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1.
Mymensingh Med J ; 28(4): 881-886, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599255

RESUMO

This case control study was conducted in the out patient department (OPD), Enam Medical College & Hospital (EMCH), Dhaka, Bangladesh from 1st January 2017 to 31st December 2017. The aim of our study was to find the possible association between serum iron state and iron deficiency anemia with bronchial asthma in women. We investigated 40 diagnosed female cases of well controlled bronchial asthma and 20 healthy female as control. In both groups complete blood count (CBC) with peripheral smear was done, C-reactive protein (CRP), serum iron, serum ferritin, and serum total iron binding capacity (TIBC) was measured. We found asthma cases had lower hemoglobin than control (mean±SD 10.92±1.34 vs. 12.30±0.73, p value 0.013), serum iron and serum ferritin were significantly lower (p value 0.016 and 0.000 respectively) and TIBC was higher (p value 0.000) in asthmatic cases as compared to controls. Non anemic asthmatics showed significant lower serum ferritin compared with non-anemic healthy controls (p value 0.005). So we conclude that iron deficiency anemia is more prevalent in asthmatic women as compared to healthy controls.


Assuntos
Anemia Ferropriva/epidemiologia , Asma/epidemiologia , Bangladesh/epidemiologia , Estudos de Casos e Controles , Feminino , Ferritinas , Hemoglobinas , Humanos
2.
Mymensingh Med J ; 28(4): 914-919, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599260

RESUMO

Allergic rhinitis is one of important risk factor for developing asthma and sometimes it appears before developing full-blown asthma in affected patients. This is a socially embarrassing condition for the patients. Current estimates are that allergy in one form or another affects some 30% or more of general population. Otolaryngologists may expect about 50% of patients encountered in their daily practice to have allergy as a major or at least a contributing cause of presenting problems. Allergy has been called "The great masquerader", because of its ability to mimic an immense variety of other conditions. Objective of the study is to determine the association of allergic rhinitis with asthma. This cross sectional study was conducted at Green Life Hospital, Dhaka, Bangladesh from January 2018 to July 2018. Ultimately 250 interested patients were enrolled in the study. 50.8% of the participants were male and 49.2% were female. Among the 250 allergic rhinitis patients 92% presented with nasal discharge, 64.8% presented with nasal blockade, 84% presented with bouts of sneezing, 27.6% presented with hyposmia, 8.8% presented with Ocular redness, 48.8% presented with headache, 18.0% presented with epistaxis. Among them 43.2% patients were previously diagnosed as asthma by competent physicians; 39.2% patients had previous history of breathlessness that relieved with asthma medication in last 12 months. At least more than one symptom like wheeze, shortness of breath, chest tightness and cough in last 12 months were experienced by 51.6% patients. Among the 250 patients 51.2% had Rhonchi on chest examination, 54.8% had some form of shortness of breath, 43.2% had chest tightness, 59.6% had dry cough during the time of history taking & physical examination. The current study found strong association between allergic rhinitis and asthma.


Assuntos
Asma/epidemiologia , Rinite Alérgica/epidemiologia , Bangladesh/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Rinite , Fatores de Risco
3.
Artigo em Chinês | MEDLINE | ID: mdl-31623046

RESUMO

Objective:To investigate the prevalence and state of allergic rhinitis, asthma, eczema, allergic conjunctivitis, and food allergy of students in primary and middle schools of Foshan, and to analyze the characteristics of each disease and correlation of the five diseases, in order to provide epidemiology evidence for management of allergic diseases. Method:Ten primary schools and 10 junior middle schools were sampled from 5 districts of Foshan, then students in grade one and grade seven from sampled schools were investigated by electronic questionnaire method formulated by the International Study of Asthma and Allergies in Childhood and the Europrevall Project Commission. Students and their parents answered and uploaded electronic questionnaires with the consent of parents, and then team members collected and analyzed uploaded data. Result:Four thousand one hundred and sixty-six effective questionnaires were collected, and the response rate was 95.77%. During the five districts, 13.97%, 2.01%, 29.29%, 5.19%, and 7.28% of the respondents in grade one had previously diagnosed with allergic rhinitis, asthma, eczema, allergic conjunctivitis, and food allergy respectively, and the correspondent rates in grade seven were 15.99%, 2.89%, 16.73%, 2.46%, and 6.97%. The prevalence rates of the five diseases in boys were higher than that in girls in both two grades. 67.27% students with asthma kept coughing and wheezing in the last 12 months, and 24.85% non-asthma students had the same respiratory symptoms. The most common allergenic food were shrimp and crabs, followed by milk and milk products, eggs, and shellfish. Cutaneous symptoms and oral allergy symptoms were predominant clinical manifestations in all students with food allergy. The prevalence of the above allergic diseases of children with atopic family history was higher than that of children without family history, and the prevalence of the 5 diseases of children living in city was higher than that of children living in rural areas. The prevalence rate of asthma of children with allergic rhinitis in both grades was higher than that of children without allergic rhinitis, and the same happened to children with eczema, allergic conjunctivitis, and food allergy. Conclusion:Prevalence rates of allergic rhinitis and asthma in primary and middle school students of Foshan increased as children grew, while the prevalence rates of eczema, allergic conjunctivitis and food allergy decreased with age. The most common allergenic food were shrimp and crabs, milk and milk products, and eggs. 67.27% students with asthma had poor respiratory control in the last 12 months. The prevalence of allergic diseases of children living in city and with atopic family history was higher than that of children living in rural areas and without family history. Students with allergic conjunctivitis, food allergy, allergic rhinitis and eczema had high risk of asthma.


