Midya Vishal, Pal Shekhar, Sinharoy Ankita, Das Jishu K, Rao Harish, Abu-Hasan Mutasim, Mondal Pritish
Division of Biostatistics and Bioinformatics, College of Medicine, Pennsylvania State University, Hershey, PA, United States.
Calcutta School of Tropical Medicine, Kolkata, India.
Front Public Health. 2018 Oct 17;6:295. doi: 10.3389/fpubh.2018.00295. eCollection 2018.
Socioeconomic and environmental factors influence childhood asthma prevalence across the world. In-depth epidemiological research is necessary to determine the association between asthma prevalence and socio-environmental conditions, and to develop public health strategies to protect the asthmatic children against the environmental precipitators. Our research was based on aggregative data and sought to compare the asthma prevalence between children of two different age-groups across the world and to identify the association among the key socio-environmental conditions with increased childhood asthma prevalence. We included forty countries with available data on various socio-environmental conditions (2014-2015). Childhood asthma prevalence of two different age groups (6-7 and 13-14 years) were obtained from global asthma report 2014. Because of significant diversities, the selected countries were divided into two groups based on human developmental index (HDI), a well-recognized parameter to estimate the overall socioeconomic status of a country. Robust linear regression was conducted using childhood asthma prevalence as the dependent variable and female smoking prevalence, tertiary school enrollment (TSE), PM (particulate matter ≤10 μm in diameter) and gross domestic product (GDP) as predictors. Asthma prevalence was not different between two age groups. Among all predictors, only female smoking prevalence (reflecting maternal smoking) was associated with asthma prevalence in the countries with lower socio-economic conditions (HDI), but not in the higher HDI group. The results were unchanged even after randomization. Childhood asthma prevalence did not change significantly with age. Female smoking may have a positive correlation with childhood asthma prevalence in lower HDI countries.
社会经济和环境因素影响着全球儿童哮喘的患病率。开展深入的流行病学研究对于确定哮喘患病率与社会环境状况之间的关联，以及制定公共卫生策略以保护哮喘儿童免受环境诱发因素的影响而言是必要的。我们的研究基于汇总数据，旨在比较全球两个不同年龄组儿童的哮喘患病率，并确定关键社会环境状况与儿童哮喘患病率增加之间的关联。我们纳入了40个具备各种社会环境状况数据（2014 - 2015年）的国家。两个不同年龄组（6 - 7岁和13 - 14岁）的儿童哮喘患病率取自《2014年全球哮喘报告》。由于存在显著差异，所选国家根据人类发展指数（HDI）分为两组，HDI是一个公认的用于估算国家总体社会经济状况的参数。以儿童哮喘患病率作为因变量，以女性吸烟率、高等学校入学率（TSE）、PM（直径≤10μm的颗粒物）和国内生产总值（GDP）作为预测变量，进行了稳健线性回归分析。两个年龄组的哮喘患病率并无差异。在所有预测变量中，仅女性吸烟率（反映母亲吸烟情况）与社会经济状况较低（HDI）国家的哮喘患病率相关，而在HDI较高的组中则不然。即使经过随机化处理，结果依然不变。儿童哮喘患病率并未随年龄显著变化。在HDI较低的国家，女性吸烟可能与儿童哮喘患病率呈正相关。
