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Himamoni Deka, 1 Putul Mahanta, 2 Sultana Jesmin Ahmed, 3 Madhab Ch Rajbangshi, 4 Ranjumoni Konwar, 5 Bharati Basumatari51 Department of Anatomy, Guwahati Medical College, Assam, India, 2 Dib, Assam, India Department of Forensic Medicine and Toxicology, Assam Medical College , Rugar; 3 Keʻena o ka Lapaʻau Lapaʻau, Assam Medical College, Dibrugarh, Assam, India; 4 Tezpur College of Medicine and Hospital Surgery, Tezpur, Assam, India; 5 Ke Keʻena Radiology, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam, India ʻO ka mea kākau kūpono: Putul Mahanta, Department of Forensic Medicine and Toxicology, Assam Medical College and Hospital, Dibrugarh, Assam, 786002, India, tel. +919435017802, leka uila [email protected] keakea ea. Hāʻawi nā kumu ʻelua a me nā mea kūlohelohe i ka piʻi ʻana o ka hānō. ʻO ke kumu o kēia noiʻi, ʻo ia ke loiloi i nā ʻano like ʻole o ka nohona a me ke kaiapuni e pili ana i ke kumu o ka hānō o nā keiki i nā maʻi e hōʻike ana i ka ʻoihana pediatric o ke Kulanui Lapaʻau ʻo Gauhati a me ka Halemai (GMCH) ma Assam. Nā mea hana a me nā ʻano hana. Ua koho ʻia he 150 mau maʻi me ka hānō i ʻike ʻia ma ke ʻano lapaʻau ma ka lakio 1: 1 ma waena o nā hihia i piha i ka makahiki 3-12 a me nā maʻi o ka hui makahiki like me ka ʻole o ka maʻi hanu a me ka mōʻaukala o ka hānō ma ke ʻano he mau kaohi. Ua hōʻiliʻili ʻia nā ʻikepili me ka hoʻohana ʻana i kahi ʻano i hoʻolālā mua ʻia a hoʻāʻo mua ʻia, a ua loaʻa ka ʻae ʻia i kākau ʻia mai nā kahu kānāwai āpau o nā mea komo. Ua kālailai ʻia nā ʻikepili e ka hoʻāʻo chi-square a me ka regression logistic binary me ka hoʻohana ʻana iā SPSS V20 i hoʻoponopono ʻia no nā p-values. Nā hopena: Ua ʻike ʻia nā keiki kūlanakauhale a me nā kāne he kiʻekiʻe aʻe ka pilikia o ka hoʻomohala ʻana i ka hānō. Nā keiki ma nā wahi kūlanakauhale (OR = 4, 53; 95% CI: 1.57-13.09; ppppppp Nā hopena: Hiki i nā keiki ke loaʻa i ka hānō i hoʻoulu ʻia e ke kaiapuni Pono nā hana hoʻomaopopo a me nā hana pale e kāohi a hōʻemi i ke kaumaha o ka hānō i nā keiki Nā huaʻōlelo koʻikoʻi: hānō, nā kumu kaiapuni, nā keiki, nā maʻi allergies, atopic
ʻO ka hānō kahi maʻi māmā mau loa i hōʻike ʻia e ke ālai ʻana o ke ala ea i hoʻohuli ʻia i hoʻokumu ʻia e ka mumū o nā ala ea i loko o nā māmā a me ke kuʻi ʻana o nā ʻiʻo a puni. ʻO nā alakaʻi hou mai ka Global Initiative on Asthma (GINA) e wehewehe ana i ka hānō he "maʻi heterogeneous i hōʻike pinepine ʻia e ka mumū mau loa o nā ala ea". ʻO nā hōʻailona hanu e like me ka wheezing, ka pōkole o ka hanu, ka paʻa o ka umauma a me ka ʻū ʻana, a me ka palena o ke kahe expiratory fluctuating, he mau hōʻailona ia o ka hānō. hoʻokahi
I ka poʻe me ka hānō, hiki ke loaʻa nā hōʻailona koʻikoʻi ma muli o nā ʻano mea hoʻonāukiuki like ʻole, e like me nā cigarettes a me nā ʻano puhipaka ʻē aʻe, ka ʻōpala, ka pollen, ka lepo, ka dander holoholona, ​​​​ka hoʻoikaika kino, ka ea anuanu, nā huahana hale a me nā ʻoihana, ka haumia o ka ea, a me nā maʻi. 2 ʻO ka hui pū ʻana o nā kumu genetic a me ke kaiapuni e wehewehe ana i ka nui o ka nui o ka hānō ma kekahi mau kaiāulu. I ka manawa pinepine, hiki i kēia mau kumu ʻē aʻe ke kōkua i nā ʻokoʻa, me ka lāhui a i ʻole ka lāhui kanaka nā mea i maʻalahi ke ʻike ʻia ma waena o nā hui like ʻole o ka poʻe. 3
He maʻi lapaʻau ka ʻike ʻana o ka hānō no ka mea ʻaʻohe wehewehe maʻamau no ke ʻano, ke koʻikoʻi, a i ʻole ka alapine (frequency) o nā hōʻailona. He maʻi maʻamau ka hānō bronchial e kau ana i kahi kaumaha nui ma luna o ka hana lapaʻau maʻamau a me ka hoʻokipa ʻia ʻana i ka haukapila.4 ʻOiai he nui nā ʻano like o ka ʻike ʻana o ka hānō i nā keiki a me nā pākeke, ʻo ka ʻike ʻokoʻa, ke ʻano kūlohelohe o ka wheezing, ka hiki ke hāʻawi i ka lāʻau lapaʻau kikoʻī, a me kona waiwai diagnostic e pili ana i ka makahiki.
