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Himamoni Deka, 1 Putul Mahanta, 2 Sultana Jesmin Ahmed, 3 Madhab Ch Rajbangshi, 4 Ranjumoni Konwar, 5 Bharati Basumatari51 Ishami rya Anatomy, Ishuri Rikuru ry’Ubuvuzi rya Guwahati, Assam, Ubuhinde, 2 Dib, Assam, Ishami ry’ubuvuzi bw’ubucamanza n’uburozi, Assam Medical College, Rugar; Ishami ry'ubuvuzi rusange, Ishuri Rikuru ry'Ubuvuzi rya Assam, Dibrugarh, Assam, Ubuhinde; 4 Tezpur College of Medicine and Surgery Hospital, Tezpur, Assam, Ubuhinde; Ishami rya Radiologiya, Fakhruddin Ali Ahmed Medical College n’ibitaro, Barpeta, Assam, mu Buhinde Umwanditsi wandikiraga: Putul Mahanta, ishami ry’ubuvuzi bw’ubucamanza n’uburozi, Ishuri rikuru ry’ubuvuzi n’ibitaro, Dibrugarh, Assam, 786002, Ubuhinde, tel. +919435017802, imeri [imeri irinzwe] inzitizi yumuyaga. Ibintu byombi bikomoka ku bidukikije no ku bidukikije bigira uruhare runini kuri asima. Intego y'ubu bushakashatsi kwari ugusuzuma ibintu bitandukanye by’imibereho n’ibidukikije bigira ingaruka ku mpamvu zitera asima mu bana ku barwayi bagana ishami ry’abana rya Gauhati Medical College and Hospital (GMCH) muri Assam. Ibikoresho n'uburyo bwo kuyikoresha. Abarwayi 150 bose hamwe barwaye asima basuzumwe mu buryo bw’ubuvuzi batoranijwe mu kigereranyo cya 1: 1 hagati y’abafite imyaka 3-12 n’abarwayi b’ikigero kimwe badafite indwara z’ubuhumekero n’amateka ya asima nk’uburyo bwo kuyigenzura. Amakuru yakusanyijwe hakoreshejwe uburyo bwateguwe mbere kandi bwapimwe, kandi uburenganzira bwanditse bwatanzwe n’abashinzwe kwita ku bitabiriye bose. Amakuru yasesenguwe hakoreshejwe ikizamini cya chi-square na binary logistic regression hakoreshejwe SPSS V20 yahinduwe hakurikijwe agaciro ka p. Ibisubizo: Abana bo mu mijyi n’abahungu bagaragaye ko bafite ibyago byinshi byo kurwara asima. Abana bo mu mijyi (OR = 4, 53; 95% CI: 1.57-13.09; pppppp Umwanzuro: Abana bashobora kurwara asima iterwa n'ibidukikije Hakenewe ingamba zo gukangurira no gukumira kugira ngo hagenzurwe kandi hagabanywe umutwaro wa asima mu bana Amagambo y'ingenzi: asima, ibintu bifitanye isano n'ibidukikije, abana, allergie, atopic
Asima ni indwara idakira y’ibihaha irangwa no kubura uburyo bwo guhumeka bushobora guhinduka bitewe no kubyimba kw’inzira z’ubuhumekero mu bihaha no guhagarara kw’imitsi ikikije. Amabwiriza aheruka gutangwa n’Umuryango Mpuzamahanga wita ku Asima (GINA) asobanura asima nk’ “indwara itandukanye ikunze kurangwa no kubyimba uburyo bwo guhumeka budashira”. Ibimenyetso by’ubuhumekero nko guhumeka nabi, guhumeka nabi, gufunga igituza no gukorora, ndetse no kugabanuka k’umuvuduko w’umwuka uhumeka, ni ibimenyetso by’indwara ya asima.