Assuntos
Hipersensibilidade/epidemiologia , Asma/epidemiologia , Criança , China/epidemiologia , Conjuntivite Alérgica/epidemiologia , Eczema/epidemiologia , Hipersensibilidade a Ovo/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Estudantes , Inquéritos e Questionários
4.
Georgian Med News ; (291): 53-58, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31418731

RESUMO

Allergic diseases (AD) have been one of the most urgent problems on nowadays worldwide. In some countries with a high AD prevalence according to ISAAC Phase One, compared to ISAAC Phase Three, especially in English-speaking countries, there is a tendency to reduction of respiratory symptoms prevalence, while in other countries, on the contrary, it continues to grow. The aim of the study is to conduct a comparative analysis of the prevalence of asthma, rhinitis and eczema in the Kyiv region of Ukraine in the dynamics for the period 2017-2018 and 1998-1999, to understand current epidemiological trends. 3186 children of different age groups, living in different regions of the Kyiv region, have been surveyed. For comparative analysis, data from asthma, rhinitis and eczema and two age groups of 6-7 years (n=1647) and 13-14 years old (n=1539) were used as required by the design of ISAAC. The epidemiological study of the prevalence of AD symptoms among children in the Kyiv region in dynamics of the 19-year period showed that there was a slight decrease in the prevalence of asthma in both age groups, although their level remains rather high. But the rate of severe asthma, especially among adolescents, has risen. Thus, the prevalence of asthma symptoms among children aged 6-7 years decreased from 16.8% to 15.4% (-0.07% per year), and among adolescents from 15.2% to 11.2% (-0, 2% per year). The prevalence of rhinitis and eczema symptoms among children in the Kyiv region continues to grow in both age groups over the years, which is consistent with the global world trends. The steady growth of allergic diseases prevalence requires further investigation of causative factors and possible ways of their solution for both Ukraine as a whole and for the Kyiv region in particular. Worrying problems of insufficient asthma control also flow out from the performed analysis, especially in regards the adolescent age category, which determines the future research directions.


Assuntos
Hipersensibilidade/epidemiologia , Adolescente , Asma/epidemiologia , Criança , Eczema/epidemiologia , Inquéritos Epidemiológicos , Humanos , Prevalência , Rinite/epidemiologia , Ucrânia/epidemiologia
5.
Medicine (Baltimore) ; 98(35): e16540, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464891

RESUMO

Antibiotics during infancy, delivery, and breastfeeding affect the intestinal microbiota in early life and is associated with allergic disease. Gastroenteritis (GE) during infancy also affects intestinal microbiota in early life, however, its relationship to allergic disease has not been investigated.Data of 45,499 males and 49,430 females, from birth to 5 years of age, were collected from a national database in Taiwan. Subjects were categorized into early GE (GE within 0-6 months) and non-early GE group (no GE within 0-6 months). The rates of asthma (AS), allergic rhinitis (AR), and atopic dermatitis (AD) over 5 years were evaluated and compared between the groups. In patients with AS, AR, and AD, the number of clinical visits and drug prescriptions for the allergic disease was also evaluated to assess the effect of early GE on allergic disease.After adjusting for the effect of GE in later life and other factors, the rates of AS [OR (odds ratio) 1.54, 95% confidence interval (CI) 1.48-1.60], AR [OR 1.49, 95% CI 1.45-1.54], and AD [OR 1.40, 95% CI 1.33-1.47] were higher in the early GE group than in the non-early GE group. The magnitude of the increase was higher in females than in males. In those with AS, AR, and AD, the number of clinical visits and drug prescriptions was not different between the early GE and non-early GE groups. In children with early GE, good control of GE in the following years lowered the rate of allergic disease.Early-life GE was associated with increased rates of AS, AR, and AD in later life and this was trend more prominent in females.


