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资源匮乏地区儿童哮喘控制的相关因素

Factors associated with childhood asthma control in a resource-poor center.

作者信息

Kuti Bankole Peter, Omole Kehinde Oluyori, Kuti Demilade Kehinde

机构信息

Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Ilesa, Nigeria.

Department of Paediatrics, Wesley Guild Hospital, Ilesa, Nigeria.

出版信息

J Family Med Prim Care. 2017 Apr-Jun;6(2):222-230. doi: 10.4103/jfmpc.jfmpc_271_16.

Abstract

INTRODUCTION

Optimal asthma control is a major aim of childhood asthma management. This study aimed to determine factors associated with suboptimal asthma control at the pediatric chest clinic of a resource-poor center.

METHODS

Over a 12-month study period, children aged 2-14 years with physician-diagnosed asthma attending the pediatric chest clinic of the Wesley Guild Hospital (WGH), Ilesa, Nigeria were consecutively recruited. Asthma control was assessed using childhood asthma control questionnaire. Partly and uncontrolled asthma was recorded as a suboptimal control. Relevant history and examinations findings were compared between children with good and suboptimal asthma control. Binary logistic regression analysis was used to determine the predictors of suboptimal asthma control.

RESULTS

A total of 106 children participated in the study with male:female ratio of 1.5:1, and majority (83.0%) had mild intermittent asthma. Suboptimal asthma control was observed in 19 (17.9%) of the children. Household smoke exposure, low socioeconomic class, unknown triggers, concomitant allergic rhinoconjunctivitis, and poor parental asthma knowledge, were significantly associated with suboptimal control ( < 0.05). Low socioeconomic class (odds ratio [OR] =6.231; 95% confidence interval [CI] =1.022-8.496; = 0.005) and poor parental asthma knowledge (OR = 7.607; 95% CI = 1.011-10.481; = 0.007) independently predict suboptimal control.

CONCLUSION

Approximately, one in five asthmatic children attending the WGH pediatric chest clinic who participated in the study had suboptimal asthma control during the study. More comprehensive parental/child asthma education and provision of affordable asthma care services may help improve asthma control among the children.

摘要

引言

实现哮喘的最佳控制是儿童哮喘管理的主要目标。本研究旨在确定资源匮乏中心儿科胸科门诊中哮喘控制不佳的相关因素。

方法

在为期12个月的研究期间,连续招募了在尼日利亚伊莱萨韦斯利公会医院(WGH)儿科胸科门诊就诊、年龄在2至14岁且经医生诊断为哮喘的儿童。使用儿童哮喘控制问卷评估哮喘控制情况。部分控制和未控制的哮喘被记录为控制不佳。比较哮喘控制良好和不佳的儿童的相关病史及检查结果。采用二元逻辑回归分析来确定哮喘控制不佳的预测因素。

结果

共有106名儿童参与研究,男女比例为1.5:1,大多数(83.0%)患有轻度间歇性哮喘。19名(17.9%)儿童哮喘控制不佳。家庭烟雾暴露、社会经济地位低、诱因不明、合并过敏性鼻结膜炎以及家长对哮喘的认知不足与控制不佳显著相关(<0.05)。社会经济地位低(优势比[OR]=6.231;95%置信区间[CI]=1.022 - 8.496;=0.005)和家长对哮喘的认知不足(OR = 7.607;95% CI = 1.011 - 10.481;=0.007)独立预测控制不佳。

结论

参与本研究的在WGH儿科胸科门诊就诊的哮喘儿童中,约五分之一在研究期间哮喘控制不佳。更全面的家长/儿童哮喘教育以及提供负担得起的哮喘护理服务可能有助于改善儿童的哮喘控制情况。

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