2000年北京城区儿童哮喘患病情况调查分析

目的了解北京儿童哮喘的患病率、发病规律及影响因素,并进行10年前后的对比研究.方法采取整群抽样调查方法,按照10年前的调查范围,在北京市朝阳区及西城区2～4个街区内,向家长发放初筛问卷,筛选出相关疾病的可疑患者,再经哮喘中心医师统一问诊查体,填写调查表.所有数据经sas/pc统计软件分析.结果实际调查人数10 163人,2年内有喘息发作的哮喘现患率为2.05%,男女患病率分别为2.80%及1.24%,既往有哮喘的累计患病率为2.69%.性别、首次发作年龄、呼吸道感染、过敏及遗传因素与哮喘发作有关.早期正确诊断及应用吸入治疗的比率仍较低.对比1990年哮喘现患率的0.78%,2000年哮喘现患率是10年前的2.6倍.结论本次调查0～14岁儿童哮喘的患病率较10年前显著升高,且主要发生于学龄期.哮喘发作受诸多因素的影响,目前按GINA方案在哮喘的规范化治疗上仍有明显差距.     

2000年苏州市区6174名儿童哮喘患病情况调查

目的 了解苏州市儿童哮喘的患病率、发病规律及影响因素。方法 采取整群抽样的调查方法，在苏州市的金阊区所抽取的街区内，向家长发放初筛问卷，筛选出相关疾病的可疑患者，再经哮喘中心医师统一问诊查体，填写调查表。所有数据经asa/pc统计软件分析。结果 实际调查6174人中，哮喘（婴幼儿及儿童哮喘）累计患病率为4．5％，两年内有喘息发作的哮喘近患率为3．74％，男女患病率分别为4．81％与2．64％。两年内有近患的广义哮喘（包括婴幼儿哮喘、儿童哮喘及咳嗽变异性哮喘）患病率为4．32％。性别、首次发作年龄、呼吸道感染、过敏及遗传因素与哮喘发作有关。发作季节主要为春秋季及季节更迭期。早期正确诊断及应用吸入治疗的比率仍较低。结论 苏州市0－14岁儿童哮喘的患病率较10年前显著升高，且主要发生于学龄期。生活模式的改变可能与哮喘的发病上升有关；哮喘发作受诸多因素的影响，目前按GINA方案在哮喘的规范化治疗上仍有明显差距。     

Prevalence and Treatment of Children's Asthma in Rural Areas Compared with Urban Areas in Beijing

Background:

The prevalence of childhood asthma has been increasing in China. This study aimed to compare the prevalence, diagnosis, and treatment of asthmatic children from urban and rural areas in Beijing, China.

Methods:

Schools, communities, and kindergartens were randomly selected by cluster random sampling from urban and rural areas in Beijing. Parents were surveyed by the same screening questionnaires. On-the-spot inquiries, physical examinations, medical records, and previous test results were used to diagnose asthmatic children. Information on previous diagnoses, treatments, and control of symptoms was obtained.

Results:

From 7209 children in rural areas and 13,513 children in urban areas who completed screening questionnaires, 587 children were diagnosed as asthma. The prevalence of asthma in rural areas was lower than in urban areas (1.25% vs. 3.68%, χ² = 100.80, P < 0.001). The diagnosis of asthma in rural areas was lower than in urban areas (48.9% vs. 73.9%, χ² = 34.6, P < 0.001). Compared with urban asthmatic children (56.5%), only 35.6% of rural asthmatic children received inhaled corticosteroids (P < 0.05). The use of bronchodilators was also lower in rural areas than in urban areas (56.5% vs. 66.4%, χ² = 14.2, P < 0.01).

Conclusion:

The prevalence of asthma in children was lower in rural areas compared with children in the urban area of Beijing. A considerable number of children were not diagnosed and inadequately treated in rural areas.     