Assuntos
Asma/epidemiologia , Dermatite Atópica/epidemiologia , Gastroenterite/complicações , Rinite Alérgica/epidemiologia , Asma/etiologia , Estudos de Casos e Controles , Pré-Escolar , Dermatite Atópica/etiologia , Feminino , Gastroenterite/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Rinite Alérgica/etiologia , Caracteres Sexuais , Taiwan/epidemiologia
6.
Sci Total Environ ; 691: 549-561, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31325855

RESUMO

BACKGROUND: Mounting evidence suggests that short-term exposure to ozone increases the risk of asthma exacerbations. However, ozone exposures have been assessed using ambient ozone concentrations averaged over different time periods in different studies. OBJECTIVE: To evaluate the risks for asthma exacerbations related to ambient ozone measured as 1-hour or 8-hour daily maximum and 24-hour average concentrations. METHODS: Based on a literature search in PubMed, EMBASE and Web of Science, we identified all time-series studies as of December 4th, 2018 and included 47 eligible studies in our analyses. Asthma exacerbation is defined as the risk for emergency room visits or hospital admissions. Pooled relative risks (RRs) and 95% confidence intervals (95%CIs) for a 10 µg/m3 increase in daily ozone concentration were estimated using random effect models. Subgroup analyses and sensitivity analyses were also performed to examine the risks for different seasons, regions and age groups and for the robustness of our main findings. RESULTS: Significant and similar associations were found for O3-1 h max (RR,1.012; 95%CI, 1.005-1.019) and O3-8 h max (RR, 1.011; 95%CI, 1.007-1.014), while marginal effect was identified for O3-24 h average (RR, 1.005; 95%CI, 0.996-1.014). No significant publication bias but high heterogeneities were observed. During the warm season, ozone was significantly associated with asthma exacerbation. O3-1 h max had the highest RR of 1.014 (95%CI, 1.005-1.024), followed by O3-8 h max (RR, 1.012; 95%CI, 1.009-1.016), while marginal association was identified for O3-24 h avg (RR, 1.008; 95%CI, 0.998-1.017). During the cold season, null associations were identified for all the three averaging times. Variations were also observed in region and age. CONCLUSION: Ozone exposure measured as 1-hour or 8-hour daily max were more consistently associated with asthma exacerbations than 24-hour average exposure during the warm season.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Asma/epidemiologia , Exposição por Inalação/estatística & dados numéricos , Ozônio/análise , Monitoramento Ambiental , Humanos
7.
BMJ ; 366: l4151, 2019 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-31292120

RESUMO

OBJECTIVE: To determine whether any association exists between exposure to 2009 pandemic H1N1 (pH1N1) influenza vaccination during pregnancy and negative health outcomes in early childhood. DESIGN: Retrospective cohort study. SETTING: Population based birth registry linked with health administrative databases in the province of Ontario, Canada. PARTICIPANTS: All live births from November 2009 through October 2010 (n=104 249) were included, and children were followed until 5 years of age to ascertain study outcomes. MAIN OUTCOME MEASURES: Rates of immune related (infectious diseases, asthma), non-immune related (neoplasms, sensory disorders), and non-specific morbidity outcomes (urgent or inpatient health services use, pediatric complex chronic conditions) were evaluated from birth to 5 years of age; under-5 childhood mortality was also assessed. Propensity score weighting was used to adjust hazard ratios, incidence rate ratios, and risk ratios for potential confounding. RESULTS: Of 104 249 live births, 31 295 (30%) were exposed to pH1N1 influenza vaccination in utero. No significant associations were found with upper or lower respiratory infections, otitis media, any infectious diseases, neoplasms, sensory disorders, urgent and inpatient health services use, pediatric complex chronic conditions, or mortality. A weak association was observed between prenatal pH1N1 vaccination and increased risk of asthma (adjusted hazard ratio 1.05, 95% confidence interval 1.02 to 1.09) and decreased rates of gastrointestinal infections (adjusted incidence rate ratio 0.94, 0.91 to 0.98). These results were unchanged in sensitivity analyses accounting for any potential differential healthcare seeking behavior or access between exposure groups. CONCLUSIONS: No associations were observed between exposure to pH1N1 influenza vaccine during pregnancy and most five year pediatric health outcomes. Residual confounding may explain the small associations observed with increased asthma and reduced gastrointestinal infections. These outcomes should be assessed in future studies.


Assuntos
Saúde da Criança , Vírus da Influenza A Subtipo H1N1 , Vacinas contra Influenza/efeitos adversos , Influenza Humana/prevenção & controle , Pandemias/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Efeitos Tardios da Exposição Pré-Natal , Adulto , Asma/epidemiologia , Pré-Escolar , Feminino , Gastroenteropatias/epidemiologia , Humanos , Lactente , Recém-Nascido , Infecção/epidemiologia , Ontário/epidemiologia , Gravidez , Pontuação de Propensão , Sistema de Registros , Estudos Retrospectivos , Adulto Jovem
8.
Sci Total Environ ; 691: 296-305, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31323575

