Department of Occupational and Environmental Medicine, Bavarian Health and Food Safety Authority, Munich, Germany.
Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany.
J Asthma. 2022 Jul;59(7):1343-1352. doi: 10.1080/02770903.2021.1926487. Epub 2021 May 24.
Asthma is among the most common chronic conditions in children. The aim of this publication is to describe prevalence rates and factors associated with asthmatic or wheezing preschoolers and to evaluate medical care and treatment with regard to urban-rural differences. Data for this cross-sectional study were collected through a questionnaire, which was distributed to parents within the Health Monitoring Units in Bavaria (HMU), Germany. Data from 4767 children were available (2016/17). Those children were classified into four diagnostic groups: Unremitting Wheeze, International Study of Asthma and Allergies in Children (ISAAC) Asthma, Physician-diagnosed Asthma, and healthy control group. Urban-rural differences were tested by Pearson's chi-squared test or by Fisher's exact test. Independent variables were factors associated with health outcomes, for example, residency or migrant status. To examine associations between independent and outcome variables multivariate logistic regression analysis was performed. Prevalence rates were 6.3% for 'Unremitting Wheeze', 5.2% for 'ISAAC Asthma', and 1.2% for 'Physician-diagnosed Asthma'. Factors associated with health outcomes were the occurrence of asthma in first-degree relatives, male sex, and migrant status. Generally, higher rates of doctor's visits, positive allergy tests, and corticosteroids intake in the diagnostic groups in rural compared to urban areas were observed. Rates of performed allergy tests were 55.6% for 'ISAAC Asthma' and 74.6% for 'Physician-diagnosed Asthma'. Prevalence rates of the diagnostic groups decreased compared to the HMU 2014/15. According to previous studies, factors associated with asthmatic or wheezing health outcomes could be confirmed. Children in rural areas generally received more medical care.Key pointsChildren's prevalence rates of asthma or wheezing disorders decreased in the past 2 years within Bavaria.This study is consistent with risk factors for asthma from the literature: asthma in the family, male gender, and migrant status.Children in rural areas receive more medical care than children in urban areas.There should me more allergy tests among children with medical diagnosis in Bavaria as low rates indicate gaps in care.
哮喘是儿童最常见的慢性疾病之一。本出版物的目的是描述哮喘或喘息学龄前儿童的流行率和相关因素，并评估城乡差异的医疗保健和治疗。这项横断面研究的数据通过问卷收集，该问卷在德国巴伐利亚州的健康监测单位 (HMU) 分发给家长。共有 4767 名儿童的数据可用（2016/17 年）。这些儿童分为四个诊断组：持续喘息、国际儿童哮喘和过敏研究 (ISAAC) 哮喘、医生诊断的哮喘和健康对照组。通过 Pearson's chi-squared 检验或 Fisher's exact 检验测试城乡差异。自变量是与健康结果相关的因素，例如居住地或移民身份。为了检查自变量和结果变量之间的关联，进行了多变量逻辑回归分析。“持续喘息”的患病率为 6.3%，“ISAAC 哮喘”的患病率为 5.2%，“医生诊断的哮喘”的患病率为 1.2%。与健康结果相关的因素是一级亲属中哮喘的发生、男性和移民身份。一般来说，在农村地区，与城市地区相比，诊断组中医生就诊次数、过敏测试阳性和皮质类固醇摄入较高。ISAAC 哮喘的过敏测试率为 55.6%，医生诊断的哮喘为 74.6%。与 2014/15 年 HMU 相比，诊断组的患病率有所下降。根据之前的研究，可以证实与哮喘或喘息健康结果相关的因素。巴伐利亚州过去 2 年来，儿童哮喘或喘息疾病的患病率有所下降。本研究与文献中的哮喘危险因素一致：家族中的哮喘、男性和移民身份。与城市地区的儿童相比，农村地区的儿童接受更多的医疗保健。巴伐利亚州有医疗诊断的儿童中应进行更多的过敏测试，因为低比率表明存在护理差距。