Ma ka honua holoʻokoʻa, ʻoi aku ma mua o 300 miliona mau kānaka e ʻeha nei i ka hānō. I nā keiki, ʻo ka hānō kekahi o nā maʻi maʻi 20 kiʻekiʻe loa i nā makahiki ola i hoʻoponopono ʻia e ke kīnā o ka honua, me ka nui o ka make ʻana o 0.0-0.7 no 100,000.5 mau kānaka. Ua hōʻike ʻia ka nui o ka hānō ma India mai 2% a 23%, ma muli paha o ka ʻokoʻa nui o ka ʻāina a me ke kaiapuni o ka ʻāina. 6 Ma kahi noiʻi hou, ua ʻike ʻia kēia helu he 10.4% ma Assam. 7
ʻO ka hānō i nā keiki ke kumu o nā hōʻailona hanu e like me ka wheezing, ka ʻū, ka hanu paʻakikī, a me ka paʻa o ka umauma, a inā ʻaʻole mālama pono ʻia, hiki ke alakaʻi i ka hānō mau loa. Hiki i ka hānō o nā keiki ke hoʻopilikia nui i ke ʻano o ke ola o nā keiki maʻi ma ka hoʻonui ʻana i ka hele ʻole ʻana i ka hana a me ka hōʻemi ʻana i ke komo ʻana i ka hana.
ʻOiai ka ʻike holomua a me nā hoʻolālā lapaʻau, ua piʻi nui ka nui o ka maʻi, ka maʻi a me ka make ʻana o ka hānō i nā keiki i nā makahiki i hala iho nei8,9, a pono ka hoʻomaopopo hou ʻana i ka pathogenesis o ka hānō e mālama pono ai i ka hānō. ʻOiai ke hana nui ʻia nei ka noiʻi ma nā wahi like ʻole o India, ua liʻiliʻi loa ka mea i hana ʻia ma kēia ʻāina i hoʻomohala ʻole ʻia ma ka ʻākau hikina o India.
Ua mālama ʻia kēia noiʻi ma ka mokuʻāina ʻo Assam ma ka ʻākau hikina. ʻO ka heluna kanaka o Assam he mau hui lāhui like ʻole, nona ka 12.45% no nā kaiāulu ʻōiwi e like me Bodo, Khachari, Karbi, Miri, Mishimi, Rabah, a pēlā aku. Ua hoʻopuehu ʻia nā wahi kuaʻāina ma ka hapa nui o ka ʻāina. Ua kaulana ka mokuʻāina no kona ʻano like ʻole. ʻO ka mahiʻai, ʻo ka laiki, ke kī a me nā pulses, ʻoi aku ma mua o hoʻokahi hapakolu o ka loaʻa kālā o Assam a hoʻolimalima ma kahi o 69 pakeneka o ka poʻe hana. Hoʻopuka ka mokuʻāina i 50% o ka hana kī a India. ʻO nā ʻoihana mahiʻai waiwai ʻē aʻe e pili ana i ka mahi puaʻa, ka mahi waiū a me ka lawaiʻa me ke komo ʻana o ka heluna kanaka kuaʻāina. ʻO ka mahiʻai, ke kī, ka ʻaila a me ke kinoea, ka lanahu a me ka pōhaku lepo nā ʻoihana nui. ʻO ka nui o nā ʻokoʻa lāhui a me ka ʻāina ma ka mokuʻāina ma muli o nā ʻano loli a me ka pathogenesis o ka maʻi.
ʻO GMCH ke kikowaena kuhikuhi tertiary alakaʻi ma ka ʻāina, e mālama ana i nā maʻi mai nā wahi a pau o ka ʻākau hikina o India, me nā heluna kanaka kuaʻāina a me nā kūlanakauhale. ʻO ka hapa nui o nā maʻi he kūlana haʻahaʻa o ka nohona waiwai a me ka pae haʻahaʻa o ka hoʻonaʻauao. ʻO ka hānō bronchial i nā keiki kahi pilikia maʻamau i nā pediatrics inpatient.
ʻO ka pahuhopu o kēia haʻawina ke loiloi i nā ʻano kumu like ʻole o ka nohona a me ke kaiapuni e pili ana i ke kumu o ka hānō o nā kamaliʻi i nā poʻe maʻi i piha i nā makahiki 3-12 e hōʻike ana i kahi pediatrician GMCH.
