The association between childhood asthma and community violence, Los Angeles County, 2000

OBJECTIVE: This study's objective is to determine if there is an association between rates of violence and rates of childhood asthma in Los Angeles County communities. METHODS: Rates of hospitalization for assault and for asthma were calculated for each ZIP Code and city in Los Angeles County. Linear regression was used to determine the effect of assault rates on asthma rates while controlling for potential confounders such as poverty and racial/ethnic distribution. At the city level, crime rates were included in the model as additional measures of community violence. RESULTS: Hospitalization rates for childhood asthma and assaults were significantly correlated at both the city (r = 0.80) and the ZIP Code (r = 0.54) levels. The association remained significant when controlling for poverty and racial/ethnic distribution with linear regression (p < 0.0001). At the city level, the variables measuring the crime rate were not significant predictors of asthma hospitalizations. CONCLUSIONS: Community violence as measured by the rate of assault hospi; talizations is associated with childhood asthma in Los Angeles County. Health care providers should consider their asthmatic patients' social environments when devising treatment plans.     

Clinical heterogeneity of childhood diabetes in Baranya county

INTRODUCTION: Immune mediated type 1 diabetes is the most frequent form of childhood diabetes while type 2 and other forms are more rare in childhood in the Caucasian population. Differentiation of various diabetes subtypes has importance in the choice of treatment and prognosis. AIMS: The aim of the study was to describe clinical heterogeneity of childhood diabetes and to evaluate possibilities of phenotypical classification. METHODS: Two hundred twenty eight children (128 girls and 100 boys) with diabetes diagnosed at the Department of Pediatrics, University of Pécs, in the period of 1978-2000 were examined. Glycated hemoglobin levels, insulin requirement, body weight at diagnosis and association of type 1 diabetes with other disorders were analysed. RESULTS: Thirty one patients (13.6%) had permanently low (< 8%) glycated hemoglobin levels. Low glycated hemoglobin level associated with low insulin requirement (< 0.5 U/kg/day) was observed in three patients (1.4%) with 4 years of disease duration and in 2 patients (0.9%) during the whole disease course. These patients can be classified as non-classical type 1 diabetes cases. Obesity associated with less than 0.5 U/kg/day insulin requirement observed at least for two years from diagnosis was found in 2 cases (0.9%). These cases may be diagnosed as having childhood type 2 diabetes. The authors identified two diabetes patients with Down syndrome while MODY and transient neonatal diabetes were observed in one cases each. Diabetes associated conditions diagnosed in single cases each were as follows: thymus tumor, Duchenne muscular dystrophy, autoimmune polyglandular syndrome type 2, and T-cell lymphoma. CONCLUSIONS: Childhood diabetes cases can be classified into several subgroups on clinical grounds, insulin requirement, and glycemic control. The data suggest that the prevalence of type 2 and non-classical type 1 diabetes is probably only a few percent among children with diabetes in Hungary. Due to phenotypic overlap between different forms of diabetes, measurement of beta-cell specific autoantibodies and C peptide levels can be recommended for etiologic classification.     

Prevalence of atopic dermatitis in school children of Baranya county

INTRODUCTION: The prevalence of atopic dermatitis (AD) in children has significantly increased worldwide in the past decades. Although it is well known that the number of AD patients has also been growing in Hungary no prevalence studies on a given population have been performed so far. METHODS: The present research investigated the prevalence of AD in school children by means of questionnaires. The data of 1454 (771 girls, 683 boys) children aged 6-14 years in a big city (Pécs, Hungary) and three small settlements (Bóly, Magyarbóly, Villány; Hungary) were analyzed. RESULTS: Applying the standard point values of the Schultz-Larsen questionnaire the prevalence of AD accounted for 15.1%; it was higher in the big city (16.5%) and lower in the small settlements (13.7%). In girls the prevalence of AD (15.9%) was greater than in boys (14%); this difference was more remarkable in the big city (18.2% vs. 14.8%). The first symptoms of AD appeared before the age of two in 58.8% and it was significantly higher in the big city (63.5%) as in the small settlements (52.6%). Among the 221 AD patients there were 38 patients (17.1%) with asthma and 93 (42.1%) with allergic rhinitis. The AD family (parents, brothers and sisters, great parents) proved to be positive in 72.8%. CONCLUSIONS: The results indicate the high prevalence rate of AD in school children in Baranya County, Hungary reaching or nearly approaching the significantly high values registered in the welfare countries.     