2000年至2010年昆明市儿童哮喘流行病学调查结果比较

［摘要］目的　了解2000年至2010年之间昆明市儿童哮喘流行情况、分布特征、诱发因素及治疗情况的变化,为进一步改进哮喘患儿诊治方案提供依据．方法　采用随机整群抽样的方法,通过自填式问卷调查与集中调查相结合的方式进行调查,对2000年和2010年两次哮喘流行病学调查的初筛问卷中的可疑哮喘患儿按哮喘诊断标准进行诊断,对确诊的哮喘患儿填写哮喘儿童调查表．建立问卷数据库,并对2次调查的数据进行整理、分析．结果　2010年昆明市0~14岁儿童哮喘患病率为1.40%（150/10 717）,较2000年的0.88%（92/10 426）有明显增高（χ2＝12.52,P＜0.05）．与2000年相比,哮喘患儿既往诊断与调查时最后诊断的符合率由22.8%提高到了51.3%（χ2＝19.23,P＜0.05）,哮喘急性发作的比例由40.2%下降到了19.3%（χ2＝12.54,P＜0.05,抗生素的使用率由97.8%下降到了80.0%（χ2＝14.28,P＜0.05）,吸入激素治疗比例由12.0%上升到了64.0%（χ2＝60.53,P＜0.05＝．结论　昆明市0~14岁儿童哮喘患病率较10 a前有明显增加,哮喘既往诊断与调查时最后诊断的符合率有所提高,哮喘急性发作率有所下降,抗生素使用比例下降,而吸入糖皮质激素比例有所上升．但仍需大力推广“儿童支气管哮喘诊断与防治指南”,以进一步降低哮喘患儿的漏诊率、规范使用糖皮质激素及支气管舒张剂吸入治疗及减少抗生素的使用比例．     

延安市宝塔区学龄期儿童哮喘患病率及危险因素分析

目的 调查延安市宝塔区学龄期儿童哮喘患病率及相关危险因素等情况,为延安市学龄期儿童哮喘的防治提供科学依据。方法 以延安市宝塔区居住1年以上的6~14岁儿童为调查对象,采用分层整群抽样方法,按照东、西、南、北、中5个方位随机选取1所小学或中学的1~8年级学生,共计约9 000人。通过发放并指导填写2010年全国儿童哮喘流行病学调查协作组制定的全国儿童哮喘流行病学调查问卷表的方式来筛选哮喘患儿。对上述筛选出的哮喘儿童采用病例对照研究及Logistic回归分析方法对哮喘儿童危险因素进行分析。结果 延安市宝塔区学龄期儿童哮喘患病率为1.61%,其中女童患病率1.17%,男童患病率2.02%,男女性别差异有统计学意义（P<0.05）。过敏性鼻炎、个人药物过敏、有抗生素治疗史、天花板/墙壁/地板有霉斑、孩子出生前后家中有人吸烟是儿童哮喘的危险因素;顺产是儿童哮喘的保护性因素。结论 延安市宝塔区学龄期儿童哮喘患病率较全国水平低;接触过敏原、霉斑环境、烟草烟雾环境及滥用抗生素能够增加哮喘的发生,顺产能够降低哮喘的发生。     

海口市秀英区学龄前儿童哮喘初筛问卷调查分析

目的 初筛海口市秀英区学龄前儿童哮喘的患病率,为儿童哮喘防治和管理提供流行病学依据.方法 采用2010年全国哮喘防治协作组制定儿童哮喘流行病学调查初筛表,整群抽样,2010年9～12月对海口市秀英区学龄前儿童进行问卷调查.由家长与孩子共同完成问卷.由课题组成员收回并进行统计分析.结果 海口市秀英区共发放1 280份调查...     

The influence of altitude in bronchial asthma

BACKGROUND: Some asthmatic children living in mountain areas experience significant improvement in daily symptoms and in the degree of bronchial obstruction. The aim of this study is to investigate the effect of altitude on the prevalence and morbidity of childhood bronchial asthma. METHODS: A questionnaire regarding the history and symptoms of asthma was distributed to 874 children aged 6-12 years, to be completed by their parents with the help of their pediatrician. A total of 583 children lived at sea level, 180 at an altitude between 501 and 800 meters, and 111 at an altitude between 801 and 1,200 meters. All children with recurrent cough, shortness of breath, wheezing, and a history of bronchial asthma were considered to have bronchial asthma. RESULTS: The prevalence of childhood bronchial asthma in the mountains (800-1,200 meters) was twice as low as that at sea level (15.8% of children) (p <0.01). Parental smoking was more frequent in children who lived at sea level than in the mountains. Additionally, consumption of fish and oranges was more frequent at sea level. Children with asthma who lived in the mountains were absent fewer days from school per year (0.2) and had fewer nights with dyspnea per year (0.5) than asthmatic children who lived at sea level (1.6 days and 25 nights, respectively). CONCLUSIONS: Bronchial asthma in children who live at high altitudes is characterized by low prevalence and low morbidity.     

