BACKGROUND:Asthma and allergic diseases have increased in the developed countries. It is important to determine whether the same trends are occurring in the developing countries in Africa. We aimed to determine the time trend in the prevalence of exercise-induced bronchospasm (EIB) and atopic sensitisation over a ten-year period in Ghanaian schoolchildren. METHODS AND FINDINGS:Two surveys conducted using the same methodology ten years apart (1993 and 2003) among schoolchildren aged 9-16 years attending urban rich (UR), urban poor (UP), and rural (R) schools. Exercise provocation consisted of free running for six minutes. Children were skin tested to mite, cat, and dog allergen. 1,095 children were exercised in 1993 and 1,848 in 2003; 916 were skin tested in 1993 and 1,861 in 2003. The prevalence of EIB increased from 3.1% (95% CI 2.2%-4.3%) to 5.2% (4.3%-6.3%); absolute percentage increase 2.1% (95% CI 0.6%-3.5%, p < 0.01); among UR, UP, and R children EIB had approximately doubled from 4.2%, 1.4%, and 2.2% to 8.3%, 3.0% and 3.9% respectively. The prevalence of sensitisation had also doubled from 10.6%, 4.7%, and 4.4% to 20.2%, 10.3%, and 9.9% (UR, UP, and R respectively). Mite sensitisation remained unchanged (5.6% versus 6.4%), but sensitisation to cat and dog increased considerably from 0.7% and 0.3% to 4.6% and 3.1%, respectively. In the multiple logistic regression analysis, sensitisation (odds ratio [OR] 1.77, 95% CI 1.12-2.81), age (OR 0.88, 95% CI 0.79-0.98), school (the risk being was significantly lower in UP and R schools: OR 0.40, 95% CI 0.23-0.68 and OR 0.54, 95% CI 0.34-0.86, respectively) and year of the study (OR 1.73, 95% CI 1.13-2.66) remained significant and independent associates of EIB. CONCLUSIONS:The prevalence of both EIB and sensitisation has approximately doubled over the ten-year period amongst 9- to 16-year-old Ghanaian children irrespective of location, with both EIB and atopy being more common among the UR than the UP and R children.

译文

背景:发达国家的哮喘和过敏性疾病有所增加。重要的是要确定非洲的发展中国家是否正在出现同样的趋势。我们旨在确定加纳学童在十年期间运动诱发的支气管痉挛(EIB)和特应性致敏的流行趋势。
方法和研究结果:两次调查使用相同的方法,分别对十年级(1993年和2003年)就读于城市富人(UR),城市穷人(UP)和农村(R)学校的9-16岁的学童进行了调查。运动挑衅包括自由奔跑六分钟。对孩子的皮肤进行了螨,猫和狗过敏原测试。 1993年有1,095名儿童运动,2003年有1,848名儿童运动; 1993年对916例皮肤进行了测试,2003年进行了1,861例。EIB的患病率从3.1%(95%CI 2.2%-4.3%)增加到5.2%(4.3%-6.3%);绝对百分比提高2.1%(95%CI 0.6%-3.5%,p <0.01);在UR,UP和R儿童中,EIB分别从4.2%,1.4%和2.2%翻了一番,分别达到8.3%,3.0%和3.9%。致敏率也从10.6%,4.7%和4.4%翻了一番,达到20.2%,10.3%和9.9%(分别为UR,UP和R)。螨的敏感性保持不变(5.6%比6.4%),但是对猫和狗的敏感性从0.7%和0.3%分别显着增加到4.6%和3.1%。在多元logistic回归分析中,敏化度(比值[OR] 1.77,95%CI 1.12-2.81),年龄(OR 0.88,95%CI 0.79-0.98),学校(在UP和R学校中的风险明显较低) :OR 0.40,95%CI 0.23-0.68和OR 0.54,95%CI 0.34-0.86)和研究年份(OR 1.73,95%CI 1.13-2.66)仍然很重要,并且是EIB的独立关联者。
结论:在9年至16岁的加纳儿童中,无论位置如何,在10年期间,EIB和致敏的患病率均增加了一倍左右,UR和UUP患儿比UP和R患儿更常见EIB和特应性过敏。

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