RESUMO

BACKGROUND: With global climate change, there is growing concern about the effects of temperature changes on childhood asthma. However, current research only focuses on the effects of temperature, while ignoring the adverse effects of humidity on children. OBJECTIVES: Our study aimed to quantify the impact of humidex on childhood asthma hospitalizations, which combined temperature and humidity, and further to assess how the effect is modified by individual-factors, such as age and gender. METHODS: Poisson generalized linear models combined with distributed lag nonlinear models were used to estimate the association between daily childhood asthma hospitalizations and humidex from 2013 to 2016. Air pollutions (CO, O3, and NO2) and wind velocity were modelled simultaneously using DLNM, as well as day of week, seasonality and long-term trend. RESULTS: Low humidex was associated with an increased risk of admissions for asthma in children. The adverse effect appeared on the 4th day, with the RR of 1.045 (95%CI: 1.007-1.084) and lasted until the 7th day (RR: 1.045, 95%CI: 1.006-1.085). Compared with the male, there was an immediate effect on female exposed to low humidex. And the female seems to be more sensitive to low humidex. Besides, the significant effects of humidex on children asthma were detected in the children with preschool and school-age, whereas not for the subgroup of infants. And the school-age children are most sensitive to low humidex. CONCLUSIONS: Low humidex was associated with the increased risk of admissions for childhood asthma in Hefei. Children suffering from asthma should avoid exposure to the low humidex environment, especially in female and school-age children. In addition, the index of humidex was more significant for disease prevention and public health than the average temperature. These findings may provide epidemiology evidence for formulating precaution guidelines to reduce the risk of childhood asthma hospitalizations.


Assuntos
Asma/epidemiologia , Exposição Ambiental/estatística & dados numéricos , Umidade/efeitos adversos , Ventilação/instrumentação , Poluição do Ar , Criança , Pré-Escolar , China/epidemiologia , Feminino , Hospitalização , Humanos , Lactente , Masculino
9.
J Bras Pneumol ; 45(3): e20180138, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31271601

RESUMO

OBJECTIVE: To estimate the evolution of the prevalence of asthma and wheezing among schoolchildren in Brazil from 2012 to 2015, as well as to identify factors associated with both conditions. METHODS: This was a cross-sectional study using data from the Brazilian National School-Based Adolescent Health Survey for 2012 and 2015. To characterize the evolution of the prevalence of asthma and wheezing, we used linear regression with weighted-least-squares estimation and presented the annual percent change (APC). RESULTS: During the study period, there was a reduction in the prevalence of wheezing, from 23.2% in 2012 to 22.4% in 2015 (APC, -0.27). The prevalence of asthma increased from 12.4% in 2012 to 16.0% in 2015 (APC, 1.20). The increase in the prevalence of asthma was greatest in the southern region of the country (APC, 2.17). Having any history of smoking and having consumed alcohol in the last 30 days were factors that influenced the prevalence of wheezing and the prevalence of a self-reported diagnosis of asthma during the two years evaluated. CONCLUSIONS: There has been an increase in the prevalence of asthma in recent years in Brazil. Our data underscore the importance of improving health strategies and policies aimed at the control of asthma.


Assuntos
Asma/epidemiologia , Asma/etiologia , Sons Respiratórios/etiologia , Adolescente , Saúde do Adolescente/estatística & dados numéricos , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Prevalência , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Fatores Socioeconômicos , Inquéritos e Questionários , Fatores de Tempo
10.
Environ Monit Assess ; 191(Suppl 2): 269, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31254073

RESUMO

Asthma is the most common pediatric disease in the USA. It has been consistently demonstrated that asthma symptoms are exacerbated by exposure to ozone. Ozone (O3) is a secondary pollutant produced when volatile organic compounds (VOCs) are oxidized in the atmosphere in the presence of nitrogen oxides (NOx). At ground level, elevated ozone is typically formed as a result of human activities. However, wildfires represent an additional source of ozone precursors. Recent evidence suggests that smoke can increase ozone concentrations. We estimated the number of excess asthma-related emergency department (ED) visits in children with asthma that may be attributed to elevated ozone associated with smoke (EOAS) in the USA. We conducted a quantitative burden assessment (BA) using a Monte Carlo approach to estimate the median number of excess pediatric asthma ED visits that may be attributed to EOAS among children with asthma in the continental USA between 2005 and 2014, as well as 95% confidence bounds (95% CB). We estimated that a median of 2403 (95% CB 235-5382) pediatric asthma ED visits could be attributed to EOAS exposure between 2005 and 2014 in the continental USA. Furthermore, the impact of EOAS on estimated asthma ED visits was greatest in the eastern half of the continental USA. We found a significant increase in pediatric asthma ED visits that may be attributed to exposure to EOAS. EOAS may have a measurable negative impact on children with asthma in the USA.


