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Himamoni Deka, 1 Putul Mahanta, 2 Sultana Jesmin Ahmed, 3 Madhab Ch Rajbangshi, 4 Ranjumoni Konwar, 5 Bharati Basumatari51 Dhipatimendi reAnatomy, Guwahati Medical College, Assam, India, 2 Dib, Assam, India Department of Forensic Medicine and Toxicology, Assam Medical College; 3 Dhipatimendi reMushonga Wevanhu, Assam Medical College, Dibrugarh, Assam, India; 4 Tezpur College yeMishonga uye Kuvhiyiwa Kwechipatara, Tezpur, Assam, India; 5 Dhipatimendi reRadiology, Fakhruddin Ali Ahmed Medical College uye Chipatara, Barpeta, Assam, India Munyori anowirirana: Putul Mahanta, Dhipatimendi reForensic Medicine uye Toxicology, Assam Medical College uye Chipatara, Dibrugarh, Assam, 786002, India, tel. +919435017802, email [email protected] kuvharirwa kwemhepo. Zvese zviri zviviri genetic uye zvakatipoteredza zvinokonzeresa kuwanda kweasma. Chinangwa chechidzidzo ichi chaive chekuongorora zvinhu zvakasiyana-siyana zvemagariro evanhu uye zvakatipoteredza zvinokanganisa chikonzero cheasthma yevana muvarwere vanouya kudhipatimendi revana reGauhati Medical College and Hospital (GMCH) muAssam. Zvishandiso nenzira. Varwere vanosvika zana nemakumi mashanu vane asthma yakaonekwa kuti yakawanikwa mukiriniki vakasarudzwa muchikamu che1:1 pakati pevarwere vane makore 3-12 uye varwere vezera rimwe chete vasina chirwere chekufema uye nhoroondo yeasthma senzira dzekudzivirira. Data rakaunganidzwa uchishandisa fomati yakagadzirirwa uye yakaedzwa kare, uye mvumo yakanyorwa yakawanikwa kubva kune vese varindi vepamutemo vevatori vechikamu. Data rakaongororwa ne chi-square test uye binary logistic regression uchishandisa SPSS V20 yakagadziriswa kuti ive ne p-values. Mhedzisiro: Vana vemumaguta nevarume vakawanikwa vari panjodzi huru yekubatwa neasthma. Vana vari mumaguta (OR = 4, 53; 95% CI: 1.57-13.09; pppppp Mhedziso: Vana vanonyanya kubatwa neasthma inokonzerwa nezvakatipoteredza. Kukurudzira ruzivo uye matanho ekudzivirira zvinodiwa kudzora nekuderedza mutoro weasthma muvana. Mashoko akakosha: asthma, zvinhu zvakatipoteredza, vana, allergies, atopic.
Asthma chirwere chisingaperi chemapapu chinoratidzwa nekuvharika kwenzira yekufema inodzokororwa kunokonzerwa nekuzvimba kwenzira dzekufema mumapapu uye kushushikana kwetsandanyama dzakapoteredza. GINA ichangobva kutaurwa neGlobal Initiative on Asthma (GINA) inotsanangura asima se "chirwere chakasiyana chinowanzoonekwa nekuzvimba kwenguva refu kwenzira dzekufema". Zviratidzo zvekufema zvakaita sekufemera, kupfupika kwemweya, kuoma kwechipfuva nekukosora, pamwe nekuchinja-chinja kwemhepo inoyerera, zviratidzo zveasima.
