Odhiambo J A, Ng'ang'a L W, Mungai M W, Gicheha C M, Nyamwaya J K, Karimi F, Macklem P T, Becklake M R
Respiratory Disease Research Unit, Kenya Medical Research Institute, Nairobi.
Eur Respir J. 1998 Nov;12(5):1105-12. doi: 10.1183/09031936.98.12051105.
Grade 4 Kenyan children attending 10 randomly selected public primary schools in Nairobi (urban) and the Muranga District (rural) were surveyed to establish the prevalence of symptom markers of asthma and to assess the impact of urbanization. A respiratory health and home environment questionnaire was administered at school to parents or guardians. The questionnaire response rates were 94.2% (568/ 603) for Nairobi and 89.6% (604/674) for Muranga. The prevalence rates for asthma, defined as "attacks of shortness of breath with wheeze", were 9.5% for urban and 3.0% for rural children (odds ratio (OR) urban versus rural: 3.42; 95% confidence interval (CI): -1.96-5.91). This urban-rural gradient persisted after adjusting for urban-rural differences in host factors (including duration of breastfeeding and family history of asthma and/or allergy), but was largely explained by urban-rural differences in environmental factors, including indoor animals, sharing a bedroom with a smoker, parental education, house ventilation and exposure to motor vehicle fumes en route to school (adjusted OR: 1.59; 95% CI: 0.70-3.55). Similar results were obtained for all other symptoms. These findings confirm the clinical impression that asthma is an important illness in Kenya and underline the need for the further study of environmental factors amenable to intervention, particularly in urban areas.
对在内罗毕（城市）和穆兰加区（农村）随机抽取的10所公立小学就读的四年级肯尼亚儿童进行了调查，以确定哮喘症状标志物的患病率，并评估城市化的影响。在学校向家长或监护人发放了一份呼吸健康与家庭环境问卷。内罗毕的问卷回复率为94.2%（568/603），穆兰加为89.6%（604/674）。哮喘患病率定义为“伴有喘息的呼吸急促发作”，城市儿童为9.5%，农村儿童为3.0%（城市与农村的比值比（OR）：3.42；95%置信区间（CI）：-1.96-5.91）。在对宿主因素（包括母乳喂养时间以及哮喘和/或过敏家族史）的城乡差异进行调整后，这种城乡梯度仍然存在，但很大程度上可由环境因素的城乡差异来解释，这些环境因素包括室内饲养动物、与吸烟者共用卧室、父母教育程度、房屋通风情况以及上学途中接触机动车尾气（调整后的OR：1.59；95%CI：0.70-3.55）。所有其他症状也得到了类似结果。这些发现证实了临床上认为哮喘在肯尼亚是一种重要疾病的印象，并强调有必要进一步研究可进行干预的环境因素，尤其是在城市地区。