Ku bantu barwaye asima, ibimenyetso bikomeye bishobora guterwa n'ibintu bitandukanye bitera, nk'itabi n'ubundi bwoko bw'itabi, ibihumyo, ifu, ivumbi, uruhu rw'inyamaswa, imyitozo ngororamubiri, umwuka ukonje, ibintu byo mu ngo n'inganda, ihumana ry'umwuka, n'ubwandu. 2 Uruvange rw'ibintu bigize imiterere y'umubiri n'ibidukikije bigaragaza ko asima ikwirakwira cyane mu miryango imwe n'imwe. Akenshi, ibi bintu bindi bishobora gutuma habaho itandukaniro, aho ubwoko cyangwa ubwoko ari byo bintu byoroshye kumenyekana hagati y'amatsinda atandukanye y'abantu. 3
Gusuzuma asima ni indwara isanzwe kuko nta gisobanuro gihamye cy’ubwoko, uburemere, cyangwa inshuro ibimenyetso bifatwa. Asima yo mu bwonko ni indwara isanzwe ishyira umutwaro ukomeye ku buvuzi rusange no mu bitaro. 4 Nubwo gusuzuma asima mu bana no mu bantu bakuru bifite byinshi bisa, itandukaniro ry’isuzuma, uburyo umuntu ahumeka nabi, ubushobozi bwo gutanga ubuvuzi bwihariye, n’agaciro kayo mu gusuzuma biterwa n’imyaka.
Ku isi yose, abantu barenga miliyoni 300 barwaye asima. Mu bana, asima iri mu ndwara 20 zidakira za mbere mu myaka y’ubuzima bw’abafite ubumuga ku isi, aho igipimo cy’impfu kiri hagati ya 0.0-0.7 kuri 100.000.5. Byatangajwe ko ikwirakwira rya asima mu Buhinde riri hagati ya 2% na 23%, bishoboka ko biterwa n’ubusumbane bunini bw’ubutaka n’ibidukikije muri iki gihugu. 6 Mu bushakashatsi buherutse gukorwa, iyi mibare yagaragaye ko ari 10.4% muri Assam. 7
Asima mu bana itera ibimenyetso byo guhumeka bihoraho nko guhumeka, gukorora, guhumeka nabi, no gufunga igituza, iyo bitavuwe neza, bishobora gutera asima idakira. Asima mu bana ishobora kwangiza cyane ubuzima bw'abana barwaye binyuze mu kongera gusiba akazi no kugabanya uruhare rwabo mu kazi.
Nubwo hari ubumenyi n'ingamba zo kuvura indwara ziteye imbere, habayeho ukwiyongera gukomeye mu kugaragara kw'indwara za asima mu bana mu myaka ya vuba aha8,9, kandi hakenewe gusobanukirwa neza imiterere y'indwara za asima kugira ngo havurwe neza asima. Nubwo ubushakashatsi bwinshi buri gukorwa mu bice bitandukanye by'Ubuhinde, nta byinshi byakozwe muri aka gace kataratera imbere mu majyaruguru y'uburasirazuba bw'Ubuhinde.
Ubu bushakashatsi bwakorewe mu ntara ya Assam yo mu majyaruguru y'uburasirazuba, mu Buhinde. Abaturage ba Assam bagizwe n'amoko atandukanye, aho 12.45% bakomoka mu miryango nka Bodo, Khachari, Karbi, Miri, Mishimi, Rabah, n'ibindi. Uturere tw'icyaro dukwirakwiriye mu gace kanini. Intara izwiho ibinyabuzima bitandukanye. Ubuhinzi, cyane cyane umuceri, icyayi n'imboga, butanga amafaranga arenga kimwe cya gatatu cy'amafaranga yinjizwa na Assam kandi butanga akazi ku bakozi bagera kuri 69 ku ijana. Intara ikora 50% by'umusaruro w'icyayi mu Buhinde. Izindi nganda z'ubuhinzi zunguka zirimo ubworozi bw'ingurube, ubworozi bw'amata n'uburobyi abaturage bo mu cyaro babigizemo uruhare. Ubuhinzi, icyayi, peteroli na gaze, amakara n'amabuye y'agaciro ni zo nganda zikomeye. Ubusumbane bunini bw'amoko n'uturere muri iyo ntara buterwa ahanini n'imiterere itandukanye n'inkomoko y'indwara.
GMCH ni ikigo cy’ubuvuzi cya kaminuza gikuru muri ako karere, kivura abarwayi baturutse impande zose z’amajyaruguru y’uburasirazuba bw’Ubuhinde, harimo n’abaturage bo mu cyaro n’imijyi. Abenshi mu barwayi bari bafite imibereho mibi mu by’ubukungu ndetse n’uburezi buke. Asima y’imitsi mu bana ni ikibazo gikunze kugaragara mu bitaro by’abana.
Ubu bushakashatsi bwari bugamije gusuzuma ibintu bitandukanye by’imibereho n’ibidukikije bigira ingaruka ku mpamvu zitera asima mu bana bafite imyaka 3-12 bagana muganga w’abana wa GMCH.