辽西地区0 ～ 14 岁儿童哮喘流行病学 调查及其危险因素分析

目的 调查辽西地区0 ～ 14 岁儿童哮喘的发病情况,并分析其危险因素。方法 采用随机抽样 的方法选取2000 年7 月-2014 年6 月于辽西锦州、葫芦岛、阜新、盘锦及朝阳市抽取的0 ～ 14 岁20 000 例儿童进行哮喘流行病学调查。结果 本研究收回完整调查问卷19 679 份,应答率为98.40%。其中哮喘儿 童491 例,患病率为2.50%。诱因以呼吸道感染最常见,约为84.66%。季节交替为儿童哮喘发病的高峰,约 为41.29%,其次为冬季,约为28.31%。好发时间段以午夜和清晨为主,分别为31.54% 和27.26%。首次发病年 龄<3 岁患儿363 例,占患儿总例数的73.93%。发作类型以突然发作为主,占45.82% ;最严重发作程度以中 度为主,占60.49%。患儿中一、二级亲属有哮喘史的分别占26.27% 和18.94%。哮喘儿童个人过敏史中最常 见的是湿疹,占49.08%。491 例哮喘患儿在哮喘发作时大多数使用支气管舒张剂治疗（86.97%）。结论 男童 患病率高于女童,以学龄期儿童最高;哮喘的诱因以呼吸道感染为主;哮喘的发作具有明显的遗传倾向;目 前我国不规范治疗及滥用抗生素现象仍比较严重,应进一步普及和推广国际标准化治疗方案。     

徐荣谦教授轻摩法在儿童哮喘的临床应用

北京中医药大学东直门医院儿科徐荣谦教授结合古代按摩手法和儿童体质特点,经40多年临床,积累了丰富经验,并进行了多项相关课题研究。本文拟结合徐荣谦经验,参阅相关文献,并综合分析,探讨轻摩法在治疗儿童哮喘的临床应用前景。结果表明轻摩法在儿童哮喘的疗效肯定,操作非常方便,甚至可以教会家长,使之成为哮喘儿童的治疗师,是目前治疗儿童哮喘的新路,值得推广。     

人类白细胞抗原-DRB基因与儿童哮喘的相关性

目的 调查人类白细胞抗原(HLA)-DRB等位基因在哮喘患儿中的分布频率及其与哮喘严重程度的相关性.方法 采用序列特异性引物聚合酶链反应(PCR-SSP)对北京市117例哮喘患儿和120名健康儿童进行HLA-DRB基因分析,计算HLA-DRB各等位基因在哮喘患儿和正常儿童的分布频率、比值比(OR)值,筛查出与哮喘相关的易感基因或抗性基因.结果 HLA-DR2(15)等位基因在哮喘息儿组的频率显著高于对照组[12.0%(28/234)比5.4%(13/240),P=0.011,OR=2.590];而DR4、DR6(1402)、DR9、DR53等位基因在哮喘患儿组的频率[9.4%(22/234)、0.9%(2/234)、17.1%(40/234)、29.5%(69/234)]均显著低于对照组[16.3%(39/240)、5.0%(12/240)、31.3%(75/240)、44.2%(106/240),P=0.026、0.008、0.000、0.001,OR=0.481、0.157、0.312、0.190)];其他等位基因分布差异均无统计学意义.以DR2(15)、DR4、DR6(1402)、DR9、DR53及性别、家族史为自变量,进行哮喘发病相关因素的Logistic回归分析,各等位基因OR值的95%CI分别为1.010～2.245,0.757～1.116,0.603～1.054,0.855～1.014,0.971～1.010.对HLA-DR2(15)等位基因阳性和阴性的患儿与哮喘严重程度进行相关分析,差异无统计学意义.结论 HLA-DR2(15)为儿童哮喘的易感基因,但其与哮喘严重程度无关.     