Mai ʻApelila 2013 a Malaki 2017, ua mālama ʻia kahi noiʻi hihia-kaohi i hala ma ka 'Oihana Anatomy me ka laulima ʻana me Pediatrics Assam GMCH e noiʻi i nā kumu socio-demographic a me ke kaiapuni o ka hānō kamaliʻi i nā keiki 3-12 mau makahiki.
Ma kahi noiʻi hihia-kaohi i ʻike ʻole ʻia, ua koho ʻia he 150 mau hihia a me 150 mau kaohi ma ka lakio 1:1 e aʻo ai i nā kumu like ʻole i ka hānō o nā kamaliʻi. Ua koho ʻia nā maʻi me ka hānō i ʻike ʻia ma ke ʻano lapaʻau mai 3 a 12 mau makahiki e hōʻike ana i nā keʻena pediatric waho a me loko o ka hale ma ke ʻano he mau hihia, ʻoiai ʻo nā kaohi he mau maʻi o ka hui makahiki like, ʻoi aku ka maikaʻi e noho ana i nā kūlana like me ka ʻole o nā pilikia hanu. mōʻaukala o ka maʻi a me ka hānō.
Ua hoʻoholo ʻia ka nui o ka laʻana me ka hoʻohana ʻana i ka WinPepi mana 11.65. Hōʻike ka ʻikepili mai ke aʻo mua ʻana ʻo ka nui o ka hānō i waena o nā keiki India mai 1% a 4%. No laila, ke manaʻo nei he 1% ka nui o nā keiki me ka hānō a me nā nui like o nā hui maʻi a me ka hui kaohi, koi ke aʻo ʻana i ka nui o ka laʻana o 274 mau kānaka e hoʻokō i ka mana 80% e ʻike ai i kahi ʻokoʻa ʻelua huelo 4% ma waena o ʻelua. . Loaʻa i nā hui ʻelua kahi pae koʻikoʻi o 5%.
Eia kekahi, ke manaʻo nei ma kahi o 10% o ka poʻe pane ʻole ma muli o ka nalowale ma hope a i ʻole ka mālama ʻole ʻana, he mea kūpono ke kahakiʻi i kahi laʻana o 300 mau kānaka (me 150 mau hihia a me 150 mau kaohi).
E hoʻohana i nā ʻano hōʻiliʻili ʻikepili i hoʻolālā mua ʻia a hoʻāʻo ʻia. Ua loaʻa ka ʻae ʻia i kākau ʻia mai nā kahu kānāwai āpau o nā mea komo i ke aʻo ʻana. Ua hōʻiliʻili ʻia ka ʻikepili ma nā ʻano loli like ʻole o ka nohona a me ke kaiapuni. Ua wehewehe ʻia ke ʻano o ka hale e like me
ʻO ka hale Pucca, inā hana ʻia nā paia a me ka hale i ka piliki, ka sima a me ka pōhaku; ʻo ka hale Katcha, hana ʻia ia i ka lāʻau, ka lepo, ka mauʻu maloʻo a me nā lau maloʻo inā hana ʻia ka hale me nā paia piliki a me nā paia adobe me kahi hale ʻuʻuku a i ʻole ka pā kini a me ka sima. papahele Inā pau, he hale Semi pucca kēia. Ua loiloi ʻia ke kūlana socioeconomic me ka hoʻohana ʻana i ka unahi Kuppuswami i hoʻololi ʻia (2014).
Ua hoʻopaʻa pū ʻia ke ʻano hānau o nā mea komo, ka mōʻaukala o ka hānau ʻana me ka asphyxia, ke ʻano hānai ʻana, ka mōʻaukala o ka maʻi ʻaleka meaʻai, ka mōʻaukala makuahine o ka ʻona, ka mōʻaukala ʻohana o ka hānō, ka mōʻaukala o ka atopy a i ʻole ka allergy, a me ka mōʻaukala ʻohana o ka puhipaka a i ʻole ka uahi lua. Ua manaʻo ʻia nā lālā o ka ʻohana e noho ana ma ka hale like he poʻe puhipaka i ka mōʻaukala ʻohana. Wahi a nā GINA Epidemiological and Clinical Trial Participant Image Guidelines, ua hoʻokaʻawale ʻia ke koʻikoʻi o ka maʻi e like me nā ʻanuʻu lapaʻau i kuhikuhi ʻia, me ka noʻonoʻo ʻana he hānō iki nā maʻi i hāʻawi ʻia i ke kahua 2, a he hānō iki nā maʻi i hāʻawi ʻia i ke kahua 3-4. a ua hāʻawi ʻia i ke kahua-5. mālama ʻana i ka hānō koʻikoʻi.