Kuva muri Mata 2013 kugeza muri Werurwe 2017, hakozwe inyigo yo kugenzura uko ikibazo giteye mu ishami ry’imiterere y’umubiri ku bufatanye n’ikigo cyita ku bana cyitwa Pediatrics Assam GMCH kugira ngo hakorwe ubushakashatsi ku mibanire y’abantu n’ibidukikije by’abana bafite hagati y’imyaka 3 na 12.
Mu bushakashatsi butigeze bubaho bwo kugenzura indwara, abantu 150 n'abantu 150 bagenzurwa batoranyijwe ku gipimo cya 1: 1 kugira ngo bigane ibintu bitandukanye bya asima mu bana. Abarwayi barwaye asima basanzwe bafite imyaka 3 kugeza kuri 12 bagaragaye mu bitaro by'abana byo hanze no mu nzu batoranyijwe nk'abarwayi, mu gihe abagenzurwa bari abarwayi b'ikigero kimwe, byaba byiza baba mu buzima bumwe badafite ibibazo by'ubuhumekero.
Ingano y'icyitegererezo yagenwe hakoreshejwe verisiyo ya WinPepi 11.65. Amakuru yavuye mu bushakashatsi bw'ibanze agaragaza ko ikwirakwira rya asima mu bana b'Abahinde riri hagati ya 1% na 4%. Bityo, dufashe ko umubare w'abana barwaye asima ari 1% n'itsinda ringana ry'abarwayi n'itsinda rigenzura, ubushakashatsi busaba ko umubare w'abantu 274 bose hamwe bagerwaho n'ubushobozi bwa 80% kugira ngo hamenyekane itandukaniro rya 4% hagati y'abantu babiri. Amatsinda yombi afite urwego rw'ingenzi rwa 5%.
Byongeye kandi, dutekereje ko hafi 10% by'abatabashije kwitabira baterwa no gutakaza cyangwa kutakurikiza amabwiriza, ni byiza gushushanya icyitegererezo cy'abantu 300 (bagizwe n'abantu 150 n'abantu 150 bagenzurwa).
Koresha uburyo bwo gukusanya amakuru bwateguwe kandi bwageragejwe. Uruhushya rwanditse rwatanzwe n'abashinzwe uburenganzira bw'ikiremwamuntu bose bitabiriye ubushakashatsi. Amakuru yakusanyijwe ku bintu bitandukanye by'imibereho y'abaturage n'ibidukikije. Ubwoko bw'inzu busobanurwa nka
Inzu ya Pucca, niba inkuta n'igisenge byubatswe mu matafari, sima n'amabuye; inzu ya Katcha ikozwe mu biti, ubutaka, ibyatsi n'amababi vyumye niba inzu ikozwe mu nkuta z'amatafari n'inkuta z'amatafari zifite igisenge cy'ibyatsi cyangwa amabati na sima. Iyo yuzuye, iyi ni inzu ya Semi pucca. Imiterere y'imibereho y'abaturage yapimwe hakoreshejwe igipimo cya Kuppuswami cyahinduwe (2014).
Uburyo abitabiriye babyara, amateka y’uko umwana yavutse afite ikibazo cyo kubura umwuka, ubwoko bw’ibyo yagaburirwaga, amateka y’ibyo kurya bya ubwivumbure, amateka y’ababyeyi bafite ikibazo cyo kurwara asima, amateka y’umuryango wabo ya asima, amateka y’indwara yo kubura umwuka cyangwa aleriji, hamwe n’amateka y’umuryango wabo wanywaga itabi cyangwa umwotsi w’itabi. Abagize umuryango bose batuye mu nzu imwe bafatwaga nk’abanywa itabi mu mateka y’umuryango. Dukurikije amabwiriza ya GINA Epidemiological and Clinical Trial Participant Image Guidelines, ubukana bw’indwara bwashyizwe mu byiciro hakurikijwe intambwe zagenwe zo kuvura, hashingiwe ku kuba abarwayi bashyizwe mu cyiciro cya 2 bari bafite asima yoroheje, n’abarwayi bashyizwe mu cyiciro cya 3-4 bari bafite asima yoroheje, kandi bashyizwe mu cyiciro cya 5.
