Asthma prevalence and morbidity among rural Iowa schoolchildren
Asthma prevalence and morbidity among rural Iowa schoolchildren
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DOI：
10.1016/j.jaci.2003.09.037
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发表时间：
2004-01-01
影响因子：
14.2
通讯作者：
Merchant, J
中科院分区：
文献类型：
--
作者：
Chrischilles, E;Ahrens, R;Merchant, J
背景：关于哮喘在农场和非农场儿童中的患病率有相互矛盾的发现。目的：我们试图估计哮喘的患病率和发病率，并确定农场和nonfarm children.Methods之间的差异：研究人群包括所有6至14岁的儿童在10个学区就读于2个非连续的农村爱荷华州县，从2000年至2002年。邮寄的父母筛选问卷包括国际儿童哮喘和过敏研究核心问卷、功能严重程度指数项目、医生诊断和药物及紧急护理使用项目。喘息的12个月患病率为19.1%。13.4%的患者报告了自我报告的哮喘医生诊断。在控制年龄、性别和县的多变量分析中，生活在农场的儿童比生活在城镇的儿童更不可能有喘息（比值比，0.71; 95%CI，0.58-0.87）或在过去一年中有喘息（比值比，0.77; 95%CI，0.60-0.98）。然而，这种与农业的保护性联系只在一个研究县观察到。在那些谁喘息，农场和nonfarm儿童同样可能已被诊断为哮喘，并有可比morbidity.Conclusion：通过使用一个标准化的问卷调查，在这个大的，农村，以人口为基础的研究，哮喘患病率高的应答率相媲美，在中西部大城市。未测量的风险因素可能解释了Keokuk县明显的保护作用。这些发现对农村生活对儿童哮喘发展的保护作用提出了质疑。
Background: There are conflicting findings about the prevalence of asthma among farm and nonfarm children. Objectives: We sought to estimate asthma prevalence and morbidity and determine differences between farm and nonfarm children.Methods: The study population consisted of all children aged 6 to 14 years enrolled in 10 school districts in 2 noncontiguous rural Iowa counties from 2000 through 2002. The mailed parental screening questionnaire included the International Study of Asthma and Allergies in Childhood core questionnaire, items from the Functional Severity Index, and items on physician diagnosis and medication and urgent care use.Results: The response rate was 86.6%. The 12-month prevalence of wheeze was 19.1 %. Self-reported physician diagnosis of asthma was reported by 13.4%. On multivariable analysis controlling for age, sex, and county, children who lived on farms were less likely than those who lived in town to have ever wheezed (odds ratio, 0.71; 95% CI, 0.58-0.87) or to have wheezed during the past year (odds ratio, 0.77; 95% CI, 0.60-0.98). However, this protective association with farming was only observed in one of the study counties. Among those who wheezed, farm and nonfarm children were equally likely to have been given a diagnosis of asthma and had comparable morbidity.Conclusion: By using a standardized questionnaire with a high response rate in this large, rural, population-based study, asthma prevalence rivaled that in large Midwestern cities. Unmeasured risk factors might account for the apparent protective effect in Keokuk County. These findings cast doubt on a protective effect of rural life for the development of childhood asthma.