Effect of environmental endotoxin exposure on development of pediatric asthma among Egypytian school children

Objective: The aim of this study was to assess school indoor exposure to microbial products and prevalence of asthma and allergies in rural and urban children.Methods: This study was carried on a rural and an urban school.Environmental endotoxin level was measured in multiple samples of the ambient indoor air dust collected on special aseptic filter papers from the two schools.For two hundred children history taking,clinical examination,allergen skin prick test and basic pulmonary function test were preformed.Results: Environmental endotoxin levels showed significantly higher mean values(P<0.01) in rural school(3 EU/mg) as compared to the urban school(0.1 EU/mg) with(OR=5.163;95% CI: 0.95-28).History of allergic symptoms was significantly more in urban than rural students(P=0.01).Mean values of pulmonary function parameters were significantly lower values in urban students compared to rural students.Skin prick test results showed significant reactions to all tested allergens in urban children compared to rural children(P<0.05).Conclusion: There is an inverse association between environmental exposure to endotoxins and susceptibility for allergic manifestations in school children.

2010年福建省福州城乡0~14岁儿童哮喘流行病学调查

目的了解福建省福州城乡儿童哮喘的患病特点和诊治现状。方法采取整群抽样的调查方法 ,于2010年10月至2011年10月抽取福州城市12 235例和农村6 000例儿童作为调查对象,由全国儿童哮喘防治协作组统一制定调查方案,通过发放问卷及现场问诊、体检的方式完成调查。分析城市和农村儿童哮喘患病特点和诊治情况。结果①城市共发放儿童哮喘初筛问卷12 235份,实际收回有效问卷11 738份,应答率为95.9%,确诊儿童哮喘485例(4.13%);农村共发放儿童哮喘初筛问卷6 000份,实际收回有效问卷5 860份,应答率为97.7%,确诊儿童哮喘119例(2.03%),城市与农村哮喘发生率比较差异有统计学意义(x^2=52.05,P<0.001);②福州城乡确诊儿童哮喘既往诊断正确率城市63.9%、农村61.3%,差异无统计学意义(x^2=0.27,P=0.601>0.05);③城市及农村儿童哮喘发作的常见发病诱因比较有显著性差异,其中呼吸道感染城市占88.1%,农村占96.6%;天气变化城市占43.5%,农村占76.5%;④城市及农村哮喘使用药物情况比较有显著性差异(x^2=29.81,P<0.001),其中吸入激素使用率城市占68.7%、农村占52.1%;抗生素使用率城市占69.5%、农村占81.5%。结论福建省福州城市儿童哮喘患病高于农村,根据本次调查的诊治情况,应重点加强农村哮喘吸入型激素、合理使用抗生素的防治宣教。

城市哮喘儿童抑郁障碍及相关因素分析

目的了解哮喘儿童抑郁障碍现状,探讨其相关影响因素,为健康教育提供理论依据。方法使用哮喘儿童一般情况调查表、儿童抑郁障碍自评量表(DSRSC)对408名8～16岁哮喘儿童进行抑郁障碍调查,并分析其相关影响因素。结果哮喘儿童抑郁障碍检出率为22.3%,抑郁障碍评分高于全国正常儿童常模,不同年龄组间的哮喘儿童抑郁障碍差异有显著意义(P<0.01)。抑郁障碍评分的影响因素经多元逐步回归分析,父母对哮喘的认识程度、母亲文化程度、患儿性别、家庭结构、患儿文化程度5个变量进入了回归方程,其中,患儿父母对哮喘的认识程度和母亲文化程度对抑郁障碍影响最显著,患儿文化影响最小,余下两个影响因素从大到小分别为患儿性别和家庭结构。结论哮喘儿童抑郁情绪高于全国正常儿童,受多种因素影响,应引起医护人员及家长、社会的高度重视。

Prevalence and Treatment of Children＇s Asthma in Rura Areas Compared with Urban Areas in Beijing

The prevalence of childhood asthma has been increasing in China. This study aimed to compare the prevalence, diagnosis, and treatment of asthmatic children from urban and rural areas in Beijing, China. Methods： Schools, communities, and kindergartens were randomly selected by cluster random sampling from urban and rural areas in Beijing. Parents were surveyed by the same screening questionnaires. On-the-spot inquiries, physical examinations, medical records, and previous test results were used to diagnose asthmatic children. Information on previous diagnoses, treatments, and control of symptoms was obtained. Results： From 7209 children in rural areas and 13,513 children in urban areas who completed screening questionnaires, 587 children were diagnosed as asthma. The prevalence of asthma in rural areas was lower than in urban areas （1.25% vs. 3.68%, χ^2 = 100.80, P 〈 0.001）. The diagnosis of asthma in rural areas was lower than in urban areas （48.9% vs. 73.9%, χ^2 = 34.6, P 〈 0.001）. Compared with urban asthmatic children （56.5%）, only 35.6% of rural asthmatic children received inhaled corticosteroids （P 〈 0.05）. The use ofbronchodilators was also lower in rural areas than in urban areas （56.5% vs. 66.4%, χ^2 = 14.2, P 〈 0.01）. Conclusion： The prevalence of asthma in children was lower in rural areas compared with children in the urban area of Bcijing. A considerable number of children were not diagnosed and inadequately treated in rural areas,

Bronchospasm Diagnosis in Motorcycle Taxi Drivers Exposed to Automotive Pollutants in Porto-Novo