Dietary survey in Hungary, 2003-2004

The third Hungarian national dietary survey was conducted in 2003-2004. This publication describes the first part of the energy and nutrient intake findings in a sample consisting of a population of 1179 persons over 19 years of age (energy and macro nutrients). Energy and nutrient intake values were calculated based on 3 x 24- hour dietary records filled out by the subjects themselves. The authors evaluated the results in light of the two previous dietary surveys in Hungary and the Hungarian and international reference intake data. The total fat intake found in this survey lower than the previous data marks a favourable development, just as the higher unsaturated fatty acid and lower saturated fatty acid energy percent, and furthermore the lower cholesterol intake level. The favourable developments include further a polyunsaturated/saturated fatty acid ratio considerably higher than that obtained earlier (the values conforming to the international reference data), a higher carbohydrate energy percentage, as well as lower added sugar energy percentage, this latter being in the recommended range. The overweight ratio in men was 58.9%, while the female value was 49.5%, not much different from the previous survey data.     

The associations between childhood asthma and atopy, and parental asthma, hay fever and smoking

Summary. The aim of this analysis was to examine the degree to which a life time prevalence of asthma in a 7-year-old child is statistically associated with atopic conditions of the child, and with parental asthma, hay fever and smoking. In 1968, 8585 children who were born in 1961 and who were attending school in Tasmania were surveyed. This comprised 99% of the eligible population. The prevalence of a history of asthma in the 7-year-olds was 16.2% (males 19.0%, females 13.2%). Multiple logistic regression analysis showed that a history of asthma in a 7-year-old was associated with the child being male (odds ratio [OR] 1.56; 99% confidence interval 1.30–1.86), having a history of hay fever (3.86; 3.12–4.78), eczema (2.04; 1.63–2.55), hives (1.34; 1.09–1.65) or allergy to foods or medicines (1.70; 1.26–2.30), the child's mother or father having a history of asthma (2.63; 2.08–3.31 or 2.52; 1.99–3.19, respectively), and the mother being a smoker (1.26; 1.05–1.51). Parental hay fever and paternal smoking were not independently associated with childhood asthma. The strength of association between childhood asthma and parental asthma was independent of the sex of either the parent or the child, and of atopic conditions in the child. In the 133 children for whom both parents were asthmatic, 65 (49%) had a history of asthma. These findings, based on a population survey, are consistent, not only with a childhood history of asthma being strongly associated with atopy, but also with the existence of strong unmeasured determinants common to family members, the effects of which are not mediated via atopy. The risk for asthma being independent of both the sex of the child and of the parent, is consistent with a genetic aetiology for susceptibility to asthma.     

2003～2006年夏津县肺结核病例资料分析

[目的]了解夏津县结核病控制情况,降低肺结核发病率.[方法]分析2003～2006年结核病人的病历资料.[结果]新登记肺结核1 092例,2003～2006年平均肺结核新登记率为56.39/10万,不同年份间新涂阳登记率的差异无统计学意义(P>O.05).新登记涂阳374例,平均涂阳登记率为19.3/10万.涂阳病例男性269例,占33.37%;女性105例,占36.71%.农民为主1 039例,占95.14%;干部次之22例(占2.O1%).3～5月高发472例(占43.22%).[结论]肺结核发病率仍呈上升趋势,应进一步按项目要求,做好结核病防治工作.     