父母认知及管理对支气管哮喘患儿治疗依从性的影响

目的：探讨父母认知及管理对支气管哮喘患儿治疗依从性的影响。方法筛选2013年10月至2015年10月在我院儿科门诊就诊的支气管哮喘患儿86例,整理患者的临床资料并制作调查问卷,根据患儿在治疗期间应用糖皮质激素行为分为依从组(34例)和非依从组(52例),采用一般资料调查表、父母认知、父母管理、用药依从性调查表和药物吸入技术调查问卷进行调查,比较两组患儿和父母的一般资料、两组患儿父母对疾病知识的认知、父母对患儿管理评分以及患儿吸入技术评分,应用统计学方法分析用药依从性的影响因素。结果两组患儿和父母的一般资料比较显示,依从组患儿发作次数少,父母学历高,两组比较差异有统计学意义(P<0.05);依从组患儿父母对疾病认知调查结果评分为(18.6±2.6)分,高于非依从组的(12.5±2.1)分,两组比较差异具有统计学意义(P<0.05);依从组父母管理结果评分为(119±7)分,低于对照组的(145±8)分,两组比较差异具有统计学意义(P<0.05);依从组患儿的吸入技术评分为(5.2±0.8)分,高于对照组的(2.1±1.3)分,两组比较差异具有统计学意义(P<0.05);采用Logistic回归分析显示,父母认知程度[OR=1.04,95%CI (1.00~1.13),P=0.02]、父母管理[OR=0.06,95%CI (0.50~0.92),P=0.01]以及患儿吸入技术[OR=2.68,95%CI (1.52~6.53),P=0.01]是影响支气管患儿治疗依从性的因素(P<0.01)。结论提高父母的认知及管理水平可以提高支气管哮喘患儿的用药依从性,降低发病频率,改善患儿的症状。     

Recent trends in the prevalence and severity of childhood asthma.

OBJECTIVE--To examine changes in the prevalence and distribution of childhood asthma and its relationship with various measures of children's health and functioning between 1981 and 1988. It was hypothesized that there would be an increase in the prevalence of asthma, especially among black children, and that available measures would suggest a deterioration in the health and functioning of children with asthma over this period. DESIGN--Analyses of data from the Child Health Supplements to the National Health Interview Survey. SETTING AND SAMPLE--Nationally representative random sample of 15,224 children aged 0 to 17 years in 1981 and 17,110 in 1988. MAIN OUTCOME MEASURES--Changes in (1) the prevalence and distribution of asthma, and (2) among children with asthma, the percentage of children hospitalized, days spent in bed, school days lost in the year prior to survey, and parent ratings and reports of children's overall health status and behavior problems. RESULTS--The estimated prevalence of childhood asthma increased from 3.1% in 1981 to 4.3% in 1988 (P < .0001), with similar increases for children, adolescents, and both sexes. Increases occurred among white children (2.7% to 4.1%; P < .0001) but not black children (5.3% vs 5.1%; not significant). Among those with asthma in 1988 compared with 1981, there was better overall health status (11% vs 24% fair/poor; P < .0001) and fewer with 30 or more days spent in bed in the last year (3.9% vs 7.2%; P < .04). We also observed trends toward a lower rate of hospitalization in the last year (10% vs 14%; P = .07), fewer school days missed (2% vs 6% with > 30 days; P = .08), and a lower rate of extreme behavior problem scores (13% vs 18%; P = .09) in 1988 compared with 1981. Reductions were similar among both black and white children. CONCLUSIONS--These results indicate that the estimated prevalence of asthma among children in the United States increased by almost 40%, and that although the increase occurred exclusively among white children, the prevalence of asthma still remains higher in black children than in white children. There was no support for increasing asthma severity and functional impact among either black or white children with asthma in 1988 compared with 1981. These findings provide no evidence to support the beliefs that asthma prevalence is increasing largely among black children or that the severity of asthma among most children in the United States is increasing.     

Prevalence and management of asthma in children under 16 in one practice

The prevalence of childhood asthma in a small town in west Cumbria was studied. Medical records were scrutinised for keywords, children who were entered in the study were examined, and their parents were interviewed. A control group of children who were matched for sex and age was used to estimate the prevalence of asthma for the practice in the town. At the same time treatment was evaluated and improved where necessary. As expected, asthma in children was grossly underdiagnosed. The prevalence of asthma in children aged under 16 years in the practice was 15.6%, although the recorded prevalence before the study was only 7.8%. Treatment was inadequate for 42% of the children. The reasons for this were explored, and recommendations were made on management.     