Nā pae hoʻokomo a me ka hoʻokaʻawale: Manaʻo ka palapala e pono e hoʻokomo ʻia nā hihia pediatric i loko o ke aʻo ʻana a hiki i ka 18 mau makahiki. Eia nō naʻe, ma GMCH, ʻo ka hapa nui o nā keiki i kuhikuhi ʻia ma lalo o 12 mau makahiki. Eia kekahi, ʻoi aku ka nui o ka maʻi hānō o nā kamaliʻi ma mua o ka laha o ka maʻi ma mua a ma hope o ka wā ʻōpio. No laila, ua koho ʻia ka hui makahiki mai 3 a 12 mau makahiki no ke aʻo ʻana. Ua komo pū ka haʻawina i nā maʻi me ka maʻi hānō bronchial i ʻike ʻia ma ke ʻano lapaʻau mai 3 a 12 mau makahiki i ʻae e komo i ke aʻo ʻana. ʻO nā keiki mai 3 a 12 mau makahiki i ʻae e komo i ke aʻo ʻana me ka ʻole o ka maʻi hanu, ʻoi aku ka maikaʻi o ka noho ʻana ma nā kūlana like, ua koho ʻia ʻo ia ka hui kaohi.
Ua kāpae ʻia nā keiki 0-3 makahiki mai ke aʻo ʻana no ka mea ʻaʻole lawa ka hanu ʻana i kēia hui makahiki e ʻike ai i ka hānō. Eia kekahi, ua kāpae ʻia nā keiki o nā hui makahiki kūpono a me ko lākou mau kahu i ʻae ʻole e komo i ke aʻo ʻana.
Ka loiloi helu. Ua kālailai ʻia nā ʻokoʻa o nā lakio me ka hoʻohana ʻana i ka hoʻāʻo χ. Ua hoʻohana ʻia ka regression logistic binary no nā palena koʻikoʻi i ka loiloi univariate, a ua hoʻohana ʻia ka hoʻāʻo χ 2 a Wald e ana i ka hāʻawi kūʻokoʻa o ka lāʻau.
ʻApono kūpono: Ma mua o ka hōʻiliʻili ʻana i ka ʻikepili, ua loaʻa ka ʻae etika mai nā Institutional Ethics Committees o ka Institute, ʻo ia hoʻi nā Institutional Ethics Committees o GMCH, Guwahati, Assam a me India, Ref: No: 233/2018/215.
No nā maʻi 112,323 i hele mai i ka ʻāpana pediatric i ka wā o ke aʻo ʻana, he 18.88% nā maʻi hanu. Ma waena o nā keiki i ka hui makahiki o 3-12 mau makahiki, ua loaʻa iā 2.96% ka maʻi hānō bronchial. ʻO ka hapa nui o nā hihia o ka hānō kamaliʻi i hana ʻia i ka hāʻule o Kepakemapa a me ʻOkakopa (Kiʻi 1).
Ua komo pū kēia haʻawina hihia-kaohi i 150 mau keiki me ka hānō a me 150 mau kaohi. ʻO ka awelika (± SD) makahiki o nā mea komo i ke aʻo ʻana he 8.38 (± 2.69) mau makahiki. ʻO ke kuni a me ka pōkole o ka hanu nā hōʻailona lapaʻau maʻamau i nā hihia. ʻO ka hapa nui (77.3%) o nā hihia i loaʻa nā hoʻouka hānō episodic a he 8.7% wale nō o nā hihia i loaʻa ka hānō koʻikoʻi. Ua ʻike ʻia ka nui o nā hihia i ka hāʻule (30%). Ma kahi o 38% o nā hihia, ua hōʻike ʻia nā hōʻailona i ka pō (Papa 1).
Wahi a ka poʻe i pane mai, ʻo nā mea inu anu (82.7%), ka ʻaikalima (71.6%) a me ka lepo (35%) nā mea hoʻoulu maʻamau o ka hānō. Kokoke i ka 19.3% o nā hihia i hōʻike ʻia ka haʻalele ʻana i ke kula ma muli o ka maʻi.
ʻO ka awelika makahiki (maʻamau ʻokoʻa) o nā mea komo he 8.34 (2.69) mau makahiki. ʻO ka hapa nui o nā hihia ma ka hui makahiki 7-12 a he kāne. ʻO ka hapa nui o nā mea komo i ke aʻo ʻana he Hindu a ʻaʻole he ʻohana.