Ibipimo byo gushyiramo no kwirukana: Inyandiko zigaragaza ko abana bagomba gushyirwa mu bushakashatsi kugeza ku myaka 18. Ariko, muri GMCH, abana benshi boherejwe bari munsi y'imyaka 12. Byongeye kandi, umubare munini w'abandura asima mu bana warenze ubwandu bw'iyi ndwara mbere na nyuma y'ubugimbi. Kubwibyo, itsinda ry'imyaka kuva kuri 3 kugeza kuri 12 ryatoranyijwe kugira ngo rikorerwe ubushakashatsi. Ubu bushakashatsi bwarimo abarwayi ba asima yo mu bwoko bwa bronchial basanzwe bafite imyaka 3 kugeza kuri 12 bemeye kwitabira ubushakashatsi. Abana bari hagati y'imyaka 3 na 12 bemeye kwitabira ubushakashatsi badafite indwara z'ubuhumekero, byaba byiza baba mu mimerere nk'iyo, batoranyijwe nk'itsinda rishinzwe kugenzura.
Abana bari hagati y’imyaka 0 na 3 ntibashyizwe mu bushakashatsi kuko guhumeka mu mutwe muri iki kigero bitari bihagije kugira ngo bamenye asima. Byongeye kandi, abana bo mu byiciro by’imyaka bikwiye n’ababarera banze kwitabira ubushakashatsi ntibashyizwe mu bushakashatsi.
Isesengura ry'imibare. Itandukaniro mu bipimo ryasesenguwe hakoreshejwe ikizamini cya χ. Isubiramo ry'ibipimo bya binary ryakoreshejwe ku bipimo by'uburemere mu isesengura ry'ibipimo bito, naho ikizamini cya Wald cya χ 2 cyakoreshejwe mu gupima uruhare rwigenga rw'ubuvuzi.
Kwemeza imyitwarire: Mbere yo gukusanya amakuru, kwemeza imyitwarire byabonetse muri komite ishinzwe imyitwarire yinzego yikigo, ni ukuvuga komite ishinzwe imyitwarire yinzego za GMCH, Guwahati, Assam n'Ubuhinde, Ref: No: 233/2018/215.
Mu barwayi 112.323 bitabiriye ishami ry’abana mu gihe cy’ubushakashatsi, 18.88% bari abarwayi b’ubuhumekero. Mu bana bari hagati y’imyaka 3-12, 2.96% barwaye asima yo mu bwoko bwa bronchial. Inshuro nyinshi za asima yo mu bwana zabaye mu gihe cy’impeshyi ya Nzeri n’Ukwakira (Ishusho ya 1).
Ubu bushakashatsi bwo kugenzura indwara bwakorewe ku bana 150 barwaye asima n'abandi 150 bagenzura. Impuzandengo y'imyaka (± SD) y'abitabiriye ubu bushakashatsi yari imyaka 8.38 (± 2.69). Inkorora no kubura umwuka nibyo bimenyetso byakunze kugaragara muri ubu bushakashatsi. Abenshi (77.3%) mu barwaye indwara ya asima barwaye indwara z'amara naho 8.7% gusa by'abarwaye asima ikomeye ni bo bagaragaje indwara y'amara. Ikwirakwira ry'abarwaye ryagaragaye mu gihe cy'umuhindo (30%). Mu bantu bagera kuri 38%, ibimenyetso byagaragaye nijoro (Imbonerahamwe ya 1).
Nk’uko ababajijwe babivuga, ibinyobwa bikonje (82.7%), ice cream (71.6%) n’ivumbi (35%) ni byo bikunze gutera asima. Hafi 19.3% by’abanduye bagaragaje ko batajyayo kubera uburwayi.
Impuzandengo y'imyaka (itandukaniro risanzwe) ry'abitabiriye ubushakashatsi yari imyaka 8.34 (2.69). Abenshi mu banduye bari mu kigero cy'imyaka 7-12 kandi bari abagabo. Abitabiriye ubushakashatsi biganjemo Abahindu n'abatari abo mu bwoko bwabo.