Background: In African cities, chronic exposure to pollutants is the most common public health problem faced daily by motorcycle taxi drivers. In Benin, studies conducted on motorcycle drivers, have shown the presence of nitrogen oxides, carbon monoxide, sulfur dioxide, volatile organic compounds and particulate matter in ambient air, which may affect lung function. Aims: This study aims to diagnose potential respiratory problems among 48 motorcycle taxi drivers (47.02 ± 8.75 years) compared to a control group made up of 52 people (46.38 ± 8.81 years) in Porto-Novo, Benin. Methods: A questionnaire, two exploration pulmonary function tests and two 6-minute walk tests were used to identify symptoms and changes in respiratory variables that reveal the existence of bronchospasm. Results: The frequency of respiratory symptoms noted among motorcycle taxi drivers is higher than that recorded among members of the control group. We observed that motorcycle drivers at rest and after physical effort have significantly lower respiratory variables (FVC, FEV1, PEF, FEF25-75, FEF50 and FEF25) (p < 0.05) than those recoded in control group. Conclusion: It can therefore be concluded that, because of the relatively long duration of exposure among motorcycle taxi drivers, the inhalation of automobile pollutants, may cause respiratory problems in this population.

儿童支气管哮喘城乡联合网络信息化数据库管理模式的探索研究

目的:采用多中心城乡联合网络信息化数据库管理模式进行儿童支气管哮喘规范治疗以及管理的推广,并进行应用效果评价。方法:对确诊的418例支气管哮喘患儿制定个体化治疗方案并建立数据库。通过中山市多中心城乡联合网络信息管理平台,对哮喘儿童进行分级管理,并通过该渠道实施哮喘规范化管理的推广,对比管理前后哮喘患儿临床病情控制情况、急性发作和急诊就医次数、家庭经济负担情况、患儿误学以及家长误工的情况。结果:实施该管理体系使中山市哮喘患儿用药更趋合理,能有效提高支气管哮喘患儿疾病控制率,减少哮喘急性发作和急诊就医次数,减少患儿误学及家长误工天数,降低社会及家庭经济负担。结论:采用多中心城乡联合网络信息管理平台在中山市进行儿童哮喘规范管理模式的推广对儿童哮喘的防治效果显著。

郊区和城区空气污染物浓度差异及与儿童哮喘患病情况的关系

目的探索郊区和城区空气污染物浓度差异及空气污染指数与儿童哮喘患病情况的关系,为哮喘防治提供理论依据。方法本次研究对象为2017年1月—2019年12月期间中国医科大学附属盛京医院收治的211例哮喘患儿,均进行肺功能、哮喘评分评估,同时选取辽宁省沈阳市城区面积23.71 km^(2),郊区面积22.86 km^(2)进行空气污染物浓度检测,并分析城区、郊区空气污染物、儿童哮喘患病情况之间的关系。结果城区空气污染物中总计PM_(10)浓度[(0.139±0.032)mg/m^(3)]、API浓度(65.455±8.741)、PM_(2.5)[(0.061±0.010)mg/m^(3)]高于郊区空气中总计PM_(10)浓度[(0.048±0.012)mg/m^(3)]、API浓度(56.955±8.774)、PM_(2.5)[(0.061±0.010)mg/m^(3)](t=24.256、6.827、17.575,P<0.001)。从哮喘发生情况分析,城区总计哮喘发生率高于郊区(χ^(2)=26.626,P<0.001),组间对比FEV、PEF差异无统计学意义(P>0.05),但哮喘评分差异有统计学意义(t=18.863,P<0.001)。经Pearson法分析,城区、郊区患者哮喘评分与NO_(2)、SO_(2)、PM_(10)、PM_(2.5)、API呈正相关性(r_(城区)=0.197、0.318、0.252、0.451、0.167,P<0.05;r_(郊区)=0.281、0.241、0.428、0.395、0.487,P<0.05);经Spearman法分析,城区、郊区哮喘病情严重程度与NO_(2)、SO_(2)、PM_(10)、API、哮喘评分、PM_(2.5)、FEV_(1)、PEF呈正相关性(r_(城区)=0.458、0.398、0.478、0.498、0.356、0.524、0.511、0.528,P<0.05;r_(郊区)=0.457、0.419、0.589、0.524、0.398、0.425、0.424、0.407,P<0.05)。结论城区和郊区的空气污染物浓度存在差异,与哮喘儿童病情严重程度呈正相关性。污染越严重,儿童患病程度越严重。

城市哮喘患儿对食物过敏状况分析

目的探索城市哮喘患儿对食物过敏状况。方法选取2018年1月至2019年1月于绵阳市妇幼保健院接受治疗的1462例哮喘患儿作为观察组,选取同期于该院接受体检的1828名体检儿童作为对照组。统计常见食物过敏的种类及占比,统计两组研究对象出现临床症状的种类及占比。结果研究观察组共发现219例食物过敏儿童,患病率为14.98%,对照组共发现72例食物过敏儿童,患病率为3.94%(χ^2=5.036,P=0.024)。观察组花生过敏率显著高于对照组,水果过敏率明显低于对照组,数据对比差异有统计学意义(P<0.05)。观察组痒感、口唇黏膜红肿、喷嚏、休克临床症状发生率显著高于对照组,皮肤瘙痒、皮疹临床症状发生率明显低于对照组,数据对比差异有统计学意义(P<0.05)。结论支气管哮喘患儿食物过敏患病率高于非支气管哮喘儿童,且支气管哮喘常见食物过敏种类及临床症状与非支气管哮喘儿童具有明显差异,临床医师可以根据儿童常见食物过敏种类及临床症状进行初步诊断。