Lawson Joshua A, Rennie Donna C, Cockcroft Don W, Dyck Roland, Afanasieva Anna, Oluwole Oluwafemi, Afsana Jinnat
Department of Medicine and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 5E5, Canada.
College of Nursing and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada.
BMC Pulm Med. 2017 Jan 5;17(1):4. doi: 10.1186/s12890-016-0355-5.
Asthma prevalence is generally lower in rural locations with some indication of an urban-rural gradient. However, among children with asthma, certain rural exposures thought to protect against the development of asthma could aggravate the condition. We examined childhood asthma prevalence and related conditions along an urban-rural gradient and also examined the characteristics of those with asthma along the urban-rural gradient.
In 2013 we completed a cross-sectional survey of 3509 children aged 5-14 years living in various population densities of Saskatchewan, Canada. Location of dwelling was identified as belonging to one of the following population densities: large urban region (approximately 200,000), small urban (approximately 35,000), or rural (small town of <1,500 or farm dweller). Physician-diagnosed asthma and asthma-related symptoms were ascertained from responses in the parental-completed questionnaires.
Of the study population, 69% lived in a large urban region, 11% lived in a small urban centre and 20% were rural dwellers. Overall, asthma prevalence was 19.6% with differences in asthma prevalence with differences between locations (large urban = 20.7%; small urban = 21.5%; rural = 15.1%; p = 0.003). After adjustment for potential confounders, the association between location of dwelling and asthma remained significant. Despite a lower prevalence of asthma in the rural area, the prevalence and risk of ever wheeze and having more than 3 wheezing episodes in the past 12 months among those who reported asthma, was higher in rural locations after adjustment for potential confounders.
The results of this study support the evidence of a difference in childhood asthma prevalence between urban and rural locations and that once a child has asthma, certain rural exposures may aggravate the disease.
农村地区哮喘患病率通常较低，有迹象表明存在城乡梯度差异。然而，在患有哮喘的儿童中，某些被认为可预防哮喘发病的农村暴露因素可能会使病情加重。我们研究了城乡梯度上儿童哮喘患病率及相关情况，还研究了城乡梯度上哮喘患儿的特征。
2013年，我们对居住在加拿大萨斯喀彻温省不同人口密度地区的3509名5 - 14岁儿童进行了横断面调查。居住地点被确定属于以下人口密度之一：大城市地区（约20万人口）、小城市（约3.5万人口）或农村（人口不足1500人的小镇或农场居民）。通过家长填写的问卷回答来确定医生诊断的哮喘及哮喘相关症状。
在研究人群中，69%生活在大城市地区，11%生活在小城市中心，20%是农村居民。总体而言，哮喘患病率为19.6%，不同地点之间哮喘患病率存在差异（大城市 = 20.7%；小城市 = 21.5%；农村 = 15.1%；p = 0.003）。在对潜在混杂因素进行调整后，居住地点与哮喘之间的关联仍然显著。尽管农村地区哮喘患病率较低，但在对潜在混杂因素进行调整后，农村地区报告患有哮喘的人群中，过去12个月内曾经喘息的患病率和风险以及喘息发作超过3次的情况更高。
本研究结果支持城乡儿童哮喘患病率存在差异的证据，并且一旦儿童患有哮喘，某些农村暴露因素可能会使病情加重。