北京市哮喘儿童社区管理效果探讨

目的探讨社区管理对儿童哮喘病情、家长知信行水平及家居环境的影响。方法2009年12月至2010年12月,对北京市朝阳区六里屯和三里屯社区0—14岁哮喘儿童93例建立哮喘健康管理档案,并按社区分为管理组（49例）和对照组（44例）。对管理组患儿进行社区综合管理,管理内容包括定期随访、病情监测和健康教育等;对照组患儿仅接受一般临床治疗。1年后根据患儿哮喘健康管理档案记录的变化情况,比较两组儿童哮喘发作、家长的知信行水平和家居环境改善情况。结果管理组患儿哮喘复发率降低27．9％（12／43）,哮喘住院率（27．9％）明显下降（χ^2=8．174,P=0．004）,缺课睛况（23．2％）也明显减少（χ^2=4．962,P=0．026）,与对照组（分别为11．4％、0．0％、4．5％）比较,差异均有统计学意义。管理组家长哮喘知信行水平的提高率为67．4％（29／43）,而对照组仅为20．5％（9／44）,差异有统计学意义（χ^2=19．517,P〈0．01）,其中,家长哮喘知识水平的提高最为明显。管理组患儿家居环境有明显改善,改善率为76．7％（33／43）,其中室内饲养宠物（χ^2=3．906,P=0．048）和室内蟑螂情况（χ^2=4．962,P=0．026）的改善在两组间差异有统计学意义。此外,管理组患儿室内过敏相关症状改善率为30．2％（13／43）,而对照组仅为9．1％（4／44）（χ^2=6．183,P=0．013）。结论社区综合管理能有效提高患儿家长的哮喘知识水平,改善遵医行为,促进家居环境改善;从而有效减轻患儿居家过敏的相关症状,改善哮喘严重程度,减少疾病对患儿日常生活和学习的影响。     

上海市黄浦区儿童哮喘流行病学调查

目的：了解上海市黄浦区儿童哮喘患病率及发病情况。方法：2000年5－10月随机选取黄浦区1个街道内的2个居委会所有0－14岁儿童作为调查对象，进行详细的询问和体检，填写哮喘调查表。结果：共调查1223名儿童，哮喘97例（7．93％），其中男65例（11．28％），女32例（4．95％），男：女为2．2：1，咳嗽变异性哮喘4例（0．33％），可疑哮喘7例（0．57％）。上呼吸道感染和气候变化为其发病的主要诱因。结论：上海市黄浦区为儿童哮喘高发地区，需进行积极的预防和治疗。     

IL-17基因启动子区单核苷酸多态性与儿童哮喘的关系

目的探讨IL-17基因启动子区单核苷酸多态性（SNP）与儿童哮喘及患儿血清总IgE水平之间的关系。方法提取287例哮喘患儿和217例健康儿童外周血基因组DNA,采用PCR-LDR技术检测了IL-17基因启动子区的4个SNPs位点（rs4711998、rs8193036、rs3819024和rs2275913）,与GenBank公布的IL-17基因序列（NT₀07952.15 GI:224514668）比较,分析其在两组儿童中的基因型及等位基因频率的分布,以及哮喘患儿血清总IgE水平及其在不同基因型中的差异。结果两组rs4711998位点基因型分布差异有统计学意义（P=0.03）,哮喘组GG纯合子基因频率为9.6%,明显高于健康对照儿童组（4.1%）;rs8193036、rs3819024、rs2275913三个SNP位点的基因型分布在两组间差异无统计学意义。哮喘组血清总IgE水平在4个SNP位点基因型间的分布差异均无统计学意义。结论 IL-17基因启动子区SNP rs4711998可能是儿童哮喘易感位点,其中rs4711998 GG纯合子基因型与哮喘发病密切相关。     