Muvanhu vane asthma, zviratidzo zvakakomba zvinogona kuitika nekuda kwezvinhu zvakasiyana-siyana zvinokonzera, zvakaita sefodya nedzimwe mhando dzekusvuta, chakuvhuvhu, mukume, guruva, ganda remhuka, kurovedza muviri, mhepo inotonhora, zvigadzirwa zvemumba nemaindasitiri, kusvibiswa kwemhepo, uye hutachiona. 2 Musanganiswa wezvinhu zvemajini nezvakatipoteredza unotsanangura kuwanda kweasthma mune dzimwe nharaunda. Kazhinji, zvimwe zvinhu izvi zvinogona kukonzera kusiyana, nerudzi kana dzinza zviri zvinhu zviri nyore kuzivikanwa pakati pemapoka akasiyana evanhu. 3
Kuongororwa kweasthma kunoitwa nekiriniki nekuti hapana tsananguro yakajairika yerudzi, kuoma, kana kuwanda kwezviratidzo. Asthma yebronchial chirwere chakajairika chinoisa mutoro mukuru pakurapa kwakajairika uye kugara muchipatara. 4 Kunyangwe kuongororwa kweasthma muvana nevakuru kune zvakawanda zvakafanana, kusiyana kwekuongorora, nzira yechisikigo yekufema, kugona kupa kurapwa kwakananga, uye kukosha kwayo kuongororwa zvinoenderana nezera.
Pasi rose, vanhu vanopfuura mamiriyoni mazana matatu vanotambura neasthma. Muvana, asthma iri pakati pezvirwere makumi maviri zvepamusoro zvehupenyu hwevakaremara pasi rose, nehuwandu hwerufu huri pakati pe0.0-0.7 pavanhu 100,000.5. Kuwanda kweasthma muIndia kwakataurwa kuti kuri pakati pe2% kusvika 23%, zvichida nekuda kwekusiyana kukuru kwenzvimbo nenzvimbo. 6 Muongororo yakaitwa munguva pfupi yapfuura, nhamba iyi yakawanikwa iri 10.4% muAssam. 7
Asthma muvana inokonzera zviratidzo zvekufema zvinogara zvichiitika zvakaita sekufemera, kukosora, kufema zvakaoma, uye kusimba kwechipfuva, izvo, kana zvikasarapwa zvakanaka, zvinogona kukonzera asima isingaperi. Asthma yevana inogona kukanganisa zvakanyanya hupenyu hwevana vanorwara nekuwedzera kusavapo kuchikoro uye kuderedza kutora chikamu mubasa.
Pasinei neruzivo rwepamusoro uye nzira dzekurapa, kwave nekuwedzera kukuru kwekupararira, kurwara uye kufa kweasthma muvana mumakore achangopfuura8,9, uye kunzwisisa kwakawanda kwechikonzero cheasthma kunodiwa kuti kurapa asthma zvinobudirira. Kunyange zvazvo tsvakiridzo yakawanda iri kuitwa munzvimbo dzakasiyana dzeIndia, zvishoma zvakaitwa munzvimbo iyi isina kubudirira kuchamhembe kwakadziva kumabvazuva kweIndia.
Chidzidzo ichi chakaitwa mudunhu rekuchamhembe kwakadziva kumabvazuva kweAssam, India. Huwandu hwevanhu vekuAssam hune marudzi akasiyana-siyana, ayo 12.45% ari emadzinza akadai seBodo, Khachari, Karbi, Miri, Mishimi, Rabah, nezvimwewo. Nzvimbo dzekumaruwa dzakapararira munzvimbo zhinji dzedunhu iri. Dunhu iri rinozivikanwa nekusiyana-siyana kwezvinhu. Kurima, kunyanya mupunga, tii nembesa, kunopa mari inopfuura chikamu chimwe muzvitatu chemari inowanikwa neAssam uye kunoshandisa vanhu vanosvika 69 muzana. Dunhu iri rinoburitsa 50% yekurima tii muIndia. Mamwe mabhizinesi ekurima anobatsira anosanganisira kurima nguruve, kurima mukaka uye kubata hove nevanhu vekumaruwa. Kurima, tii, mafuta negasi, marasha nedombo remabwe ndiwo maindasitiri makuru. Kusiyana kukuru kwemarudzi nenzvimbo munyika iyi kunokonzerwa nekusiyana kwesimba uye pathogenesis yechirwere ichi.
GMCH ndiyo nzvimbo inotungamira yekupa rubatsiro rwechiremba mudunhu iri, ichirapa varwere vanobva kuchamhembe kwakadziva kumabvazuva kweIndia, kusanganisira vagari vekumaruwa nevemumaguta. Vazhinji vevarwere ava vaive vasina hupfumi hwakakwana uye vaive nedzidzo yakaderera. Asima yebronchial muvana idambudziko rinowanzoitika muvana vari muchipatara.
