Mustakov Tihomir B, Popov Todor A, Kralimarkova Tanya Z, Staevska Maria T, Dimitrov Vasil D
Clinic of Allergy and Asthma, Medical University, 1, Georgi Sofiyski St., 1431 Sofia, Bulgaria.
World Allergy Organ J. 2016 Apr 4;9:11. doi: 10.1186/s40413-016-0103-6. eCollection 2016.
In an attempt to circumvent low response rates and high cost of classical epidemiological trials, we carried out a real-life survey among practicing physicians consulting patients for nasal symptoms. In this fragment of our work we analyze similarities and differences between children and adults and within the different strata of pediatric age.
A survey was carried out by 69 physicians across Bulgaria (general practitioners, allergists and otorhinolaryngologists) and made possible calculation of the proportion of subjects with nasal symptoms from all other patients seen. Its structure allowed classification of rhinitis according the ARIA guidelines.
Out of the 1685 completed survey forms, 506 pertained to the age group below 18 years. The gender predominance differed in children and adults: 57.3 % vs. 42.8 % of males respectively, P < 0.001. The prevalence of persistent rhinitis in children was 55.7 %, lower than in adults, 63.3 %, P = 0.004. In both pediatric and adult patients moderately severe and severe forms of rhinitis prevailed, 93.7 % vs. 94.6 %, with nasal obstruction as leading symptom: 59.9 % vs. 58.8 %. Cough was significantly more prevalent among children, 72.5 %, gradually decreasing until reaching adulthood, 58.7 %, P < 0.001. Prevalence of doctor diagnosed asthma was also higher among children, 25.1 %, than in adults, 19.5 %, P = 0.011. A gradient for characteristics, which were different in children, emerged across the pediatric age strata.
Our study uses an unorthodox design targeting the patient population visiting physicians' offices because of nasal symptoms, achieving a much higher level of credibility of the results at minimal expense. As we base our survey on international guidelines, we believe this approach demonstrates the applicability of such consensus documents for practical purposes when in the hands of qualified physicians.
Moderate and severe rhinitis symptoms motivate patients and their guardians to seek medical advice. While nasal congestion is a leading bothersome symptom in both adults and children, specific other features characterize the pediatric age and differ across its strata.
为了避免传统流行病学试验的低响应率和高成本，我们对因鼻部症状而咨询医生的执业医师进行了一项实际调查。在我们工作的这一部分中，我们分析了儿童和成人之间以及不同儿童年龄层之间的异同。
保加利亚的69名医生（全科医生、过敏症专科医生和耳鼻喉科医生）开展了一项调查，这使得能够计算出鼻部症状患者在所有其他就诊患者中所占的比例。其结构允许根据变应性鼻炎及其对哮喘的影响（ARIA）指南对鼻炎进行分类。
在1685份填写完整的调查问卷中，506份属于18岁以下年龄组。儿童和成人的性别优势有所不同：男性分别占57.3%和42.8%，P<0.001。儿童持续性鼻炎的患病率为55.7%，低于成人的63.3%，P=0.004。在儿科和成人患者中，中度严重和重度鼻炎占主导，分别为93.7%和94.6%，主要症状为鼻塞：分别为59.9%和58.8%。咳嗽在儿童中更为常见，占72.5%，在成年期逐渐下降直至58.7%，P<0.001。医生诊断为哮喘的患病率在儿童中也高于成人，分别为25.1%和19.5%，P=0.011。在不同的儿童年龄层中，出现了儿童中不同特征的梯度变化。
我们的研究采用了一种非传统的设计，针对因鼻部症状前往医生办公室就诊的患者群体，以最低的成本实现了更高水平的结果可信度。由于我们的调查基于国际指南，我们认为这种方法证明了此类共识文件在合格医生手中用于实际目的时的适用性。
中度和重度鼻炎症状促使患者及其监护人寻求医疗建议。虽然鼻塞是成人和儿童中主要的困扰症状，但特定的其他特征是儿童年龄层所特有的，且在不同年龄层有所不同。