Abana n'abagabo bari hagati y'imyaka 7 na 12 bari bafite igipimo cyo hejuru cy'ubwandu, nubwo isano yari idafite ishingiro mu mibare. Nanone, asima yo mu bwana yari ifitanye isano rikomeye na BMI (p-value<0.05). Nanone, asima yo mu bwana yari ifitanye isano rikomeye na BMI (p-value<0.05). Кроме того, детская матма б кон значительно свяаза с ИМТ (значение р <0,05). Byongeye kandi, asima yo mu bwana yari ifitanye isano rikomeye na BMI (agaciro ka p<0.05).此外，儿童哮喘与 BMI 显着相关（ p 值 <0.05 ）。此外，儿童哮喘与 BMI 显着相关（ p 值 <0.05 ）。 Кроме того, детская матма б кон значительно свяаза с ИМТ (значение p <0,05). Byongeye kandi, asima yo mu bwana yari ifitanye isano rikomeye na BMI (agaciro ka p <0.05).Amahirwe yo kugira ibiro binini (OR = 2.22, 95% CI: 1.17–4.18) n'umubyibuho ukabije (OR = 2.72, 95% CI: 1.46–5.09) yari hejuru inshuro zirenga ebyiri ugereranije n'abana bafite ibiro bisanzwe. Abana bo mu mijyi baba mu miryango isanzwe, mu bibanza by'imyanda, no mu mazu adafite umwuka uhagije bafite ibyago byinshi byo kwandura iyi ndwara. Mu gikoni gifatanye, ibicanwa bitanga umwotsi bitari LPG, imiti yica imibu, Dhuna, nibindi, nabyo bifitanye isano rikomeye na asima yo mu bwana (agaciro ka p<0.05). Mu gikoni gifatanye, ibicanwa bitanga umwotsi bitari LPG, imiti yica imibu, Dhuna, nibindi, nabyo bifitanye isano rikomeye na asima yo mu bwana (agaciro ka p<0.05). В прим данющих кухнях использование значительно выделяющего дым топлива, кроме сжиженного кинтяного чиа, реп рентентов от комаров, Дхуна и т. д., также связано с детской шәһәрмой (значение p <0,05). Mu bikoni byegeranye, ikoreshwa ry'ibicanwa bitanga umwotsi mwinshi bitari LPG, imiti yica imibu, Dhuna, nibindi, nabyo bifitanye isano na asima yo mu bwana (agaciro ka p < 0.05).LPG 、驱蚊剂、 Dhuna 等以外的产生烟雾的燃料也与儿童哮喘显着相关（ p 值 <0.05 ）。 Dhuna 等以外的产生与儿童哮喘显着相关（ p 值 <0.05 ）、 Дымооб. д. Ibikoresho bitanga umwotsi bitari LPG, imiti yica imibu, Dhuna, nibindi nabyo byafitanye isano rikomeye n’indwara ya asima mu bana mu bikoni byegeranye (agaciro ka p <0.05).Byagaragaye kandi ko abana bafite amatungo bari bafite amahirwe menshi yo kurwara asima inshuro 8 (Imbonerahamwe ya 2).
Nkuko bigaragara mu mbonerahamwe ya 3, 46.7% by'abanduye bari abo mu miryango ifite imibereho myiza n'ubukungu. Uburezi bw'ababyeyi nabwo bwari hasi mu banduye (agaciro ka p<0.05). Uburezi bw'ababyeyi nabwo bwari hasi mu banduye (agaciro ka p<0.05). Материнское оборование также было ниже с дан случаев (значение p <0,05). Uburezi bw'ababyeyi nabwo bwari hasi mu banduye (agaciro ka p<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 мнее обованными (значение p <0,05). Ababyeyi muri ibi bihe nabo ntibari bafite ubumenyi buke (agaciro ka p <0.05).
Abana bavutse binyuze mu kubagwa (CS) cyangwa ubundi buryo bwo kubyara, ndetse n'abana bafite amateka yo kubura umwuka, bafite ibyago byinshi byo kurwara iyi ndwara. Byongeye kandi, abana bonsa cyane/bavanze bari bafite amahirwe menshi yo kurwara iyi ndwara inshuro eshanu kurusha abonsa (Imbonerahamwe ya 4).