Chidzidzo ichi chaive nechinangwa chekuongorora zvinhu zvakasiyana-siyana zvemagariro evanhu uye zvakatipoteredza zvinokanganisa chikonzero cheasthma yevana muvarwere vane makore 3-12 vachienda kuna chiremba wevana weGMCH.
Kubva muna Kubvumbi 2013 kusvika munaKurume 2017, chidzidzo chekuongorora nyaya dzakaitika kare chakaitwa kuDhipatimendi reAnatomy pamwe chete nePediatrics Assam GMCH kuti vaongorore zvinhu zvine chekuita nemagariro evanhu uye nharaunda zvinokonzera asthma yevana vane makore 3-12.
Muchidzidzo chekuongorora nyaya dzisina kumboitika, nyaya 150 ne150 dzakasarudzwa muchikamu che1:1 kuti dzidzidze zvinhu zvakasiyana-siyana zvine chekuita neasthma yevana. Varwere vane asthma yakaonekwa kuti yakabatwa nekiriniki vane makore 3 kusvika ku12 vachiuya kumakiriniki evana vari kunze uye mukati meimba vakasarudzwa sevarwere, nepo varwere vezera rimwe chete, zviri nani kuti vagare mumamiriro ezvinhu akafanana vasina matambudziko ekufema.
Saizi yemuenzaniso yakaongororwa uchishandisa WinPepi version 11.65. Data kubva muongororo yekutanga inoratidza kuti kuwanda kweasthma pakati pevana vekuIndia kuri pakati pe1% kusvika 4%. Saka, tichifunga nezve 1% yevana vane asthma uye saizi yakaenzana yevarwere nemapoka evanodzora, chidzidzo ichi chinoda huwandu hwesample hwevanhu 274 kuti vawane simba re80% rekuona musiyano we4% pakati pevaviri . . Mapoka ese ari maviri ane kukosha kwe5%.
Pamusoro pezvo, tichifunga kuti vanenge 10% vevasina kupindura vanokonzerwa nekurasikirwa kana kusatevedzera, zvine musoro kutora muenzaniso wevanhu mazana matatu (vanosanganisira nyaya zana nemakumi mashanu uye vanhu zana nemakumi mashanu vanoongorora).
Shandisa mafomati ekuunganidza data akagadzirwa kare uye akaedzwa. Mvumo yakanyorwa yakawanikwa kubva kune vese vari pamutemo vevaya vakapinda muchidzidzo. Data rakaunganidzwa pane zvakasiyana-siyana zvemagariro evanhu uye zvakatipoteredza. Rudzi rweimba runotsanangurwa se
Imba yePucca, kana madziro nedenga zvakagadzirwa nezvidhinha, simende nematombo; imba yeKatcha yakagadzirwa nematanda, ivhu, huswa nemashizha akaoma kana imba yakagadzirwa nemadziro ezvidhinha nemadziro edove ane denga reuswa kana retini nekongiri. Kana yapera, iyi imba yeSemipucca. Mamiriro ehupfumi hwevanhu akaongororwa uchishandisa modified Kuppuswami scale (2014).
Nzira yekusununguka yevatori vechikamu, nhoroondo yekuzvarwa vasina simba rekufema, rudzi rwekudya, nhoroondo yeallergy yechikafu, nhoroondo yekuzvimba kweamai, nhoroondo yemhuri yeasthma, nhoroondo yeatopy kana allergy, uye nhoroondo yemhuri yekuputa kana kusvuta fodya yakabatwa nevamwe vatori vechikamu yakanyorwawo. Chero nhengo dzemhuri dzinogara mumba imwe chete dzaionekwa sevanosvuta munhoroondo yemhuri. Sekureva kweGINA Epidemiological and Clinical Trial Participant Image Guidelines, kuoma kwechirwere kwakarongwa zvichienderana nematanho ekurapa akatarwa, tichifunga kuti varwere vakaiswa padanho rechipiri vaive neasthma isina simba, uye varwere vakaiswa padanho rechitatu kusvika rechina vaive neasthma isina simba uye vakapihwa kurapwa kweasthma yakaoma padanho rechitatu.