Incidence of childhood diabetes in Hungary

A retrospective epidemiological study using primary data sources and external validation was made to assess the incidence of childhood diabetes (0-14 yr) over a ten-year period. The degree of ascertainment was 96.2 per cent. Age-specific incidence rates increased until puberty with peak incidence in girls at 10 year and in boys at 13 year. There was a seasonal variation of onset with peaks in autumn and winter. The yearly incidence rates showed an increasing trend, the incidence in 1987 (8.7/100,000) was 2.3 times higher than in 1978. The rise in incidence was not continuous, incidence rates were similar in the years 1978-79, 1980-84 and 1985-87, but relatively sharp increases could be observed in 1980 and in 1985 which were mainly due to increases in incidence of the age group 5 to 9 years. Dynamic changes have taken place in the incidence of childhood diabetes in Hungary between 1978 and 1987, but it is not known whether the increases can be regarded as epidemics or parts of a discontinuous trend.     

Prevalence of childhood asthma in urban communities: the impact of ethnicity and income

PURPOSE: The goal of this study was to assess the relationship between hospitalization rates and asthma prevalence in New York City children and investigate the role that sociodemographic factors play in asthma. METHODS: A parent-report questionnaire was distributed in 26 randomly selected New York City public elementary schools, stratified according to neighborhood hospitalization rates. RESULTS: The overall student response rate was 76.9% (5250 students). Prevalence of current asthma was 17.9%, 9.59%, 6.39% (p < .001) in areas of high, median, and low asthma hospitalization rates, respectively. The overall prevalence of current asthma was 13.0%. Children living in predominantly low socioeconomic status (SES) communities had a 70% greater risk of current asthma, independent of their own ethnicity and income level. Asthma prevalence within different ethnic and income groups was consistently lower in neighborhoods of greater socioeconomic status, except among Puerto Rican children, who had high asthma prevalence, regardless of school attended or income. CONCLUSIONS: Prevalence of current asthma is strongly associated with attending a school in a low-income neighborhood. Although hospitalization rates have been used as an indicator of the burden of asthma in a neighborhood, it alone does not reflect the level of disparities that exist among communities with different socioeconomic backgrounds.     

2003—2006年临武县麻疹流行病学特征分析

目的了解临武县2003—2006年麻疹流行病学特征，为更好地预防、控制麻疹提供科学依据。方法对2003—2006年临武县麻疹发病情况进行描述流行病学分析，检测流动人口、常住人口健康儿童的麻疹抗体水平进行分析。结果4年里临武县报告麻疹病例221例，年均发病率为17．67／10万；流动人口、常住人口发病89例、132例，年均发病率80．99／10万、10．59／10万。流动人口、常住人口3～7岁健康儿童的麻疹抗体水平检测147人、150人，麻疹抗体水平≥1：800的阳性保护率为45．57％、72．67％，差异有统计学意义（x^2=22．56，P〈0．005）。结论流动人口儿童麻疹报告病例的增多是临武县麻疹病例报告急增的主要原因。流动儿童的麻疹抗体阳性保护率过低，存在发病隐患和免疫空白点，是控制麻疹发病急需解决的问题。     

Traffic, susceptibility, and childhood asthma

Results from studies of traffic and childhood asthma have been inconsistent, but there has been little systematic evaluation of susceptible subgroups. In this study, we examined the relationship of local traffic-related exposure and asthma and wheeze in southern California school children (5-7 years of age). Lifetime history of doctor-diagnosed asthma and prevalent asthma and wheeze were evaluated by questionnaire. Parental history of asthma and child's history of allergic symptoms, sex, and early-life exposure (residence at the same home since 2 years of age) were examined as susceptibility factors. Residential exposure was assessed by proximity to a major road and by modeling exposure to local traffic-related pollutants. Residence within 75 m of a major road was associated with an increased risk of lifetime asthma [odds ratio (OR)=1.29; 95% confidence interval (CI), 1.01-1.86], prevalent asthma (OR=1.50; 95% CI, 1.16-1.95), and wheeze (OR=1.40; 95% CI, 1.09-1.78). Susceptibility increased in long-term residents with no parental history of asthma for lifetime asthma (OR=1.85; 95% CI, 1.11-3.09), prevalent asthma (OR=2.46; 95% CI, 0.48-4.09), and recent wheeze (OR=2.74; 95% CI, 1.71-4.39). The higher risk of asthma near a major road decreased to background rates at 150-200 m from the road. In children with a parental history of asthma and in children moving to the residence after 2 years of age, there was no increased risk associated with exposure. Effect of residential proximity to roadways was also larger in girls. A similar pattern of effects was observed with traffic-modeled exposure. These results indicate that residence near a major road is associated with asthma. The reason for larger effects in those with no parental history of asthma merits further investigation.     