Assuntos
Poluentes Atmosféricos/análise , Asma/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Ozônio/análise , Fumaça/análise , Compostos Orgânicos Voláteis/química , Adolescente , Poluentes Atmosféricos/efeitos adversos , Asma/etiologia , Atmosfera , Criança , Pré-Escolar , Monitoramento Ambiental , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Oxirredução , Ozônio/efeitos adversos , Pediatria , Fumaça/efeitos adversos , Estados Unidos/epidemiologia , United States Environmental Protection Agency , Incêndios Florestais
11.
Internist (Berl) ; 60(8): 792-798, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31240339

RESUMO

Atopic dermatitis (AD) is one of the most frequent chronic inflammatory skin diseases, characterized by pruritic eczematous lesions. Due to the fact that AD is accompanied by signs of systemic inflammation and that an increased number of novel systemic treatment options are currently emerging, research into general medical comorbidities in moderately to severely affected AD patients has received great impetus in recent years. These studies have confirmed an increased risk of atopic diseases such as allergic asthma in AD patients. Furthermore, an association between AD and dermatological diseases with autoimmune pathophysiology such as vitiligo and alopecia areata has been demonstrated. Moreover, several studies have revealed an increased risk for internal autoimmune diseases in AD patients, e.g. inflammatory bowel disease and rheumatoid arthritis. A differentiated view of the data on AD as a possible risk factor for cardiovascular disease is needed. Large cross-sectional studies in the US revealed a correlation between AD and cardiovascular comorbidities. This has not been confirmed as yet in large German, Danish and Canadian investigations. Whether diverse "coping" strategies in different countries can explain these variances remains to be discussed. In terms of microbial comorbidities, AD patients display a particular susceptibility to viral infections.


Assuntos
Dermatite Atópica/patologia , Eczema/patologia , Asma/epidemiologia , Doenças Autoimunes/epidemiologia , Doenças Cardiovasculares/epidemiologia , Comorbidade , Dermatite Atópica/epidemiologia , Eczema/epidemiologia , Humanos , Viroses/epidemiologia
12.
Environ Pollut ; 252(Pt A): 599-606, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31185348

RESUMO

Previous studies have linked ambient PM2.5 to decreased pulmonary function, but the influence of specific chemical elements and emission sources on the severe asthmatic is not well understood. We examined the mass, chemical constituents, and sources of PM2.5 for short-term associations with the pulmonary function of adults with severe asthma in a low air pollution environment in urban Nagasaki, Japan. We recruited 35 asthmatic adults and obtained the daily record of morning peak expiratory flow (PEF) in spring 2014-2016. PM2.5 filters were extracted from an air quality monitoring station (178 days) and measured for 27 chemical elements. Source apportionment was performed using Positive Matrix Factorization (PMF). We fitted generalized linear model with generalized estimating equation (GEE) method to estimate changes in PEF (from personal monthly maximum) and odds of severe respiratory deterioration (first ≥ 15% PEF reduction within a 1-week interval) associated with mass, constituents, and sources of PM2.5, with adjustment for temperature and relative humidity. Constituent sulfate (SO42-) and PM2.5 from oil combustion and traffic were associated with reduced PEF. An interquartile range (IQR) increase in SO42- (3.7 µg/m3, average lags 0-1) was associated with a decrease of 0.38% (95% confidence interval = -0.75% to -0.001%). An IQR increase in oil combustion and traffic-sourced PM2.5 (2.64 µg/m3, lag 1) was associated with a decrease of 0.33% (-0.62% to -0.002%). We found a larger PEF decrease associated with PM2.5 from dust/soil on Asian Dust days. There was no evidence linking total mass and metals to reduced pulmonary function. The ventilatory capacity of adults with severe asthma is susceptible to specific constituents/sources of PM2.5 such as sulfate and oil combustion and traffic despite active self-management of asthma and low air pollution levels in the study location.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Asma/epidemiologia , Exposição por Inalação/estatística & dados numéricos , Material Particulado/análise , Adulto , Poluição do Ar/análise , Poeira/análise , Monitoramento Ambiental/métodos , Humanos , Japão/epidemiologia , Pulmão/química , Testes de Função Respiratória , Estações do Ano , Solo , Temperatura Ambiente
13.
Lancet ; 394(10196): 407-418, 2019 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-31230828