ʻOi aku ka kiʻekiʻe o nā hihia o nā keiki a me nā kāne i piha i ka makahiki 7-12, ʻoiai ʻaʻole koʻikoʻi ka pilina. Eia kekahi, ua pili nui ka hānō o nā keiki me ka BMI (p-value<0.05). Eia kekahi, ua pili nui ka hānō o nā keiki me ka BMI (p-value<0.05). Кроме того, детская астма была значительно связана с ИМТ (значение р<0,05). Eia kekahi, ua pili nui ka hānō o nā keiki me ka BMI (waiwai p <0.05).此外，儿童哮喘与BMI 显着相关（p ‼<0.05）。此外，儿童哮喘与BMI 显着相关（p ‼<0.05）。 Кроме того, детская астма была значительно связана с ИМТ (значение p <0,05). Eia kekahi, ua pili nui ka hānō o nā keiki me ka BMI (waiwai p <0.05).ʻOi aku ka nui o ke kaumaha (OR = 2.22, 95% CI: 1.17–4.18) a me ka momona (OR = 2.72, 95% CI: 1.46–5.09) ma mua o ka pālua o ke kiʻekiʻe ma mua o nā keiki o ke kaumaha maʻamau. ʻOi aku ka nui o ka pilikia o nā keiki kūlanakauhale e noho ana i nā ʻohana i kaʻana like ʻia, nā pā hale ʻōpala, a me nā hale noho pulu a me ka ea ʻole i lawa ʻole ka ea o ka loaʻa ʻana o ka maʻi. Ma nā lumi kuke i hoʻopili ʻia, ʻo nā wahie hana uahi ʻē aʻe ma mua o ka LPG, nā mea pale makika, Dhuna, a me nā mea ʻē aʻe, ua pili nui pū me ka hānō o nā keiki (p-value <0.05). Ma nā lumi kuke i hoʻopili ʻia, ʻo nā wahie hana uahi ʻē aʻe ma mua o ka LPG, nā mea pale makika, Dhuna, a me nā mea ʻē aʻe, ua pili nui pū me ka hānō o nā keiki (p-value <0.05). В примыкающих кухнях использование значительно выделяющего дым топлива, кроме сжиженного нефтяного галот, ренкто галрот Дхуна и т. д., также связано с детской астмой (значение p<0,05). Ma nā lumi kuke e pili ana, ʻo ka hoʻohana ʻana i nā wahie e hana nui ana i ka uahi ma waho aʻe o ka LPG, nā mea pale makika, Dhuna, a me nā mea ʻē aʻe, ua pili pū ʻia me ka hānō o nā keiki (p value < 0.05).在附属厨房中，除LPG、驱蚊剂、Dhuna 等以外的产生烟雾的燃料也与儿童哮喘显着着‼<0.05）. Dhuna 等以外的产生与儿童哮喘显着相关（p 值<0.05）、 Дымообразующие виды топлива, кроме сжиженного нефтяного газа, средства от комаров, Dhuna и т. д., также были в значительной степени связаны с детской астмой на примыкающих кухнях (значение p <0,05). Ua pili nui pū nā wahie e hana ana i ka uahi ma waho aʻe o ka LPG, ka mea pale makika, Dhuna, a me nā mea ʻē aʻe me ka hānō o nā keiki i nā lumi kuke e pili ana (p value <0.05).Ua ʻike ʻia hoʻi he 8 mau manawa ka nui o ka loaʻa ʻana o ka hānō i nā keiki me nā holoholona (Papa 2).
E like me ka mea i hōʻike ʻia ma ka Papa 3, 46.7% o nā hihia no nā ʻohana o ke kūlana haʻahaʻa o ka nohona waiwai. Ua haʻahaʻa hoʻi ka hoʻonaʻauao makuahine i waena o nā hihia (p-value <0.05). Ua haʻahaʻa hoʻi ka hoʻonaʻauao makuahine i waena o nā hihia (p-value <0.05). Материнское образование также было ниже среди случаев (значение p<0,05). Ua haʻahaʻa hoʻi ka hoʻonaʻauao makuahine i waena o nā hihia (p value <0.05).病例中的母亲教育程度也较低（p 值<0.05）。病例中的母亲教育程度也较低（p 值<0.05）。 Матери в этих случаях также были менее образованными (значение p <0,05). ʻAʻole hoʻi i hoʻonaʻauao iki ʻia nā makuahine ma kēia mau hihia (p value <0.05).
ʻO nā keiki i hānau ʻia ma o ka ʻoki caesarean (CS) a i ʻole nā ​​​​ʻano hana hānau ʻē aʻe, a me nā keiki me ka mōʻaukala o ka asphyxia hānau, ua piʻi aʻe ka pilikia o ka maʻi. Eia kekahi, ʻo nā keiki hānai kiʻekiʻe/hui ʻia ua aneane ʻelima mau manawa ka nui o ka loaʻa ʻana o ka maʻi ma mua o nā keiki hānai waiū (Papa 4).