Zvinodiwa zvekubatanidzwa uye zvekuregererwa: Mabhuku anoratidza kuti nyaya dzevana dzinofanira kubatanidzwa muchidzidzo ichi kusvika pamakore 18 ekuberekwa. Zvisinei, paGMCH, ruzhinji rwevana vanotumirwa kune vamwe vari pasi pemakore 12. Pamusoro pezvo, kuwanda kwechirwere cheasthma muvana kwakapfuura kuwanda kwechirwere ichi vasati vasvika uye mushure mekuyaruka. Nokudaro, boka rezera kubva pamakore 3 kusvika ku12 rakasarudzwa kuti riitwe muchidzidzo ichi. Chidzidzo ichi chaisanganisira varwere vane asthma yebronchial vakaonekwa kuti vane chirwere ichi vane makore 3 kusvika ku12 vakabvuma kutora chikamu muchidzidzo ichi. Vana vane makore 3 kusvika ku12 vakabvuma kutora chikamu muchidzidzo vasina chirwere chekufema, zviri nani kuti vagare mumamiriro akafanana, vakasarudzwa seboka rekutonga.
Vana vane makore ari pakati pe0-3 vakabviswa muchidzidzo ichi nekuti kufemera muboka iri rezera hakuna kukwana kuti vaonekwe kuti vane asthma. Pamusoro pezvo, vana vemazera akakodzera pamwe nevachengeti vavo vasina kubvuma kutora chikamu muchidzidzo ichi vakabviswa.
Kuongororwa kwenhamba. Musiyano muhuwandu hwakaongororwa uchishandisa bvunzo yeχ. Kudzokororwa kwehurongwa hwebinary kwakashandiswa pamatanho ekukosha mukuongorora kweunivariate, uye bvunzo yaWald yeχ 2 yakashandiswa kuyera mupiro wakazvimirira wekurapa.
Ethical Approval: Pamberi pekuunganidza data, mvumo yetsika yakawanikwa kubva kuInstitutional Ethics Committees yeInstitute, kureva Institutional Ethics Committees yeGMCH, Guwahati, Assam neIndia, Ref: Kwete: 233/2018/215.
Pavarwere 112,323 vaipinda muchikamu chevana panguva yekudzidza, 18.88% vaive varwere vekufema. Pakati pevana vari muboka remakore 3-12, 2.96% vairwara neasthma yebronchial. Zviitiko zvakawanda zveasthma yevana zvakaitika mumatsutso aGunyana naGumiguru (Mufananidzo 1).
Chidzidzo ichi chekuongorora nyaya iyi chaisanganisira vana 150 vane asthma uye 150 vane asthma. Avhareji yezera (± SD) revatori vechikamu muchidzidzo ichi raive makore 8.38 (± 2.69). Kukosora uye kushaya mweya ndizvo zviratidzo zvakanyanya muzviitiko izvi. Ruzhinji (77.3%) rwevaya vane asthma yakaitika panguva imwe chete uye 8.7% chete yevaya vane asthma yakaipisisa. Kuwanda kwevaya vane asthma kwakaonekwa mumatsutso (30%). Muzviitiko zvinenge 38%, zviratidzo zvakataurwa husiku (Tafura 1).
Sekureva kwevaya vakapindura, zvinwiwa zvinotonhora (82.7%), ice cream (71.6%) uye guruva (35%) ndizvo zvinowanzo kukonzera asthma. Vanhu vanosvika 19.3% vakashuma kusavapo kuchikoro nekuda kwekurwara.
Avhareji yezera (kusiyana kwakajairwa) revanhu vakatora chikamu raive makore 8.34 (2.69). Vazhinji vevanhu ava vaive vari pakati pemakore 7-12 uye vaive varume. Vatori vechikamu vechidzidzo ichi vaive vazhinji vechiHindu uye vasiri vedzinza.
