Analysis of Main Risk Factors of Childhood Asthma in Jinan
|Keywords||children asthma risk factors rhinitis questionnaire survey|
ObjectiveTo understand the major risk factors of childhood asthma and their characteristics in Jinan city.MethodsBy adopting random cluster sampling method and using the form of decentralized home visits and concentrated survey, an epidemiological survey was performed among 0-14 years old children in Jinan city from September 2010 to April 2011. According to the diagnostic criteria of the third national epidemiological survey of childhood asthma, Pediatric respiratory specialists confirmed the diagnosis of children may suffer from asthma In the preliminary screening and fill out the questionnaire. A random sample of 280 typical cases (Male 171, female 109 cases) of asthma as a case group, and non-asthmatic children in the control group. Based on age, gender, ethnic matching principle, conducting a 1:1 matched case-control study. Whether the incidence of asthma as the dependent variable, the survey in 142 suspicious factors as independent variables. Using SPSS 19.0 for conditional Logistic regression to analyze the major factors affecting the incidence of asthma.Results1. The number of men (171 cases) in case group more than women (109case), and the ratio is about 1.57:1. The age of onset of both male and female was mostly 5 to 9 years old, each group accounting for 47.4%,46.8%.2. Respiratory tract infections as the main incentive for childhood asthma attack, accounting for 84.47%. Usually asthma attack related to the changes of weather, exercise, fatigue, poor diet, paint, decoration smell, fumes and so on.25.11% are diet incentive,3.20% home has carpets,13.24% families with pets.3. In the single-conditional Logistic regression analysis received the following factors were associated with the onset of asthma. They were personal drug allergy (OR=2.323,95%CI:1.524-3.539), penicillin anaphylaxis (OR=2.037,95%CI: 1.285-3.229), family history of allergies (OR=4.310,95%CI:2.878-6.456), history of first-degree relatives asthma (OR=7.200,95%CI:2.825-18.348), history of first-degree relatives other allergy (OR=2.800,95%CL-1.845-4.248), history of second-degree relatives with asthma (OR=4.100,95%CI:2.054-8.185) and other allergies (OR=6.250,95%CI:2.963-13.183), the phenomenon of sneeze, congestion, nasal itching or eye itch without a cold (OR=4.955,95%CI:3.134-7.833) and its appear age (3-4 years old, compared with 5 years of age, OR=2.433,95%CI:1.142-5.186), last 12 months without a cold, the phenomenon sneezing, runny nose, nasal congestion, nasal itching, or eye itch (OR=3.710,95%CI:2.495-5.516), last 12 months hay fever (OR=4.300,95%CI:2.161-8.557), allergic rhinitis (OR=7.176, 95%CI-4.321-11.920), repeated skin rash, itching or joint flexures (OR=2.138, 95%CI:1.376-3.323), repeated skin rash, itching or joint flexures last 12 months (OR=1.692,95%CI:1.042-2.748), eczema (OR=9.667,95%CI:2.945-31.733), eczema-like skin lesions (OR=7.500,95%CI:1.715-32.796), food allergy discomfort after eating (OR=3.652,95%CI:2.303-5.793), rash, itching after eating (OR=4.000, 95%CI:2.066-7.745), sneezing, runny or stuffy nose (OR=65.289,95%CI:1.028-4148.469), cough, wheezing after eating (OR=65.289,95%CI:3.974-1072.640), discomfort after eating fish (OR=2.929,95%CI:1.597-5.372), the time of appearing uncomfortable after eating (compared with uncomfortable after 2 hours, appeared uncomfortable in 10-30 minutes, OR=4.070,95%CI:1.157-14.319; appeared uncomfortable in 30 minutes-2 hours, OR=4.903,95%CI:1.207-19.907), allergens detection of milk or dairy products (OR=5.333,95%CI:1.554-18.304), egg (OR=4.667,95%CI:1.341-16.239), fish or shrimp (OR=7.000,95%CI:2.455-19.956), dust mites (OR=10.250,95%CI:3.672-28.616), mould (OR=65.289, 95%CI:1.792-2378.620), pollen (OR=9.000,95%CI:2.730-29.667) and cat/dog hair (OR=65.289,95%CI:1.172-3636.081) show positive, food allergy (OR=3.160, 95%CI:2.015-4.955), premature (OR=2.667,95%CI:1.240-5.737), low birth weight (birth weight<2.5Kg compared with 2.5-4.0Kg, OR=2.803,95%CI:1.009-7.784), the age of started the use of antibiotics (compared with the beginning use of antibiotics after 3 years of age, within 1 year of age, OR=0.395,95%CI:0.229-0.681; 1-2 years old, OR=0.525,95%CI:0.295-0.933), types of housing (living in the tower, compared with cottage, OR=2.820,95%CI:1.179-6.746), wall paint (OR=2.250, 95%CI:0.978-5.175), methods of winter heating (use warm air conditioning, compared with heating, OR=0.495,95%CI:0.287-0.856), the type of cooking fuel (use of coal gas/natural gas/liquefied gas, compared with the use of electricity, OR=1.933,95%CI:1.111-3.364), keep plants at home (OR=0.576,95%CI: 0.411-0.808), total home smoking (smoking≥1 pack/day, compared with smoking<10 cigarettes/day, OR=0.502,95%CI:0.266-0.947) and materials used in pillows (compared with cotton, buckwheat husk, OR=2.512,95%CI: 1.466-4.302; sponge, OR=2.375,95%CI:1.128-5.002).4. Analysis of Multi-factor conditional logistic regression obtained 13 main factors affecting the incidence of childhood asthma. According to standardized partial regression coefficient (SPRC), compares the influence to the incidence of asthma by the great to small in order as allergic rhinitis (OR=11.615,95%CI:5.129-26.302), eczema (OR=14.139,95%CI:2.594-77.075), history of first-degree relatives asthma (OR=9.062,95%CI:2.044-40.167), dust mite allergy (OR=7.815,95%CI: 1.786-34.197), history of first-degree relatives other allergy (OR=5.046,95%CI: 1.599-15.921), low birth weight (OR=21.763,95%CI:2.259-209.663), history of second-degree relatives other allergies (OR=2.324,95%CI:1.139-4.741), wall paint (OR=5.716,95%CI:1.250-26.148), materials used in pillows (compared with cotton, buckwheat husk, OR=2.567,95%CI:1.047-6.298; eiderdown, OR=19.644,95%CI: 1.121-344.169; sponge, OR=4.351,95%CI:1.181-16.028), egg allergy (OR=9.019, 95%CI:1.203-67.617), history of penicillin allergy (OR=2.397,95%CI:1.050-5.475), the age of started the use of antibiotics (compared with the beginning use of antibiotics after 3 years of age, within 1 year of age, OR=0.175,95%CI:0.066-0.469; 1-2 years old, OR=0.252,95%CI:0.093-0.683) and total home smoking (smoking≥1 pack/day, compared with smoking<10 cigarettes/day, OR=0.331,95%CI:0.113-0.967). Conclusions1. Respiratory tract infections are a major cause of asthma attacks.2.The most common risk factors of childhood asthma are allergic rhinitis, eczema, history of first-degree relatives allergies, low birth weight, paint and pillows materi-als.To prevent asthma should pay attention to the prevention of respiratory tract infection, avoid pungent odor and allergy food,reduce and avoid the use of interior decoration and paint. Attention to strengthening prenatal care and prevention of the occurrence of low birth weight children and premature infants. In asthma symptom control is not ideal, should be excluded from dust mites and other allergens allergic, check the pillow material and avoid family smoking.