RESUMO

BACKGROUND: Asthma is a common chronic airway disease worldwide. Despite its large population size, China has had no comprehensive study of the national prevalence, risk factors, and management of asthma. We therefore aimed to estimate the national prevalence of asthma in a representative sample of the Chinese population. METHODS: A representative sample of 57 779 adults aged 20 years or older was recruited for the national cross-sectional China Pulmonary Health (CPH) study using a multi-stage stratified sampling method with parameters derived from the 2010 census. Ten Chinese provinces, representative of all socioeconomic settings, from six geographical regions were selected, and all assessments were done in local health centres. Exclusion criteria were temporary residence, inability to take a spirometry test, hospital treatment of cardiovascular conditions or tuberculosis, and pregnancy and breastfeeding. Asthma was determined on the basis of a self-reported history of diagnosis by a physician or by wheezing symptoms in the preceding 12 months. All participants were assessed with a standard asthma questionnaire and were classed as having or not having airflow limitation through pulmonary function tests before and after the use of a bronchodilator (400 µg of salbutamol). Risk factors for asthma were examined by multivariable-adjusted analyses done in all participants for whom data on the variables of interest were available. Disease management was assessed by the self-reported history of physician diagnosis, treatments, and hospital visits in people with asthma. FINDINGS: Between June 22, 2012, and May 25, 2015, 57 779 participants were recruited into the CPH study. 50 991 (21 446 men and 29 545 women) completed the questionnaire survey and had reliable post-bronchodilator pulmonary function test results and were thus included in the final analysis. The overall prevalence of asthma in our sample was 4·2% (95% CI 3·1-5·6), representing 45·7 million Chinese adults. The prevalence of asthma with airflow limitation was 1·1% (0·9-1·4), representing 13·1 million adults. Cigarette smoking (odds ratio [OR] 1·89, 95% CI 1·26-2·84; p=0·004), allergic rhinitis (3·06, 2·26-4·15; p<0·0001), childhood pneumonia or bronchitis (2·43, 1·44-4·10; p=0·002), parental history of respiratory disease (1·44, 1·02-2·04; p=0·040), and low education attainment (p=0·045) were associated with prevalent asthma. In 2032 people with asthma, only 28·8% (95% CI 19·7-40·0) reported ever being diagnosed by a physician, 23·4% (13·9-36·6) had a previous pulmonary function test, and 5·6% (3·1-9·9) had been treated with inhaled corticosteroids. Furthermore, 15·5% (11·4-20·8) people with asthma reported at least one emergency room visit and 7·2% (4·9-10·5) at least one hospital admission due to exacerbation of respiratory symptoms within the preceding year. INTERPRETATION: Asthma is prevalent but largely undiagnosed and undertreated in China. It is crucial to increase the awareness of asthma and disseminate standardised treatment in clinical settings to reduce the disease burden. FUNDING: National Key R&D Program of China, Ministry of Science and Technology of China; the Special Research Foundation for Public Welfare of Health, Ministry of Health of China; the Chinese National Research Program for Key Issues in Air Pollution Control; and the National Natural Science Foundation of China.


Assuntos
Asma/tratamento farmacológico , Asma/epidemiologia , Bronquite/epidemiologia , Fumar Cigarros/epidemiologia , Pneumonia/epidemiologia , Rinite Alérgica/epidemiologia , Administração por Inalação , Corticosteroides/uso terapêutico , Adulto , Asma/etiologia , Bronquite/complicações , China/epidemiologia , Fumar Cigarros/efeitos adversos , Estudos Transversais , Gerenciamento Clínico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia/complicações , Prevalência , Rinite Alérgica/complicações , Fatores de Risco , Inquéritos e Questionários
14.
BMC Public Health ; 19(1): 663, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31146713

RESUMO

BACKGROUND: Previous studies on asthma mortality and hospitalizations in Reunion Island indicate that this French territory is particularly affected by this pathology. Epidemiological studies conducted in schools also show higher prevalence rates in Reunion than in Mainland France. However, no estimates are provided on the prevalence of asthma among adults. In 2016, a cross-sectional survey was conducted to estimate the prevalence of asthma and to identify its associated factors in the adult population of Reunion Island. METHODS: A random sample of 2419 individuals, aged 18-44 years, was interviewed by telephone using a standardized, nationally validated questionnaire. Information was collected on the respiratory symptoms, description of asthma attacks and triggering factors for declared asthmatics, as well as data on the indoor and outdoor home environment. "Current asthma" was defined as an individual declaring, at the time of the survey, having already suffered from asthma at some point during his/her life, whose asthma was confirmed by a doctor, and who had experienced an asthma attack in the last 12 months or had been treated for asthma in the last 12 months. "Current suspected asthma" was defined as an individual presenting, in the 12 months preceding the study, groups of symptoms suggestive of asthma consistent with the literature. RESULTS: The estimated prevalence of asthma was 5.4% [4.3-6.5]. After adjustment, women, obesity, a family member with asthma, tenure in current residence and presence of indoor home heating were associated with asthma. The prevalence of symptoms suggestive of asthma was 12.0% [10.2-13.8]. After adjustment, marital status, passive smoking, use of insecticide sprays, presence of mold in the home and external sources of atmospheric nuisance were associated with the prevalence of suspected asthma. CONCLUSION: Preventive actions including asthma diagnosis, promotion of individual measures to reduce risk exposure as well as the development of study to improve knowledge on indoor air allergens are recommended.


