Center for International Health, Ludwig-Maximilians-University, Ziemssenstr, 1, 80336 Munich, Germany.
BMC Pulm Med. 2014 Mar 10;14:40. doi: 10.1186/1471-2466-14-40.
Asthma and allergies are world-wide common chronic diseases among children and young people. Little information is available about the prevalence of these diseases in rural areas of Latin America. This study assesses the prevalence of symptoms of asthma and allergies among children in urban and rural areas at Oropeza Province in Bolivia.
The Spanish version of the ISAAC standardized questionnaire and the ISAAC video questionnaire were implemented to 2584 children attending the fifth elementary grade in 36 schools in Oropeza province (response 91%). Lifetime, 12 months and severity prevalence were determined for asthma, rhinitis and eczema symptoms. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated adjusting for age using generalized linear mixed-effects models.
Median age of children was 11 years, 74.8% attended public schools, and 52.1% were female. While children attending urban schools had lower prevalence of self-reported wheeze in the written questionnaire (adjusted OR 0.6; 95% CI 0.4-1.9), they were more likely than children attending rural schools to report wheeze in the video questionnaire (aOR 2.1; 95% CI 1.0-2.6). They also reported more frequently severe rhinoconjunctivitis (aOR 2.8; 95% CI 1.2-6.6) and severe eczema symptoms (aOR 3.3; 95% CI 1.0-11.0).
Overall in accordance with the hygiene hypothesis, children living in urban areas of Bolivia seem to have a higher prevalence of symptoms of asthma and allergies compared to children living in the country side. In order to develop primary prevention strategies, environmental factors need to be identified in future studies.
哮喘和过敏是全世界儿童和年轻人中常见的慢性疾病。关于这些疾病在拉丁美洲农村地区的流行情况，信息有限。本研究评估了玻利维亚奥罗佩萨省城乡地区儿童哮喘和过敏症状的患病率。
使用 ISAAC 标准化问卷的西班牙语版本和 ISAAC 视频问卷对奥罗佩萨省 36 所学校的 2584 名五年级学生（应答率为 91%）进行了调查。确定了哮喘、鼻炎和湿疹症状的终身、12 个月和严重程度患病率。使用广义线性混合效应模型，根据年龄调整后计算了哮喘、鼻炎和湿疹症状的比值比（OR）及其 95%置信区间（95%CI）。
儿童的中位数年龄为 11 岁，74.8%就读于公立学校，52.1%为女性。虽然在书面问卷中，就读于城市学校的儿童报告的自我报告喘息患病率较低（调整后的 OR 0.6；95%CI 0.4-1.9），但他们比就读于农村学校的儿童更有可能在视频问卷中报告喘息（aOR 2.1；95%CI 1.0-2.6）。他们还更频繁地报告严重的鼻结膜炎（aOR 2.8；95%CI 1.2-6.6）和严重的湿疹症状（aOR 3.3；95%CI 1.0-11.0）。
总体而言，与卫生假说一致，与生活在农村地区的儿童相比，生活在玻利维亚城市地区的儿童似乎有更高的哮喘和过敏症状患病率。为了制定初级预防策略，需要在未来的研究中确定环境因素。