Amateka y’uburwayi bw’ibiryo mu bwana n’indwara ya atopy yakunze kugaragara mu bana, ahanini byagaragaye ko bifitanye isano na asima mu bwana. Nanone, abana bakomoka mu miryango ifite amateka yo kurwara indwara ya allergie na asima (p-value<0.05) bari bafite amahirwe menshi yo kwandura iyi ndwara. Nanone, abana bakomoka mu miryango ifite amateka yo kurwara indwara ya allergie na asima (p-value<0.05) bari bafite amahirwe menshi yo kwandura iyi ndwara. Также высокой склонносту к заболеванию отличались дети из семей с анамнезом аллергии и матми (значение p <0,05). Nanone, abana bakomoka mu miryango ifite amateka yo kurwara allergie na asima bari bafite allergie nyinshi (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 аммой в анамнезе (р-значение <0,05) были высоко восприимчивы. Byongeye kandi, abana bakomoka mu miryango ifite amateka yo kurwara allergie na asima (p-value <0.05) ni bo bakunze kwibasirwa cyane. Kunywa itabi ryihariye binyuze mu bandi bagize umuryango nabyo byongera ibyago byo kurwara asima inshuro umunani mu bana (p-value<0.05). Kunywa itabi ryihariye binyuze mu bandi bagize umuryango nabyo byongera ibyago byo kurwara asima inshuro umunani mu bana (p-value<0.05). Пасвирное курение через других членов семьи также увеличивает риск развития матми у детей поти восемь раз (значение p <0,05). Kunywa itabi ryihariye binyuze mu bandi bagize umuryango nabyo byongera ibyago byo kurwara asima ku bana hafi inshuro umunani (agaciro ka p <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 值 <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 Пасвирное курение через других членов семьи также увеличивало риск развития матми у детей поти в 8 раз (p-значение <0,05). Kunywa itabi ryihariye binyuze mu bandi bagize umuryango nabyo byongera ibyago byo kurwara asima ku bana hafi inshuro 8 (agaciro ka p <0.05).(Imbonerahamwe ya 5)
Isubiranyuma ry’ibikoresho ry’umubiri ryagaragaje ko abana bo mu mijyi, ahantu hakonje, ubukungu buri hasi, amatungo, amateka y’umuryango wagize ikibazo cyo kubura umwuka/allergie, amateka y’umuryango wagize ikibazo cyo kunywa itabi/itabi ry’isuku, hamwe n’indyo ivanze ari byo byagize uruhare runini mu gutera indwara ya asima mu bana (Imbonerahamwe ya 6).
Imbonerahamwe ya 6 Isesengura ry’imiterere y’ibintu byinshi (multivariate logistic regression analysis) kugira ngo harebwe ibintu by’ingenzi bigira ingaruka ku bana bafite asima.
Mu myaka makumyabiri kugeza kuri mirongo itatu ishize, umubare w’indwara ziterwa n’imisemburo y’ubuhumekero wiyongereye, bituma habaho ibiganiro byinshi ku mihindagurikire y’ibidukikije, umwanda, n’uburyo ubudahangarwa bw’umubiri buterwa n’udukoko twandura. Ikwirakwizwa ry’ibidukikije ndetse n’intege nke z’ibinyabuzima n’uturemangingo bigira uruhare mu iterambere rya asima.
Muri ubu bushakashatsi, 2.96% by'abarwayi bari hagati y'imyaka 3 na 12 bavuze ko barwaye asima mu bwana. Ariko, hari ubushakashatsi bwakozwe mbere bwagaragaje ubwoko butandukanye bwa asima mu bwana mu bana b'Abahinde. Itandukaniro ry'uturere n'ibidukikije mu Buhinde bigira ingaruka ku buryo butaziguye ku bintu bishobora gutera asima. 6 Bityo, kugira ngo iyi ndwara yirindwe neza kandi ku gihe, ni ngombwa gusuzuma ibintu by'ingenzi bya asima mu bwana mu karere.
Abana bari hagati y'imyaka 7-12, abagabo n'abana batuye mu mijyi bafite ibyago byinshi byo kurwara asima mu bana. Inyigo yakozwe mu Buhinde n'abagabo ni yo yagaragaye mu bushakashatsi bwakozwe mu mijyi,10 nk'uko twabigaragaje. Ariko, iyi sano yari ifite agaciro gakomeye mu mibare gusa mu bijyanye n'aho batuye.