Increase in prevalence of childhood asthma in Budapest between 1995 and 2003: correlation with air pollution data and total pollen count

INTRODUCTION: According to the data of the Hungarian pulmonological network, the prevalence of asthma in the last 15 years has increased (almost linearly) in Hungary. In 2004 it was 1.8%. There are only a few data about the prevalence of childhood asthma. AIMS: The aim of the authors was to measure the prevalence of bronchial asthma in childhood in Budapest in 1995, 1999 and 2003, using questionnaires directed to district pediatricians. METHODS: There were only two questions in these questionnaires: how many children are in their districts, and how many are suffering from asthma? Besides of this survey the dust, CO, NO(2) and SO(2) concentrations in the air were measured on-line at 8 points in Budapest, while ozone level measurements were also made at 2 stations. The counts of pollen and of fungal elements in the air were calculated separately for Buda and for Pest. RESULTS: In 1995, replies were received from 118 pediatricians in 11 districts, who were responsible for the supervision of 104,060 children, out of these 1.88+/-0.87% had been diagnosed as having asthma. In 1999 replies were sent by 153 physicians in 22 of the 23 districts, who had a total of 142,679 children under their care. These included 3228 asthmatics, i.e. a prevalence of 2.26+/-0.95%. In 2003 the authors received answers from all of the 23 districts of Budapest. The 204 pediatricians were responsible for the supervision of 176 049 children. The number of patients with the diagnosis of asthma was 4712 (corresponding for a prevalence of 2.68+/-1.3%). The increase between 1995 and 1999, and between 1999 and 2003 was highly significant (p < 0.0001). This significant increase was valid even when the authors analysed only those 11 districts, which answered already in 1995. The level of air pollution in Budapest did not deteriorate in the period in question, and the concentration of pollen grains of plants causing allergy did not increase compared to previous years. CONCLUSIONS: On the basis of the results of more than 100 thousand children, the authors conclude that between 1995 and 2003 the proportion of asthmatic children increased by 50% in Budapest, while the air pollution did not deteriorate and the pollen concentration from sensitizing plants did not increase.     

中国2011—2018年儿童哮喘患病率Meta分析

目的通过了解中国儿童哮喘患病率的流行病学特点,为儿童哮喘防治工作提供线索。方法系统收集中国知网、万方数据库、维普、PubMed数据库中与儿童哮喘患病率相关的横断面研究,应用Stata 16.0软件进行Meta分析,采用随机效应模型计算患病率,并按性别、年龄、地区进行亚组分析。结果共纳入26篇文献,研究对象213 729人,男童112 169名,女童101 560名。Meta分析结果显示,中国14岁及以下儿童哮喘总患病率为3.3%(95%CI=2.7%～4.0%)。亚组分析结果显示,中国男童哮喘患病率高于女童(Q=11.42,P=0.01),4～6岁组儿童哮喘患病率高于0～3及7～14岁组儿童(Q=8.03,P=0.02),南、北方儿童哮喘患病率差异无统计学意义(Q=0.72,P>0.05)。结论中国儿童哮喘患病率呈上升趋势,建议加大哮喘防治力度。     