Ua pili nui ka mōʻaukala o ka maʻi ʻaleka meaʻai a me ka atopy i nā keiki i ka hānō o ke keiki. Eia kekahi, ʻo nā keiki mai nā ʻohana me ka mōʻaukala o ka maʻi allergy a me ka hānō (p-value <0.05) ua nui ka maʻalahi o ka loaʻa ʻana o ka maʻi. Eia kekahi, ʻo nā keiki mai nā ʻohana me ka mōʻaukala o ka maʻi allergy a me ka hānō (p-value <0.05) ua nui ka maʻalahi o ka loaʻa ʻana o ka maʻi. Также высокой склонностью к заболеванию отличались дети из семей с анамнезом аллергии и астмы (знач,05е p<005). Eia kekahi, ʻo nā keiki mai nā ʻohana me ka mōʻaukala o nā maʻi allergies a me ka hānō he kiʻekiʻe ko lākou ʻano i ka maʻi (p <0.05).此外，来自有过敏和哮喘病史的家庭（p 值<0.05）的儿童极易患病。此外，来自有过敏和哮喘病史的家庭（p 值<0.05）的儿童极易患病。 Кроме того, дети из семей с аллергией и астмой в анамнезе (р-значение <0,05) были высоко восприимчивы. Eia kekahi, ʻo nā keiki mai nā ʻohana me ka mōʻaukala o nā maʻi allergies a me ka hānō (p-value <0.05) he maʻalahi loa lākou. Ua hoʻonui pū ka puhipaka hana ʻole ma o nā lālā ʻohana ʻē aʻe i ka aneane ʻewalu manawa o ka pilikia o ka hānō i waena o nā keiki (p-value <0.05). Ua hoʻonui pū ka puhipaka hana ʻole ma o nā lālā ʻohana ʻē aʻe i ka aneane ʻewalu manawa o ka pilikia o ka hānō i waena o nā keiki (p-value <0.05). Пассивное курение через других членов семьи также увеличивает риск развития астмы у детей почти в восемь, раз (p<0мь раз (). ʻO ka puhipaka ʻole ma o nā lālā ʻohana ʻē aʻe e hoʻonui pū i ka pilikia o ka loaʻa ʻana o ka hānō i nā keiki ma kahi o ʻewalu manawa (p value <0.05).通过其他家庭成员被动吸烟也使儿童患哮喘的风险增加了近8 倍（p 伉<0.05）。通过其他家庭成员被动吸烟也使儿童患哮喘的风险增加了近8 Пассивное курение через других членов семьи также увеличивало риск развития астмы у детей почти в 8 раз (p-зна,05). Ua hoʻonui pū ka puhipaka hana ʻole ma o nā lālā ʻohana ʻē aʻe i ka pilikia o ka loaʻa ʻana o ka hānō i nā keiki ma kahi o 8 mau manawa (p-value <0.05).(papa 5)
Ua hōʻike ʻia ka regression logistic binary he nui nā keiki ma nā wahi kūlanakauhale, nā wahi haumākū, ke kūlana socioeconomic haʻahaʻa, nā holoholona, ​​​​ka mōʻaukala ʻohana o ka atopy / allergies, ka mōʻaukala ʻohana o ka puhipaka / puhipaka passive, a me nā meaʻai i hui pū ʻia he mau mea kōkua nui. Nā mea pilikia no ka hānō kamaliʻi (Papa 6).
Papa 6 Ka loiloi regression logistic multivariate e loiloi i nā mea koʻikoʻi e hoʻopilikia ana i ka hānō o nā keiki
I nā makahiki he ʻelua a ʻekolu paha i hala iho nei, ua piʻi ka nui o nā maʻi atopic, e hoʻoulu ana i ka nui o ke kūkākūkā e pili ana i ka loli o ke kaiapuni, ka haumia, a me nā pane pale i nā pathogens infectious. ʻO ka ʻike ʻia ʻana o ke kaiapuni a me nā nāwaliwali olaola a me nā genetics e pāʻani i kahi kuleana i ka ulu ʻana o ka hānō.
Ma kēia haʻawina, ua hōʻike ʻia he 2.96% o nā maʻi ma ka hui makahiki 3 a 12 i ka hānō kamaliʻi. Eia nō naʻe, ua hōʻike kekahi mau haʻawina ma mua i nā ʻano like ʻole o ka hānō kamaliʻi i nā keiki India. 6,10-12 Hoʻopili pololei nā ʻokoʻa ʻāina a me ke kaiapuni ma India i nā mea pilikia e pili ana i ka hanana hānō. 6 No laila, no ka pale kūpono a me ka manawa kūpono o ka maʻi, pono kahi loiloi ʻāina o nā mea nui o ka hānō kamaliʻi.
ʻOi aku ka nui o ka pilikia o nā keiki 7-12 mau makahiki, nā kāne a me nā keiki e noho ana ma nā wahi kūlanakauhale i ka hānō o nā keiki. Ua ʻike ʻia ke kūlana kiʻekiʻe o ke kūlanakauhale a me nā kāne i ka nui o ka hānō ma kahi noiʻi ma India,10 e like me kā mākou mau ʻike. Eia nō naʻe, he koʻikoʻi wale nō kēia pilina ma ke ʻano helu ma ka wahi o ka home.