Ubushakashatsi bwagaragaje ko impinduka mu misemburo zishingiye ku gitsina zishobora kugira ingaruka kuri asima, kuko abahungu bafite amahirwe menshi yo kurwara asima mu bwana. Ariko, iyi shusho irahinduka nyuma y’ubugimbi, kandi abagore barwara iyi ndwara kenshi kurusha abagabo. 13-15 Byongeye kandi, abahungu bari munsi y’imyaka 10 bafite inzira nto z’ubuhumekero ugereranyije n’abakobwa bari mu kigero kimwe, kandi uburebure nabwo bufatwa nk’impamvu itera asima mu bwana ku bahungu. 16.17
Metro Kamstrup, umurwa mukuru wa Assam, yagaragaje iterambere ryihuse mu mijyi mu myaka ya vuba aha. Ubushakashatsi bwinshi buvuga ko iterambere ry’imijyi ari ikintu bigira ingaruka ku ikwirakwira rya asima, ibi bikaba bihuye n’ubushakashatsi bwacu. 18,19 Muri ubu bushakashatsi, isubira inyuma ry’ibikoresho ritahinduwe ryagaragaje ko abana bafite ibiro byinshi n’umubyibuho ukabije bari bafite amahirwe menshi yo kurwara asima inshuro zirenze ebyiri kurusha abana bafite BMI isanzwe, nk’uko bigaragazwa n’isuzuma riherutse gukorwa. 20 Byongeye kandi, urwego rwo hasi rw’ubukungu ni ikintu gishobora gutera asima mu bana. Abana bakomoka mu miryango ifite imibereho mibi y’ubukungu bari mu kaga gakomeye ko kurwara asima bitewe n’uko ubudahangarwa bw’umubiri budakora neza ndetse n’uburyo bwo kuvura buke. 21-23
Abana baba mu muryango umwe, amazu ya kaccha, amazu adafite ubushuhe, umwuka uhagije, ibikoni bifatanye, ibicanwa bitanga umwotsi, imiti yica imibu na Dhuna, nibindi, byagaragaye ko bifitanye isano rikomeye n’indwara ya asima mu bana (p-value<0.05). Abana baba mu muryango umwe, amazu ya kaccha, amazu adafite ubushuhe, umwuka uhagije, ibikoni bifatanye, ibicanwa bitanga umwotsi, imiti yica imibu na Dhuna, nibindi, byagaragaye ko bifitanye isano rikomeye n’indwara ya asima mu bana (p-value<0.05).Abana baba mu muryango umwe, bahunga urugo, amazu atose, umwuka uhagije, ibikoni bifatanye, lisansi ikora imyotsi, imiti yica imibu na Dhuna nibindi.д., были достоверно связаны с детской аммой (значение р <0,05). e., byafitanye isano rikomeye na asima yo mu bwana (agaciro 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 ）。 Abana baba mu ngo zisanzwe, mu mazu ya kaccha, mu mazu asanzwe, mu bikoni bidahumeka neza, mu gikoni gifatanye n'inzu, mu bikomoka ku myotsi, mu kwirukana imibu, na Dhuna bifitanye isano rikomeye n'indwara ya asima y'abana (agaciro ka p<0.05). Дети в общих домохозяствах, домах качча, кых жилищах, неа кавной вентиляции, пристроенных кухнях, за адленном топливе, реп адентах от комаров и Дхуна были в зн сит с с с с <0,05). Abana baba mu ngo zisanzwe, amazu asukuye, amazu atose, umwuka udahagije, ibikoni bidafite ibikoresho, ibicanwa by'umwotsi, imiti yica imibu na dhuna byagaragaye ko bifitanye isano rikomeye n'indwara ya asima mu bana (agaciro ka p < 0.05).Ubushakashatsi bwakozwe mbere bwagaragaje kandi ko ibintu bitandukanye bibera mu nzu bishobora gutera asima mu bana. 24-27 Isano hagati y’ibintu bitera allergie mu ngo n’aside yo mu bwana iravugwaho rumwe, kuko abashakashatsi bake bemeza ko guhura n’ibintu bitera allergie hakiri kare bishobora gutuma umuntu yihanganira indwara.