Assuntos
Asma/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Reunião/epidemiologia , Fatores de Risco , Adulto Jovem
15.
Environ Monit Assess ; 191(Suppl 2): 366, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31254075

RESUMO

The spatial distribution of the prevalence of asthma and chronic obstructive pulmonary disease (COPD) remains under the influence of a wide array of environmental, climatic, and socioeconomic determinants. However, a large proportion of these influences remain unexplained. In completion, this study examined the spatial associations between asthma/COPD morbidity and their determinants using ordinary least squares (OLS) and geographically weighted regressions (GWR). Inpatient records collected from the secondary and tertiary care hospitals in Kandy from 2010 to 2014 were considered as the dependent variable. Potential risk factors (explanatory variables) were identified in four distinguished classes: 1) meteorological factors, (2) direct and indirect factors of air pollution, (3) socioeconomic factors, and (4) characteristics of the physical environment. All possible combinations of candidate explanatory variables were evaluated through an exploratory regression. A comparison between the regression models was also explored. The best OLS regression models revealed about 55% of asthma variation and 62% of COPD variation while GWR models yielded 78% and 74% of the variation of asthma and COPD occurrences respectively. Relative humidity, proximity to roads (0-200 m), road density, use of firewood as a source of fuel, and elevation play a vital role in predicting morbidity from asthma and COPD. Both local and global regression models are important in assessing spatial relationships of asthma and COPD. However, the local models exhibit a better prediction capability for assessing non-stationary relationships of asthma and COPD than global models. The geostatistical aspects used in this study may also provide insights for evaluating heterogeneous environmental risk factors in other epidemiological studies across different spatial settings.


Assuntos
Asma/epidemiologia , Geografia Médica/métodos , Modelos Estatísticos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Monitoramento Ambiental/estatística & dados numéricos , Humanos , Análise dos Mínimos Quadrados , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Regressão Espacial , Sri Lanka/epidemiologia
16.
Environ Monit Assess ; 191(Suppl 2): 332, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31254081

RESUMO

In this study, we found that machine learning was able to effectively estimate student learning outcomes geo-spatially across all the campuses in a large, urban, independent school district. The machine learning showed that key factors in estimating the student learning outcomes included the number of days students were absent from school. In turn, one of the most important factors in estimating the number of days a student was absent was whether or not the student had asthma. This highlights the importance of environmental public health for student learning outcomes.


Assuntos
Absenteísmo , Asma/epidemiologia , Saúde Ambiental/métodos , Aprendizado de Máquina , Sucesso Acadêmico , Adolescente , Criança , Saúde Ambiental/estatística & dados numéricos , Feminino , Humanos , Masculino , Instituições Acadêmicas , Estudantes , Texas/epidemiologia
17.
Environ Monit Assess ; 191(Suppl 2): 330, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31254117

RESUMO

The effects of childhood exposure to ambient air pollution and their influences on healthcare utilization and respiratory outcomes in Memphis pediatric asthma cohort are still unknown. This study seeks to (1) investigate individual-level associations between asthma and exposure measures in high asthma rate and low asthma rate areas and (2) determine factors that influence asthma at first year of a child's life, first 2 years, first 5 years, and during their childhood. Datasets include physician-diagnosed asthma patients, on-road and individual PM2.5 emissions, and high-resolution spatiotemporal PM2.5 estimates. Spatial analytical and logistic regression models were used to analyze the effects of childhood exposure on outcomes. Increased risk was associated with African American (AA) (odds ratio (OR) = 3.09, 95% confidence interval (CI) 2.80-3.41), aged < 5 years old (OR = 1.31, 95% 1.17-1.47), public insurance (OR = 2.80, 95% CI 2.60-3.01), a 2.5-km radius from on-road emission sources (OR = 3.06, 95% CI 2.84-3.30), and a 400-m radius from individual PM2.5 sources (OR = 1.33, 95% CI 1.25-1.41) among the cohort with residence in high asthma rate areas compared to low asthma rates areas. A significant interaction was observed between race and insurance with the odds of AA being approximately five times (OR = 4.68, 95% CI 2.23-9.85), public insurance being about three times (OR = 2.65, 95% CI 1.68-4.17), and children in their first 5 years of life have more hospital visits than other age groups. Findings from this study can guide efforts to minimize emissions, manage risk, and design interventions to reduce disease burden.


Assuntos
Poluentes Atmosféricos/análise , Asma/epidemiologia , Exposição por Inalação/estatística & dados numéricos , Material Particulado/análise , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Monitoramento Ambiental/estatística & dados numéricos , Feminino , Humanos , Lactente , Exposição por Inalação/análise , Modelos Logísticos , Masculino , Fatores de Risco , Tennessee/epidemiologia
18.
BMC Public Health ; 19(1): 723, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182075