北京市平谷区3～6岁幼儿反复呼吸道感染发病情况及影响因素调查

目的调查北京市平谷区3~6岁幼儿反复呼吸道感染发病情况及其影响因素。方法制定调查问卷表,按分层整群随机抽样的方法,在平谷区4个幼儿园3~6岁幼儿中进行问卷调查,由家长填写问卷,调查2008年1月到2008年12月间幼儿反复呼吸道感染的发病情况及影响因素。利用Ep idata3.1录入数据,导出数据后利用SPSS 13.0软件包进行数据分析,3组间计数资料用2χ检验、计量资料用两独立样本t检验或秩和检验分析;多因素分析采用非条件Logistic逐步回归分析。结果平谷区3~6岁在园儿童反复呼吸道感染的发病率为18.7%,影响幼儿反复呼吸道感染发病情况的主要因素有母亲孕期是否健康,幼儿家长是否有过敏史,幼儿是否为早产,幼儿是否有哮喘史等4项。结论影响北京市平谷区幼儿反复呼吸道感染是多因素共同作用的结果,应该采取综合措施对该病进行防治。     

气道反应性测定在哮喘遗传家系的研究

目的　以支气管反应性为表型 ,观察哮喘家系成员支气管高反应性的遗传关系。方法　以先证者为调查中心 ,收集哮喘家系 ,对每个家系成员进行病史调查同时作支气管反应性测定或支气管舒张试验。结果　通过支气管反应性的测定 ,在家系中诊断为哮喘病人和未诊断为哮喘的个体气道反应性和肺功能显著不同 (P <0 0 5 ,P <0 0 1) ,哮喘父母对子女患病率的影响以父亲患病对子女患病率的影响最大 (占 5 4% )其次为母亲对子女的影响 (占 46% )。结论　在哮喘遗传家系中未诊断为哮喘的个体也存在气道高反应性 ,父亲、母亲以及双亲患哮喘对子女发病率是不同的     

瘦素小儿单纯性肥胖与儿童哮喘的相关性研究

目的探讨Leptin、小儿单纯性肥胖在儿童哮喘发病中的作用及其相互关系。方法选择52例正常体质量的哮喘患儿,32例合并小儿单纯性肥胖的哮喘患儿,32例单纯性肥胖儿童及43例健康同龄儿童为研究对象,采用放射免疫分析法测外周血清瘦素水平。结果正常体质量的哮喘患儿以及合并单纯性肥胖的哮喘患儿,急性期血清Leptin水平均高于临床缓解期、单纯性肥胖组及对照组(P均0.05),临床缓解期Leptin水平与单纯性肥胖组及对照组比较差异均有统计学意义(P均0.05);单纯性肥胖组与对照组比较差异有统计学意义(P0.05)。合并单纯性肥胖的哮喘患儿在哮喘急性轻、中、重度发作时血清Leptin水平均高于正常体质量的哮喘患儿,比较差异均有统计学意义(P均0.05);合并单纯性肥胖的哮喘患儿在临床缓解期及12月后复诊时血清Leptin水平均高于正常体质量的哮喘患儿,比较差异均有统计学意义(P均0.05)。结论 Leptin可能参与儿童哮喘的发病;肥胖可能是儿童哮喘的一个独立危险因素。     

Asthma morbidity in Australia: an epidemiological study.

OBJECTIVE: To examine the prevalence and management of asthma in adults and children in a population sample in eastern Australia. SETTING: A random sample of children from 33 primary schools in Sydney, Melbourne, Brisbane, and the Upper Hunter Valley (New South Wales), and their parents. DESIGN: A cross-sectional analytic survey of 8753 primary school children aged between 5 and 12 years, and their parents (n = 13,945 adults). Asthma prevalence and management practices were determined by parental responses to a questionnaire, and spirometry was performed in children with "probable asthma". RESULTS: Of 8753 children whose parents responded, the prevalence of current wheeze was 19.5% and diagnosed asthma was 17.1%. Of the children with "probable asthma", 30% had their lung function measured in the previous year, and 6% possessed both a peak flow meter and an action plan for their asthma. Undertreatment was likely, as preventive asthma medications (inhaled corticosteroids or sodium cromoglycate) were used regularly by only 25.5% of these children and by 44.3% of children who had asthma symptoms more than twice per week. Children with the diagnosis of asthma reported higher rates of preventive medication use and ventilatory function measurement than children with frequent symptoms without the diagnosis. In the 13,945 adults, the reported prevalence of asthma was 7%, of whom 39% were using preventive medications, 34% had their ventilatory function assessed in the previous year, and 7% had both a peak flow meter and an asthma action plan. CONCLUSIONS: The study illustrated the gap between the current level of asthma management in the community and the standards set by the Thoracic Society of Australia and New Zealand. Undertreatment and suboptimal management of asthma remain important problems in Australia.