家养皮毛宠物与儿童哮喘关系

目的了解家养皮毛宠物与儿童哮喘的关系。方法采用整群抽样方法,在沈阳市5个行政区内随机选取10所幼儿园和5所小学,采用国际统一标准问卷ATS调查表对所有学生进行呼吸系统疾病及症状调查。结果沈阳市儿童持续咳嗽、持续咳痰、哮喘、哮喘现患、喘鸣现患和过敏性鼻炎的患病率分别为9.53%、4.49%、6.23%、2.42%、5.61%和5.27%,其中男生哮喘、喘鸣现患及过敏性鼻炎的患病率明显高于女生(P<0.05);家养宠物对儿童哮喘无明显影响,但与宠物同室睡会增加儿童患哮喘的危险(P<0.05);logistic回归分析显示,与无家族易感史且未饲养宠物的儿童相比,具有家族易感史的儿童患哮喘的危险增加了229%(95%CI=2.55～4.25),而同时暴露家族易感史和宠物的儿童患哮喘的危险增加了101%(95%CI=1.17～3.43),家族易感史与家养宠物的交互效应差异无统计学意义(P>0.05)。结论家族易感史是儿童患哮喘及哮喘样症状的危险因素,家养皮毛宠物对儿童哮喘的影响与儿童跟宠物接触的密切程度有关。     

A prospective association between cocoon use in infancy and childhood asthma

There is increasing evidence for a role for bedding items in the development of asthma. The use of some forms of synthetic bedding, such as foam mattresses and pillows, is associated with a significantly increased risk of childhood wheeze. Our aim was to examine prospectively whether the use of synthetic cocoon/baby nests in infancy is associated with the subsequent development of wheeze in childhood. Data collected in 1988 as part of the Tasmanian Infant Health Survey were linked to the cross-sectional Childhood Asthma Survey conducted in 1995 in Tasmania, Australia. We were able to match 863 records out of the 1111 in the 1988 survey. Information including parental, child-care, and the infant's sleeping environment was collected at home interview in 1988 when the infant was 1 month of age. Data including sleep environment and asthma symptoms were available for each child at age 7 years. A generalised linear model was used to calculate the adjusted relative risk (RR) estimates for symptoms of wheeze and infant cocoon use. For children who were placed in a cocoon in infancy, there was an increased risk of recent wheeze (adjusted RR = 4.33 [95% CI 2.08, 9.02]) and night wheeze (adjusted RR = 3.35 [95% CI 1.52, 7.39]) at age 7 years. In view of the increasing prevalence of childhood asthma, the identification of potentially modifiable environmental factors which might operate in infancy is of importance. The present findings implicate infant bedding choice as a significant factor and further studies on the infant sleeping environment are indicated.     

Prevalence of doctor-diagnosed arthritis and arthritis-attributable effects among Hispanic adults, by Hispanic subgroup--United States, 2002, 2003, 2006, and 2009

Arthritis affects approximately 50 million adults in the United States, making it one of the most prevalent health conditions among U.S. adults and the most common cause of disability. Arthritis is associated with substantial activity limitation, work disability, increased prevalence of obesity, reduced quality of life, and high health-care costs. Among U.S. adults, the prevalence of arthritis and arthritis-attributable effects (e.g., arthritis-attributable activity limitations [AAAL]) varies among racial/ethnic groups; non-Hispanic whites and non-Hispanic blacks have a higher prevalence of doctor- diagnosed arthritis compared with Hispanics, but Hispanics and non-Hispanic blacks have a higher prevalence of arthritis-attributable effects compared with non-Hispanic whites. The prevalence of arthritis and its effects among specific Hispanic subgroups has not been studied in a nationally representative sample of U.S. adults. To determine the annualized prevalence of arthritis and arthritis-attributable effects among Hispanic subgroups, CDC analyzed National Health Interview Survey (NHIS) data for 2002, 2003, 2006, and 2009 combined. This report describes the results of that analysis, which indicated that the age-adjusted prevalence of arthritis ranged from 11.7% among Cubans/Cuban Americans to 21.8% among Puerto Ricans; an estimated 3.1 million Hispanics had arthritis during these years. Among all subgroups of Hispanics with arthritis, at least 20% of persons with arthritis reported an arthritis-attributable effect: AAAL (range: 21.1% among Cubans/Cuban Americans to 48.5% among Puerto Ricans); arthritis-attributable work limitations (AAWL) (range: 32.9% among Central/South Americans to 41.6% among Mexican Americans); and severe joint pain (SJP) (range: 23.7% among Cubans/Cuban Americans to 44.1% among Puerto Ricans). These findings identify Hispanic subgroups with high burdens of arthritis who likely are in need of interventions designed to improve their quality of life.