Ethnic variations in UK asthma frequency, morbidity, and health-service use: a systematic review and meta-analysis
Ethnic variations in UK asthma frequency, morbidity, and health-service use: a systematic review and meta-analysis
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DOI：
10.1016/s0140-6736(05)17785-x
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发表时间：
2005-01-22
期刊：
影响因子：
168.9
通讯作者：
Sheikh, A
中科院分区：
文献类型：
--
作者：
Netuveli, G;Hurwitz, B;Sheikh, A
背景 哮喘的发病率因国家而异，并且在地理较狭窄的地区的种族群体之间也可能有所不同。我们寻找英国哮喘发病率、发病率和卫生服务使用等种族差异的证据，并了解任何差异的可能原因。 方法我们检索了 MEDLINE、EMBASE、CINAHL、PSYCHInfo、PREMEDLINE、HEALTHSTAR、剑桥会议摘要登记册、论文和论文数据库以及国家研究登记处。此外，我们还检索了已确定报告的参考书目和卫生当局的网站，并联系了该学科的专家。我们的主要结果是哮喘发病率、发病率和卫生服务使用情况的比较。我们使用随机效应模型进行荟萃分析。结果 13 项研究包含相关数据。所有患病率研究均针对儿童，结果表明，与黑人和白人儿童相比，南亚儿童出现哮喘症状的频率较低（过去 12 个月的喘息史汇总率：南亚人 9.6% [95% CI 8.0-11.2%]，黑人 16.2% [12.8-19.6%]，白人 14.6% [11.5-17.8%]）。临床医生诊断儿童哮喘的汇总频率遵循类似的模式（南亚人 7.6% [3.7-11.4%]、黑人 15.0% [3.5-26.5%]、白人 10.6% [4.6-16.7%]。然而，相对于白人，南亚人儿童和成人因哮喘入院的风险更高（比值比 2.9） [2.4-3.4]）和黑人（2.1 [1.8-2.5]）。解释入院差异不能用各组之间哮喘频率的差异来解释；它们可能与哮喘严重程度的种族差异、寻求健康行为的差异或获得高质量初级保健服务的困难有关。
Background The frequency of asthma varies between countries, and may also vary between ethnic groups in more geographically confined areas. We sought evidence of such ethnic variations in the UK for asthma frequency, morbidity, and health-services use, and to understand possible reasons for any differences.Methods We searched MEDLINE, EMBASE, CINAHL, PSYCHInfo, PREMEDLINE, HEALTHSTAR, Cambridge Register of Conference Abstracts, the Dissertation and Thesis Database, and the National Registry of Research. Additionally, we searched the bibliographies of reports identified and websites of health authorities, and contacted experts in this discipline. Our main outcomes were comparisons of asthma rate, morbidity, and health-services use. We did meta-analyses using random-effects models.Findings 13 studies contained relevant data. All prevalence studies were of children and showed that south Asian children had a lower frequency of symptoms suggestive of asthma compared with black and white children (pooled rate of history of wheeze in the previous 12 months: south Asians 9.6% [95% CI 8.0-11.2%], black people 16.2% [12.8-19.6%], white people 14.6% [11.5-17.8%]). The pooled frequency of clinician-diagnosed asthma in children followed a similar pattern (south Asians 7.6% [3.7-11.4%], black people 15.0% [3.5-26.5%], white people 10.6% [4.6-16.7%]. However, relative to white people, the risk of admission for asthma in children and adults was higher for south Asians (odds ratio 2.9 [2.4-3.4]) and black people (2.1 [1.8-2.5]).Interpretation The differences in admission are not explained by differences in asthma frequency between groups; they could relate to ethnic variations in asthma severity, differences in health-seeking behaviour, or difficulties in accessing high-quality primary care services.