Department of Paediatrics, Nnamdi Azikiwe University (NAU), Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, PMB 5025, Anambra state, Nigeria.
Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra state, Nigeria.
BMC Pediatr. 2023 Apr 3;23(1):153. doi: 10.1186/s12887-023-03963-w.
Exercise Induced Bronchospasm(EIB) is not equivalent to asthma. As many as 20%of school aged children are estimated to have EIB. In Nigeria, there is still a dearth of information on EIB as a clinical entity. This study determined the presence of EIB(using pre and post-exercise percentage difference in peak expiratory flow rate(PEFR) and associated factors such as age, gender, social class and nutritional status in primary school children in Nnewi, Anambra state, South-East Nigeria. The study also grouped those with EIB into those with asthma(EIB) and those without asthma(EIB).
This was a community based cross-sectional study involving 6-12 year olds. The PEFR was taken at rest and after a 6 min free running test on the school play-ground using a Peak Flow Meter. A diagnosis of EIB was made if there was a decline of ≥ 10%. Those who had EIB were grouped further based on the degree of decline in post-exercise PEFR (a decline ≥ 10% < 25% → Mild EIB, ≥ 25% < 50% → Moderate EIB and ≥ 50% → Severe EIB) and then categorized as those with EIB/EIB.
EIB in the various minutes post-exercise was as follows: 19.2%(1min), 20.9%(5min), 18.7%(10min), 10%(20min), 0.7%(30min). Mild EIB accounted for the greater proportion in all minutes post-exercise and none of the pupils had severe EIB. Using values obtained in the 5min post-exercise for further analysis, EIB/EIB = 84.1%/15.9% respectively. Mean difference in the post-exercise PEFR of EIB/no EIB and EIB/EIB was -48.45(t = -7.69, p = < 0.001) and 44.46(t = 3.77, p = 0.01) respectively. Age and gender had a significant association to the presence of EIB and 58% of the pupils with EIB were of high social class. The BMI for age and gender z-scores of all study subjects as well as those with EIB was -0.34 ± 1.21, -0.09 ± 1.09 respectively. Other features of allergy(history of allergic rhinitis: OR-5.832, p = 0.001; physical findings suggestive of allergic dermatitis: OR-2.740, p = 0.003)were present in pupils diagnosed with EIB.
EIB has a high prevalence in primary school children in Nnewi and the greater proportion of those with EIB had EIB. EIB therefore needs to be recognized as a clinical entity and stratified properly based on the presence or absence of asthma. This will help the proper management and prognostication.
运动诱发的支气管痉挛（EIB）不等同于哮喘。据估计，多达 20%的学龄儿童患有 EIB。在尼日利亚，关于 EIB 作为一种临床实体的信息仍然匮乏。本研究旨在确定 EIB 的存在（使用运动前后呼气峰流量（PEFR）的百分比差异来确定），以及年龄、性别、社会阶层和营养状况等相关因素在尼日利亚东南部阿南布拉州 Nnewi 的小学生中的作用。该研究还将 EIB 患者分为哮喘伴 EIB（EIB）和非哮喘伴 EIB（EIB）。
这是一项基于社区的横断面研究，涉及 6-12 岁的儿童。使用峰值流量计在学校操场上进行 6 分钟自由跑步测试后，在休息时和运动后测量 PEFR。如果下降≥10%，则诊断为 EIB。那些患有 EIB 的患者根据运动后 PEFR 的下降程度进一步分组（下降≥10%<25%→轻度 EIB，≥25%<50%→中度 EIB，≥50%→重度 EIB），然后分为 EIB/EIB。
运动后各分钟的 EIB 如下：19.2%（1 分钟），20.9%（5 分钟），18.7%（10 分钟），10%（20 分钟），0.7%（30 分钟）。在所有运动后分钟中，轻度 EIB 占比更大，没有学生患有严重 EIB。使用运动后 5 分钟获得的值进行进一步分析，EIB/EIB 分别为 84.1%/15.9%。EIB/无 EIB 和 EIB/EIB 的运动后 PEFR 平均差异分别为-48.45（t=-7.69，p<0.001）和 44.46（t=3.77，p=0.01）。年龄和性别与 EIB 的存在有显著关联，58%的 EIB 患儿来自高社会阶层。所有研究对象以及患有 EIB 的研究对象的年龄和性别 BMI z 分数分别为-0.34±1.21 和-0.09±1.09。被诊断为 EIB 的儿童还存在过敏的其他特征（过敏性鼻炎史：OR-5.832，p=0.001；提示过敏性皮炎的体格检查发现：OR-2.740，p=0.003）。
EIB 在 Nnewi 的小学生中患病率很高，并且 EIB 患者中更常见 EIB。因此，需要将 EIB 视为一种临床实体，并根据是否存在哮喘进行适当分层。这将有助于进行适当的管理和预后判断。