Ubushakashatsi bwinshi bwagaragaje ko abana bavutse binyuze mu kubagwa babazwe bafite ibyago byinshi byo kurwara asima mu bwana ugereranije n'abana bavuka bisanzwe. Ibi bihuye n'ibyo twabonye. 29-32 Abana bavutse bafite amateka yo kubura umwuka nabo bafite ibyago byinshi byo kurwara asima. Asima yo kubyara ni ingenzi mu gutera ibibazo byo gutwita nko kugira ibibazo byo mu myanya y'ubuhumekero no kubura umwuka mu bana bato. 33
Nkuko bigenda ku zindi nyigo, ibyavumbuwe ubu bigaragaza ko amateka yo mu bwana ya ubwivumbure bw'ibiryo cyangwa atopy cyangwa amateka yo mu muryango ya ubwivumbure n'asima byongera cyane ibyago byo kurwara asima mu bwana. 34,35 Dukurikije ubushakashatsi bwacu, ubushakashatsi bwakozwe mbere bwagaragaje ko ingeso zo kunywa itabi mu bisekuru bitandukanye zishobora gutuma habaho impinduka mu miterere y'uturemangingo mu mubiri w'umuntu, ibyo bikaba byongera ibyago byo kurwara asima mu bana. 36
Mu minsi ishize, iterambere ryihuta ry’imijyi ryagize ingaruka ku nzego zose z’imibereho. Bitewe n’amasoko atandukanye y’amafaranga n’imirimo, abantu bakunda gutura mu mijyi bityo bakaba bahura n’ibintu bitandukanye bihumanya ibidukikije. Abagize imiryango y’abana bashobora kwandura baragirwa inama yo kwita cyane ku kwirinda ubushuhe, kunywa itabi, gutunga amatungo mu muryango ufite allergie/allergie, no kwirinda allergie/ibitera allergie ku bana bafite amateka y’imiryango yabo ya allergie/allergie. Hakwiye kongerwa ubumenyi ku konsa umwana gusa bitewe n’inyungu zo konsa mu kwirinda asima.
Abarwayi benshi baza muri Guwahati Medical College baturuka mu majyaruguru y'uburasirazuba bw'u Buhinde kuko Guwahati Medical College ari yo kigo cy’inzobere mu by’ubuvuzi cyo ku rwego rwo hejuru muri ako karere. Abenshi mu barwayi bari bafite imibereho mibi mu by’ubukungu n’uburezi buke. Asima y’imitsi mu bana ni ikibazo gikunze kugaragara mu ishami ry’abana mu bitaro byacu. Ingamba zikwiye zo kwirinda aba barwayi bafite ibyago byinshi zizafasha kugabanya indwara no kugabanya inshuro nyinshi z’uburwayi.
Nubwo hari uburyo bwose bwo kuvura asima, abarwayi benshi bakomeje kugenzurwa nabi, ariko kumenya umubare runaka w’abarwayi, harimo n’imiterere y’indwara n’imiterere yazo, bishobora kunoza uburyo zifatwa. Bityo, ubushakashatsi bwo mu karere ku ikwirakwira rya asima mu bana n’ibintu bishobora gutera ibyago bizafasha mu micungire myiza y’izi ndwara.
Muri ubu bushakashatsi, bamwe mu barwayi ntibagarutse ngo bakorerwe isuzuma no gukurikirana abandi. Ibi bishobora kuba byaratewe no kutamenya impamvu n'ingaruka z'iyi ndwara. Bitewe n'uburyo bubi bwo gutumanaho, ntitwashoboye gukurikirana abarwayi bose.
Abana bashobora kurwara asima ishingiye ku bidukikije, kandi gusobanukirwa neza ibintu bitera asima ishingiye ku bidukikije n'ibintu bishobora gutuma habaho allergie bishobora gufasha mu kugenzura no kugabanya umutwaro w'indwara. Mu miryango ifite amateka y'allergie cyangwa asima, hakwiye kwitabwaho neza kugira ngo abana bakunze kwibasirwa n'ibintu bishobora kubatera allergie.
Amakuru yose yagizwe ibanga kandi ubushakashatsi bwakozwe hakurikijwe Itangazo rya Helsinki.
Turashimira abaganga b'abana bose bafashije gukusanya amakuru no gusuzuma ibikubiye mu bumenyi bwabo. Abakozi bose bo mu ishami badufashije kubona amasomero n'ibidukikije by'ishami mu gihe cy'ubushakashatsi nabo barashimiwe.
Abanditsi bose bagize uruhare runini mu murimo w'iyi raporo, haba mu gitekerezo, mu gushushanya inyigo, mu gushyira mu bikorwa, mu gukusanya amakuru, mu gusesengura no mu gusobanura, cyangwa muri izi ngingo zose; bagize uruhare mu gutegura, kuvugurura cyangwa mu gusuzuma ingingo mu buryo bwimbitse. Kurangiza verisiyo yo gusohoka, kwemeranya ku kinyamakuru iyo nyandiko izashyikirizwa, no kwemera kuba ushinzwe ibice byose by'akazi.
1. Ingamba mpuzamahanga zo kuvura no gukumira asima. Gahunda Mpuzamahanga ya Asima. 2018. Iboneka kuri: https://ginastma.org/wp-content/uploads/2019/01/2018-GINA.pdf. Guhera ku ya 2 Ukuboza 2021