Ua hōʻike ʻia nā haʻawina e hiki i nā loli hormonal e pili ana i ke kāne ke hoʻopilikia i ka hānō, ʻoiai ʻoi aku ka nui o ka loaʻa ʻana o ka hānō i nā keikikāne i ka wā kamaliʻi. Eia nō naʻe, loli kēia kiʻi ma hope o ka wā ʻōpio, a ʻoi aku ka nui o ka loaʻa ʻana o ka maʻi i nā wahine ma mua o nā kāne. 13-15 Eia kekahi, ʻoi aku ka liʻiliʻi o nā ala ea o nā keikikāne ma lalo o 10 mau makahiki ma mua o nā kaikamahine o ka makahiki like, a ua manaʻo ʻia hoʻi ke kiʻekiʻe he kumu ia o ka hānō o nā keikikāne i nā kamaliʻi. 16.17
Ua hōʻike ʻo Metro Kamstrup, ke kapikala o Assam, i ka wikiwiki o ke kūlanakauhale i nā makahiki i hala iho nei. Nui nā haʻawina e hōʻike ana he kumu ke kūlanakauhale e hoʻopilikia ana i ka nui o ka hānō, kahi e kūlike me kā mākou haʻawina. 18,19 Ma ke aʻo ʻana i kēia manawa, ua hōʻike ka regression logistic i hoʻoponopono ʻole ʻia he ʻoi aku ka nui o nā keiki kaumaha a me ka momona ma mua o ka pālua o ka loaʻa ʻana o ka hānō ma mua o nā keiki me ka BMI maʻamau, e kūlike me kahi loiloi hou. 20 Eia kekahi, ʻo ke kūlana socioeconomic haʻahaʻa he kumu pilikia paha no ka hānō o nā kamaliʻi. ʻO nā keiki mai nā ʻohana o ke kūlana socioeconomic haʻahaʻa he kiʻekiʻe aʻe ka pilikia o ka loaʻa ʻana o ka hānō ma muli o ka pane pale haʻahaʻa a me nā kumuwaiwai mālama ola haʻahaʻa. 21-23
ʻO nā keiki e noho ana i loko o kahi ʻohana hui, nā hale kaccha, nā hale noho pulu, ka ea kūpono ʻole, nā lumi kuke pili, nā wahie hana uahi, nā mea pale namu a me Dhuna, a me nā mea ʻē aʻe, ua pili nui lākou me ka hānō o nā keiki (p-value <0.05). ʻO nā keiki e noho ana i loko o kahi ʻohana hui, nā hale kaccha, nā hale noho pulu, ka ea kūpono ʻole, nā lumi kuke pili, nā wahie hana uahi, nā mea pale namu a me Dhuna, a me nā mea ʻē aʻe, ua pili nui lākou me ka hānō o nā keiki (p-value <0.05).ʻO nā keiki e noho ana i loko o kahi ʻohana hui, e holo ana mai ka home aku, nā hale haumakū, ka ea kūpono ʻole, nā lumi kuke pili, ka wahie hana uahi, nā mea pale makika a me nā Dhuna, a pēlā aku.д., были достоверно связаны с детской астмой (значение р<0,05). e., ua pili nui me ka hānō o nā kamaliʻi (waiwai p<0.05).共同家庭的儿童、kaccha房屋、潮湿的住宅、通风不足、附属厨房、产生烟雾的燃料、驱蚊剂和Dhuna等与儿童哮喘显着相关（p 值<0.05）。 ʻO nā keiki i loko o nā hale i kaʻana like ʻia, nā hale kaccha, nā hale haumaʻu, ka ea kūpono ʻole, ka lumi kuke pili, ka wahie hana uahi, nā mea pale namu, a me Dhuna e pili nui ana i ka hānō o nā keiki (p value <0.05). Дети в общих домохозяйствах, домах качча, сырых жилищах, неадекватной вентиляции, пристроенныхто кухнымя, залид репеллентах от комаров и Дхуна были в значительной степени связаны с детской астмой (значение p <0,05). ʻO nā keiki e noho ana i nā hale i kaʻana like ʻia, ka mālama ʻana i ka hale, nā hale pulu, ka ea kūpono ʻole, nā lumi kuke i hoʻolako ʻia, ka wahie uahi, nā mea pale namu a me nā dhuna ua pili nui lākou me ka hānō o nā keiki (p value < 0.05).Ua hōʻike pū ʻia nā noiʻi ma mua e hiki i nā ʻano kumu like ʻole o ke kaiapuni o loko ke hoʻoulu i ka hānō i nā keiki. 24-27 He mea hoʻopaʻapaʻa ka pilina o nā mea hoʻonāukiuki holoholona o loko me ka hānō o ke kamaliʻi, no ka mea, he kakaikahi nā kānaka noiʻi e manaʻoʻiʻo nei e hiki i ka ʻike mua ʻana i nā mea hoʻonāukiuki ke kōkua i ka hoʻomohala ʻana o ka hoʻomanawanui. 28
Ua hōʻike ʻia nā haʻawina he nui he nui ka nui o ka pilikia o ka hānō kamaliʻi i nā keiki i hānau ʻia ma o ka ʻoki ʻoki caesarean i hoʻohālikelike ʻia me nā hānau maʻamau. He kūlike kēia me kā mākou mau ʻike. 29-32 ʻO nā keiki me ka mōʻaukala o ka asphyxia hānau he nui aʻe ko lākou pilikia o ka loaʻa ʻana o ka hānō. He mea nui ka hānō makuahine i nā pilikia hāpai e like me ka respiratory distress syndrome a me ka neonatal asphyxia. 33
E like me nā haʻawina ʻē aʻe, hōʻike nā ʻike o kēia manawa ʻo ka mōʻaukala kamaliʻi o ka allergy meaʻai a i ʻole ka atopy a i ʻole ka mōʻaukala ʻohana o nā allergies a me ka hānō e hoʻonui nui i ka pilikia o ka hānō kamaliʻi. 34,35 E like me kā mākou haʻawina, ua hōʻike nā haʻawina multi-generational mua e hiki i nā hana puhipaka intergenerational ke alakaʻi i nā loli genetic i loko o ka epigenome e hoʻonui ai i ka pilikia o ka hānō i nā keiki. 36
I nā lā i hala iho nei, ua hoʻopilikia ka wikiwiki o ke kūlanakauhale i nā ʻāpana āpau o ke kaiāulu. Ma muli o nā kumu loaʻa kālā like ʻole a me nā ʻoihana, makemake ka poʻe e noho i nā kūlanakauhale a no laila ua pilikia lākou i nā mea haumia o ke kaiapuni. Ua ʻōlelo ʻia nā ʻohana o nā keiki palupalu e makaʻala nui i ka pale ʻana i ka makū, ka puhi paka, ka mālama ʻana i nā holoholona i loko o kahi ʻohana me nā maʻi allergies/allergies, a me ka pale ʻana i nā maʻi allergies/mea hoʻoulu maʻi i nā keiki me ka mōʻaukala ʻohana o nā maʻi allergies/allergies. Pono e hoʻonui ʻia ka ʻike i ka hānai waiū kūʻokoʻa ma muli o nā pono o ka hānai waiū i ka pale ʻana i ka hānō.
