Dawood Fatimah S, Fry Alicia M, Goswami Doli, Sharmeen Amina, Nahar Kamrun, Anjali Bilkis Ara, Rahman Mustafizur, Brooks W Abdullah
Influenza Division, Centers for Disease Control and Prevention, Atlanta.
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Pediatr Pulmonol. 2016 Jun;51(6):588-95. doi: 10.1002/ppul.23343. Epub 2015 Nov 27.
Early childhood wheezing substantially impacts quality of life in high-income countries, but data are sparse on early childhood wheezing in low-income countries. We estimate wheezing incidence, describe wheezing phenotypes, and explore the contribution of respiratory viral illnesses among children aged <5 years in urban Bangladesh.
During 2004-2010, respiratory illness surveillance was conducted through weekly home visits. Children with fever or respiratory illness were referred for examination by study physicians including lung auscultation. During 2005-2007, every fifth referred child had nasal washes tested for human metapneumovirus, respiratory syncytial viruses, and influenza and parainfluenza viruses.
During April 2004-July 2010, 23,609 children were enrolled in surveillance. Of these, 11,912 (50%) were male, median age at enrollment was 20 months (IQR 5-38), and 4,711 (20%) had ≥1 wheezing episode accounting for 8,901 episodes (733 [8%] associated with hospitalization); 25% wheezed at <1 year of age. Among children aged <5 years, incidences of wheezing and wheezing hospitalizations were 2,335/10,000 and 192/10,000 child-years. Twenty-eight percent had recurrent wheezing. Recurrent versus non-recurrent wheezing episodes were more likely to be associated with oxygen saturation <93% (OR 6.9, 95%CI 2.8-17.3), increased work of breathing (OR 1.6, 95%CI 1.4-1.8), and hospitalization (OR 2.0, 95%CI 1.6-2.4). Respiratory viruses were detected in 66% (578/873) of episodes with testing.
In urban Bangladesh, early childhood wheezing is common and largely associated with respiratory virus infections. Recurrent wheezing is associated with more severe illness and may predict children who would benefit most from closer follow-up and targeted interventions. Pediatr Pulmonol. 2016;51:588-595. © 2015 Wiley Periodicals, Inc.
幼儿喘息对高收入国家的生活质量有重大影响，但低收入国家幼儿喘息的数据却很稀少。我们估算了孟加拉国城市地区5岁以下儿童的喘息发病率，描述了喘息的表型，并探讨了呼吸道病毒感染在其中的作用。
在2004年至2010年期间，通过每周的家访进行呼吸道疾病监测。发热或患有呼吸道疾病的儿童被转介给研究医生进行检查，包括肺部听诊。在2005年至2007年期间，每五名被转介的儿童中就有一名接受鼻洗液检测，以检测人偏肺病毒、呼吸道合胞病毒、流感病毒和副流感病毒。
在2004年4月至2010年7月期间，共有23,609名儿童纳入监测。其中，11,912名（50%）为男性，入组时的中位年龄为20个月（四分位间距5 - 38），4,711名（20%）有≥1次喘息发作，共计8,901次发作（733次[8%]与住院相关）；25%的儿童在1岁前出现喘息。在5岁以下儿童中，喘息发病率和喘息住院率分别为每10,000儿童年2,335例和192例。28%的儿童有复发性喘息。复发性喘息发作与非复发性喘息发作相比，更有可能与血氧饱和度<93%（比值比6.9，95%置信区间2.8 - 17.3）、呼吸做功增加（比值比1.6，95%置信区间1.4 - 1.8）和住院（比值比2.0，95%置信区间1.6 - 2.4）相关。在接受检测的发作中，66%（578/873）检测到呼吸道病毒。
在孟加拉国城市地区，幼儿喘息很常见，且主要与呼吸道病毒感染有关。复发性喘息与更严重的疾病相关，可能预示着哪些儿童将从密切随访和针对性干预中获益最大。《儿科肺病学》。2016年；51:588 - 595。©2015威利期刊公司。
