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ICD Code: 493. Asthma

ICD Code: 493. Article Review
Title: Zhao J et al; "Self-Reported Prevalence of Childhood Allergic Diseases in Three Cities of China: A Multicenter Study." BMC Public Health; V.10; 2010; p551     DOI:10.1186/1471-2458-10-551
      STUDY DESIGN: This study determined the prevalence rates of asthma in children from three major cities in China, to provide baseline information for clinicians and health policymakers. The present study was conducted in Beijing, Chongqing and Guangzhou, three large cities located in different regions of China. Beijing is in the northern part of the country, and has a relatively low average humidity. Chongqing lies in Southwest China, in a region of high humidity. Guangzhou is in the south of China, and has a subtropical climate. In each city, two urban districts were randomly selected, and 3-5 schools and kindergartens were chosen at random in each selected district, depending on the population of the city. All children aged 0-14 years in selected schools and kindergartens took part in the survey. A total of 24,290 children were randomly selected, of whom 10,372 were from Beijing, 9846 from Chongqing, and 4072 from Guangzhou. An International Study of Asthma and Allergies in Childhood (ISAAC) group questionnaire, a standardized epidemiologic tool used to compare the prevalence of allergic diseases in different regions, was utilized in the survey. Asthma, rhinitis, and eczema were considered present if "yes" responses were given to the question: "Has your child ever had asthma, rhinitis, or eczema?" All parents who replied in the affirmative offered details on the ailments suffered by their child. Overall, 24,290 children aged 0-14 years took part in the survey. The response rates in Beijing, Chongqing, and Guangzhou were 98.60%, 97.21%, and 90.90%, respectively.
      PEDIATRIC PREVALENCE BY REGION (CHINA): The prevalence of asthma was reported as follows in Beijing, Chongqing, and Guangzhou, respectively: ages 0-1 years, 0.55%, 0%, 0%; ages 1-2 years, 1.76%, 0%, 3.73%; ages 2-3 years, 4.47%, 11.26%, 4.07%; ages 3-4 years, 4.33%, 9.70%, 2.18%; ages 4-5 years, 5.00%, 12.29%, 3.92%; ages 5-6 years, 4.86%, 8.30%, 3.32%; ages 6-7 years, 3.93%, 8.57%, 2.09%; ages 7-8 years, 3.70%, 9.35%, 2.62%; ages 8-9 years, 4.46%, 8.14%, 2.88%; ages 9-10 years, 3.76%, 6.15%, 0.95%; ages 10-11 years, 3.51%, 4.80%, 0.92%; ages 11-12 years, 1.08%, 4.66%, 1.01%; ages 12-13 years, 1.72%, 4.42%, 0.93%; ages 13-14 years, 1.48%, 3.83%, 0.98%; total, 3.15%, 7.45%, 2.55%. The prevalence of asthma in Chongqing (7.45%) was significantly higher than the rates in Beijing and Guangzhou (3.15% and 2.55%, respectively). Overall, 68.50%, 56.54%, and 68.24% of surveyed asthmatic children in Beijing, Chongqing, and Guangzhou, respectively, had demonstrated asthmatic symptoms (wheezing, cough, or both) within the 12 months prior to the survey, but the prevalence rates of such symptoms in these 12 months did not parallel the prevalence of asthma.
      COMORBID ALLERGIC DISEASE: Of all asthmatic children, 49.54%, 50.14%, and 34.83% also had allergic rhinitis in Beijing, Chongqing, and Guangzhou, respectively. The proportions of asthmatic children with eczema in these cities were 45.23%, 32.29%, and 19.10%, respectively. The percentages of asthmatic children with both allergic rhinitis and eczema were 23.08%, 21.25%, and 10.11%, respectively, in the three cities. Of children with allergic rhinitis, 10.73%, 18.30%, and 10.20% suffered from asthma.
      DISCUSSION: The authors found that the prevalence rates of asthma were significantly higher than in previous surveys, and that the gap that previously existed in the prevalence of allergic diseases between China and Western countries is gradually narrowing. Environmental and lifestyle changes may have contributed to this trend. Further studies are necessary to discern the precise reasons explaining the observed trend. The authors also found that the prevalence rates of allergic diseases were relatively high in very young children. In addition, all of asthma, allergic rhinitis, and eczema, the principal allergic diseases in children, often coexist, and may thus mutually interact to increase the severity of each individual condition.

Search Criteria: Text - BMC Public Health; V.10; 2010; p551