Thongkham D, Tran J, Clunes M T, Brahim F
Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies.
Department of Physiology and Neuroscience, School of Medicine, St. George's University, Grenada, West Indies.
BMJ Open. 2015 Oct 19;5(10):e008557. doi: 10.1136/bmjopen-2015-008557.
The goal of this study was to determine the prevalence of asthma in school children in the tri-island Caribbean nation of Grenada.
SETTING, PARTICIPANTS AND OUTCOMES: This was a self-report study provided to the guardians of all primary school children between ages 6 and 7 throughout Grenada, Carriacou and Petite Martinique in 2013. Of the 2362 surveys provided, 1374 were returned, resulting in a response rate of 58.2%. Only responders listing birthdays between 1 January 2006 and 31 December 2007 were included in the analysis, resulting in 1165 qualifying responders. Asthma diagnosis was based on previous physician diagnosed asthma and/or self-reported presence of wheeze in the past 12 months (current wheeze). Severity of asthma, medication usage, environmental exposures, physician and emergency department visits were compared among respondents.
The prevalence of wheezing in the past year was 30.5±1.8%, and of these 68.4% were previously diagnosed with asthma. Of the current wheeze participants, 39.9±9.2% reported moderate to severe asthma symptoms and increased exposure to cigarette smoke, excessive dust, burning brush and landfills. Carriacou and Petite Martinique, the two smaller islands, had a lower incidence of current wheeze (14.1±7.7%) and exposure rates to cigarette smoke and burning brush as compared to the larger, denser island of Grenada. Although 65.7% of respondents diagnosed with asthma reported taking medication, the number of annual doctor and emergency department visits were high (2.82 and 0.86, respectively). Respondents with the most severe asthma symptoms reported the most emergency department visits with an average of 1.05 visits annually, whereas respondents with moderate asthma symptoms had the most doctor visits with an average of 3.33 visits annually.
This study indicates that the prevalence of childhood asthma in Grenada is very high and warrants policy consideration in public health and education to decrease its morbidity.
本研究的目的是确定加勒比海三岛国家格林纳达学龄儿童哮喘的患病率。
研究背景、参与者及结果:这是一项于2013年向格林纳达、卡里亚库岛和小马提尼克岛所有6至7岁小学生的监护人提供的自我报告研究。在提供的2362份调查问卷中,有1374份被退回,回复率为58.2%。分析仅纳入列出2006年1月1日至2007年12月31日生日的回复者,最终有1165名符合条件的回复者。哮喘诊断基于既往医生诊断的哮喘和/或过去12个月内自我报告的喘息(当前喘息)情况。对回复者的哮喘严重程度、药物使用情况、环境暴露情况、看医生和急诊的次数进行了比较。
过去一年喘息的患病率为30.5±1.8%,其中68.4%既往被诊断为哮喘。在当前有喘息症状的参与者中,39.9±9.2%报告有中度至重度哮喘症状,且接触香烟烟雾、过多灰尘、燃烧的灌木丛和垃圾填埋场的情况增加。与较大且人口密集的格林纳达岛相比,两个较小的岛屿卡里亚库岛和小马提尼克岛当前喘息的发生率较低(14.1±7.7%),接触香烟烟雾和燃烧灌木丛的比例也较低。尽管65.7%被诊断为哮喘的回复者报告正在服药,但每年看医生和急诊的次数仍然很高(分别为2.82次和0.86次)。哮喘症状最严重的回复者急诊就诊次数最多,平均每年1.05次,而中度哮喘症状的回复者看医生次数最多,平均每年3.33次。
本研究表明,格林纳达儿童哮喘的患病率非常高,在公共卫生和教育方面需要政策考量以降低其发病率。