ʻO ka hapa nui o nā maʻi e hele mai ana i ke Kulanui Lapaʻau ʻo Guwahati mai nā wahi a pau o ʻĀkau Hikina o India ʻoiai ʻo ke Kulanui Lapaʻau ʻo Guwahati ke kikowaena loea kiʻekiʻe loa ma ka ʻāina. ʻO ka hapa nui o nā maʻi he kūlana haʻahaʻa socioeconomic a me ka pae haʻahaʻa o ka hoʻonaʻauao. ʻO ka hānō bronchial i nā keiki kahi pilikia maʻamau i ka ʻoihana pediatric o kā mākou haukapila. ʻO nā hoʻolālā pale kūpono no kēia mau maʻi kiʻekiʻe e kōkua i ka hōʻemi ʻana i ka maʻi a me ka hoʻemi ʻana i ke alapine o nā exacerbations.
ʻOiai nā lāʻau lapaʻau hānō āpau i loaʻa, nui nā maʻi e noho paʻa pono ʻole ana, akā ʻo ka ʻike ʻana i nā heluna kanaka maʻi kikoʻī, me nā phenotypes a me nā endotypes, hiki ke hoʻomaikaʻi i kā lākou hoʻokele ʻana. No laila, ʻo nā haʻawina kūloko o ka laha ʻana o ka hānō i nā kamaliʻi a me nā mea pilikia e kōkua i ka hoʻokele pono ʻana i kēia mau hihia.
Ma kēia haʻawina, ʻaʻole i hoʻi mai kekahi mau maʻi no ka hoʻokolokolo hou ʻana a me ka hahai ʻana. Ma muli paha kēia o ka nele o ka ʻike i nā kumu a me nā hopena o ka maʻi. Ma muli o nā ʻōnaehana kamaʻilio maikaʻi ʻole, ʻaʻole hiki iā mākou ke hahai i nā maʻi āpau.
He maʻalahi nā keiki i ka hānō kaiapuni, a ʻo ka hoʻomaopopo pono ʻana i nā mea hoʻoulu a me nā mea hoʻonāukiuki i ka hānō kaiapuni e hiki ke kōkua i ka kaohi a me ka hōʻemi ʻana i ke kaumaha o ka maʻi. I nā ʻohana me ka mōʻaukala o nā allergies a i ʻole ka hānō, pono e mālama pono ʻia e pale i nā keiki maʻalahi mai nā mea hoʻonāukiuki.
Ua mālama ʻia nā ʻikepili āpau a ua mālama ʻia ke aʻo ʻana e like me ka Hōʻike a Helsinki.
Mahalo i nā kauka pediatric a pau i kōkua i ka hōʻiliʻili ʻana i ka ʻikepili a me ka loiloi ʻana i ka ʻike o kā lākou ʻike. Ua mahalo pū ʻia nā hoa hana a pau o ka 'Oihana i kōkua iā mākou e komo i nā hale waihona puke a me ke kaiapuni o ka 'Oihana i ka wā o ke aʻo ʻana.
Ua hāʻawi nui nā mea kākau a pau i ka hana o ka hōʻike, inā paha ma ke kumumanaʻo, ka hoʻolālā haʻawina, ka hoʻokō ʻana, ka hōʻiliʻili ʻikepili, ka nānā ʻana a me ka wehewehe ʻana, a i ʻole kēia mau wahi a pau; ua komo lākou i ke kākau ʻana, ka hoʻoponopono hou ʻana a i ʻole ka loiloi koʻikoʻi o ka ʻatikala. E hoʻopau i ka mana no ka paʻi ʻana, e ʻaelike i ka puke pai e waiho ʻia ai ka ʻatikala, a e ʻaelike e kuleana no nā ʻano āpau o ka hana.
1. Hoʻolālā honua no ka mālama ʻana a me ka pale ʻana i ka hānō. Global Asthma Initiative. 2018. Loaʻa ma: https://ginasthma.org/wp-content/uploads/2019/01/2018-GINA.pdf. Mai ka lā 2 o Dekemaba, 2021