RESUMO

BACKGROUND: Indoor environmental quality significantly influences the occurrence of asthma attack. Zunyi District has abundant coal reserves and is regarded as one of the cities that are most severely polluted by high levels of particulate matter in China. This study aimed to examine the correlation of indoor exposure with adult respiratory health, as well as the differences in effect between winter and summer. METHODS: A cross-sectional epidemiological study was conducted among 1207 adult residents in Zunyi, Guizhou Province of Southwest China in winter and summer. Data on health variables related to asthma and home environmental factors were collected using a modified European Community Respiratory Health Survey II questionnaire. The following data were obtained: samples of particulate matter 2.5 (PM2.5) inside and outside the households under study (n = 20); lung function status, including peak expiratory flow rate, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC ratio. RESULT: The odds ratio (OR) for asthma-like symptoms and asthma in adults using coal stove for cooking or warming, relative to non-users, was 1.73 (95% CI, 1.11-2.69) in winter vs. 1.30 (95% CI, 0.79-2.14) in summer. Adult residents with exposure to cooking oil fumes were at a considerably higher risk of asthma-like symptoms and asthma [OR = 2.65 (95% CI, 1.25 to 5.61) in winter vs. OR = 7.93 (95% CI, 2.54 to 24.75] in summer] than those without such exposure. The prevalence of asthma-like symptoms and asthma was significantly higher in adults with high kitchen risk scores or high sleeping-area risk scores than in those with low scores in both seasons (p < 0.05). The relative kitchen and sleeping area PM2.5 concentrations were higher in winter than in summer (p < 0.05). Lung function was negatively associated with indoor kitchen and sleeping area relative PM2.5 concentration in winter rather than summer (p < 0.001). The effect of exposure to indoor risk factors on lung function among the residents was greater in winter than in summer (p < 0.001). CONCLUSION: Exposure to indoor risk factors, such as aerocontaminants from coal combustion, causes asthma symptoms and reduces pulmonary function. The effect of indoor risk factors on respiratory health among adults with such exposure was greater in winter than in summer.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Asma/epidemiologia , Exposição Ambiental/efeitos adversos , Material Particulado/análise , Adulto , Asma/etiologia , China/epidemiologia , Cidades , Carvão Mineral , Culinária , Estudos Transversais , Feminino , Humanos , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Fatores de Risco , Estações do Ano
19.
BMC Public Health ; 19(1): 769, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31208379

RESUMO

BACKGROUND: Studies exploring the association between weight and asthma are not conclusive. Both obesity and asthma have been increasing in Lebanon, their association is not yet documented. The aim of this study is to explore the effect of weight on asthma control in adults. METHODS: This is a cross-sectional study, involving all consecutive asthma patients presenting to the outpatient allergy clinic at the Hotel-Dieu de France (HDF) University Hospital between January 1, 2014 and December 30, 2016. Patients included were those who consented to fill the Asthma Control Test (ACT) after 3 months of therapy. BMI was reported at the same time of the questionnaire. RESULTS: A total of 183 records of diagnosed asthma cases in adults were included. Sixty-three (34.4%) were males and 120 (65.6%) females, with a mean age of 38.5 (SD = 14.3). Ninety patients (49.2%) were of normal weight, 65 (35.5%) overweight and 28 (15.3%) obese. Seventy-one percent had an ACT score ≤ 19, which corresponds to poor asthma control. Patients who were overweight or obese were more likely to have poor asthma control compared to patients who had a normal weight at the time of evaluation. CONCLUSION: In conclusion, our study showed a significant association between asthma control as assessed by the ACT and high BMI defining overweight or obesity. This is the first national study exploring the association between asthma and overweight/obesity in Lebanon. A larger study with sampling from different specialists' sites is needed to draw more conclusions about this association.


Assuntos
Asma/prevenção & controle , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Adolescente , Adulto , Asma/epidemiologia , Índice de Massa Corporal , Comorbidade , Estudos Transversais , Feminino , Humanos , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
20.
Public Health Rep ; 134(4): 338-343, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31120804

RESUMO

Few studies have examined the asthma burden among small racial/ethnic minority groups such as Asian children. We examined asthma disparities among children aged 4-17 in 6 small non-Hispanic racial/ethnic minority groups (American Indian/Alaska Native [AI/AN], Asian Indian, Chinese, Filipino, other Asian, and multiple race) by using the 2006-2015 National Health Interview Survey. These small minority groups represented a weighted 6.1% of the study population (6770 of 88 049). The prevalence of current asthma ranged from 5.5% (95% confidence interval [CI], 3.5%-7.5%) among Chinese children to 13.8% (95% CI, 10.4%-17.2%) among multiple-race children and 14.6% (95% CI, 10.8%-18.4%) among AI/AN children. Compared with non-Hispanic white children, AI/AN (adjusted odds ratio [aOR] = 1.6; 95% CI, 1.2-2.2) and multiple-race (aOR = 1.4; 95% CI, 1.0-2.0) children had higher odds for current asthma. Several small racial/ethnic minority groups are at heightened risk of asthma-associated outcomes, highlighting the need for further research on these populations.


Assuntos
Americanos Asiáticos/estatística & dados numéricos , Asma/etnologia , Asma/epidemiologia , Grupos Étnicos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Razão de Chances , Vigilância da População , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia , Estados Unidos/etnologia
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