背景：哮喘是兒童期最常見的慢性疾病之一，在過去幾十年中，其發(fā)病率一直在增加。最一致的流行病學(xué)調(diào)查結(jié)果顯示，生活在農(nóng)業(yè)或農(nóng)村環(huán)境中的兒童免受哮喘和過敏的發(fā)展，但中國農(nóng)村地區(qū)的保護(hù)因素尚不清楚。
方法：對17587名5至8歲兒童進(jìn)行了基于社區(qū)的橫斷面流行病學(xué)研究，3435人來自香港（城市），14152人來自從化（中國南方農(nóng)村）。哮喘和過敏癥狀以及環(huán)境暴露通過使用標(biāo)準(zhǔn)化和經(jīng)驗證的問卷來確定。
結(jié)果：從化農(nóng)村地區(qū)當(dāng)前喘息的患病率顯著低于香港城市地區(qū)（1.7%對7.7%，p?<?0.001)。與城市兒童相比，農(nóng)村兒童的哮喘發(fā)病率也較低（2.5%對5.3%，p?<?0.001)。在調(diào)整混雜因素后，暴露于農(nóng)業(yè)（調(diào)整后的比值比0.74，95%置信區(qū)間：0.56–0.97）和家禽（0.75，0.59–0.96）是與農(nóng)村地區(qū)哮喘保護(hù)效果相關(guān)的最重要因素。進(jìn)一步的傾向評分調(diào)整分析表明，生活在農(nóng)村環(huán)境中的這種保護(hù)主要歸因于家禽接觸。
結(jié)論：我們證實，與城市同齡人相比，農(nóng)村兒童哮喘和特應(yīng)性疾病的患病率明顯更低。在農(nóng)村地區(qū)，接觸家禽和農(nóng)業(yè)是與哮喘防護(hù)相關(guān)的最重要因素。


原始出處
Allergy                                                  
Poultry exposure and environmental protection against asthma in rural children
DOI: 10.1111/all.15365
Abstract:
Background: Asthma is one of the most common chronic diseases in childhood, and the prevalence has been increasing over the past few decades. One of the most consistent epidemiological findings is that children living in a farming or rural environment are protected from development of asthma and allergies, but the protective factors in rural China are not clear.
Methods: A community-based, cross-sectional epidemiological study was performed in a total of 17,587 children aged 5–8?years, 3435 from Hong Kong (urban) and 14,152 from Conghua (rural county in southern China). Asthma and allergic symptoms as well as environmental exposures were ascertained by using a standardized and validated questionnaire.
Results: The prevalence of current wheeze was significantly lower in rural Conghua than that of urban Hong Kong (1.7% vs. 7.7%, p?<?0.001). A lower rate of asthma ever was also reported in rural children compared with their urban counterparts (2.5% vs. 5.3%, p?<?0.001). After adjusting for confounding factors, exposure to agricultural farming (adjusted odds ratio 0.74, 95% confidence interval: 0.56–0.97) and poultry (0.75, 0.59–0.96) were the most important factors associated with the asthma-protective effect in the rural area. Further propensity score-adjusted analysis indicated that such protection conferred by living in the rural environment was mainly attributable to poultry exposure.
Conclusion: We confirmed that the prevalence of asthma and atopic disorders was significantly lower in rural children when compared with their urban peers. Exposure to poultry and agricultural farming are the most important factors associated with asthma protection in the rural area.
First Author:
Yuhan Xing
Correspondence:
Gary W.K. Wong, Department of Paediatrics, Prince of Wales Hospital, Faculty of Medicine, Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.
2022-12-16 Article