dennis, Radon Katja
Center for International Health, Ludwig-Maximilians-University, Munich, Germany.
Environ Health. 2013 Nov 5;12:95. doi: 10.1186/1476-069X-12-95.
In recent years, the prevalence of asthma, rhinoconjunctivitis and eczema symptoms in childhood has considerably increased in developing countries including Bolivia, possibly due to changes in lifestyle, environmental and domestic factors. This study aimed to assess the association between environmental factors and asthma, rhinoconjuctivitis and eczema symptoms in school-aged children from Oropeza Province in Chuquisaca, Bolivia.
A cross-sectional study was performed in 2340 children attending the fifth grade in 36 randomly selected elementary schools in Oropeza province. The prevalence of symptoms was determined using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Environmental factors were assessed by the ISAAC environmental questionnaire including questions related to exposure to pets, farm animals, indoor and outdoor pollution, presence of disease vectors at home and precarious household conditions. Generalized linear mixed-effects models were adjusted for age, sex and place of living.
Thirty seven percent of children reported that at least one of their parents smoked at home. Wood or coal was used as cooking fuel in 19% of the homes and 29% reported intense truck traffic on the street where they lived. With respect to hygiene conditions, 86% reported exposure to dogs, 59% exposure to cats and 36% regular contact to farm animals. More than one precarious household condition was reported by 8% of children. In the adjusted model exposure to dog (adjusted OR 1.4; CI 95% 1.0-1.9), cat (1.2; 1.0-1.5), farm animals (1.5; 1.2-1.8); intense truck traffic (1.3; 1.0-1.6), parents smoking at home (1.2; 1.0-1.5), presence of disease vectors at home (fourth quartile vs. first quartile: 1.6; 1.2-2.3) and two or more precarious household conditions (1.5; 1.0-2.2) were significantly associated with rhinoconjunctivitis symptoms. The associations were similar for asthma and eczema symptoms; however it did not reach the level of statistical significance for all items.
Our results support previous findings reported for poor communities especially in Latin America, showing that lower hygiene conditions did not have protective effect against asthma and rhinoconjunctivitis and eczema symptoms.
近年来，在包括玻利维亚在内的发展中国家，儿童哮喘、鼻结膜炎和湿疹症状的患病率显著上升，这可能归因于生活方式、环境和家庭因素的变化。本研究旨在评估玻利维亚丘基萨卡省奥罗佩萨省学龄儿童的环境因素与哮喘、鼻结膜炎和湿疹症状之间的关联。
对奥罗佩萨省36所随机选取的小学中2340名五年级学生进行了横断面研究。使用儿童哮喘和过敏国际研究（ISAAC）问卷确定症状的患病率。通过ISAAC环境问卷评估环境因素，包括与接触宠物、农场动物、室内和室外污染、家中病媒存在情况以及不稳定家庭状况相关的问题。对年龄、性别和居住地点进行了广义线性混合效应模型调整。
37%的儿童报告说他们至少有一位家长在家吸烟。19%的家庭使用木材或煤炭作为烹饪燃料，29%的儿童报告说他们居住的街道上有大量卡车通行。关于卫生条件，86%的儿童报告接触过狗，59%接触过猫，36%经常接触农场动物。8%的儿童报告了不止一种不稳定的家庭状况。在调整后的模型中，接触狗（调整后的比值比为1.4；95%置信区间为1.0 - 1.9）、猫（1.2；1.0 - 1.5）、农场动物（1.5；1.2 - 1.8）；大量卡车通行（1.3；1.0 - 1.6）、家长在家吸烟（1.2；1.0 - 1.5）、家中有病媒（第四四分位数与第一四分位数相比：1.6；1.2 - 2.3）以及两种或更多不稳定的家庭状况（1.5；1.0 - 2.2）与鼻结膜炎症状显著相关。哮喘和湿疹症状的关联情况类似；然而，并非所有项目都达到统计学显著水平。
我们的结果支持先前针对贫困社区（尤其是拉丁美洲）的研究发现，表明较低的卫生条件对哮喘、鼻结膜炎和湿疹症状没有保护作用。