Vana nevarume vane makore 7-12 ekuberekwa vaive nehuwandu hwakawanda hwechirwere ichi, kunyangwe hukama hwacho hwaisanyanya kukosha. Uyewo, asthma yevana yakabatana zvakanyanya neBMI (p-value<0.05). Uyewo, asthma yevana yakabatana zvakanyanya neBMI (p-value<0.05). Кроме того, детская астма была значительно связана с ИМТ (значение р<0,05). Pamusoro pezvo, asthma yevana yakabatana zvakanyanya neBMI (p value<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 астма была значительно связана с ИМТ (значение p <0,05). Pamusoro pezvo, asthma yevana yakabatana zvakanyanya neBMI (p value <0.05).Mikana yekufuta (OR = 2.22, 95% CI: 1.17–4.18) uye kufuta (OR = 2.72, 95% CI: 1.46–5.09) yaive yakapetwa kaviri kana tichienzanisa nevana vane huremu hwakajairika. Vana vemumaguta vanogara mumhuri dzakabatana, nzvimbo dzemarara, uye mudzimba dzine hunyoro, dzisina mhepo yakakwana vane njodzi yakakura yekubata chirwere ichi. Mumakicheni akabatana, mafuta anogadzira utsi kunze kweLPG, mishonga inodzinga umhutu, Dhuna, nezvimwewo, zvine chekuitawo neasthma yevana (p-value<0.05). Mumakicheni akabatana, mafuta anogadzira utsi kunze kweLPG, mishonga inodzinga umhutu, Dhuna, nezvimwewo, zvine chekuitawo neasthma yevana (p-value<0.05). В примыкающих кухнях использование значительно выделяющего дым топлива, кроме сжиженного нефтяного газа, репеллентов от, репеллентов от, репеллентов от. д., также связано с детской астмой (значение p<0,05). Mumakicheni ari pedyo, kushandiswa kwemafuta anokonzera utsi hwakawanda kunze kweLPG, mishonga inodzinga umhutu, Dhuna, nezvimwewo, kunobatanidzwawo neasthma yevana (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相关（0p. Dhuna 等以外的产生与儿童哮喘显着相关（p 值<0.05）、 Дымобразующие 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). Mafuta anogadzira utsi kunze kweLPG, mushonga unodzinga umhutu, Dhuna, nezvimwewo zvaive zvakabatana zvakanyanya neasthma yevana mukicheni dziri pedyo (p value <0.05).Zvakaonekwawo kuti vana vane zvipfuyo vaiva nemukana wekuwana asthma wakapetwa kasere (Tafura 2).
Sezvakaratidzwa muTafura 3, 46.7% yevanhu vane chirwere ichi vaive vemhuri dzine mamiriro ehupfumi akaderera. Dzidzo yemadzimai yaive yakadererawo pakati pezviitiko (p-value<0.05). Dzidzo yemadzimai yaive yakadererawo pakati pezviitiko (p-value<0.05). Материнское образование также было ниже среди случаев (значение p<0,05). Dzidzo yevanaamai yaive yakadererawo pakati pezviitiko (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). Madzimai mune izvi zviitiko aivewo asina kudzidza zvakakwana (p value <0.05).
Vana vanoberekwa nekuvhiyiwa (CS) kana dzimwe nzira dzekubereka nadzo, pamwe nevana vane nhoroondo yekuzvarwa vasina simba rekufema, vari panjodzi yakakura yechirwere ichi. Pamusoro pezvo, vana vanodya zvakasanganiswa/vakadya zvakasanganiswa vaiva nemukana wekuwana chirwere ichi kanenge kashanu kupfuura vana vanoyamwiswa (Tafura 4).
Nhoroondo yekurwara nekudya kwevana uye atopy yakabatana zvakanyanya neasthma yevana. Uyewo, vana vanobva kumhuri dzine nhoroondo yekurwara nechirwere cheallergy uye asthma (p-value<0.05) vaive nedambudziko guru rekuwana chirwere ichi. Uyewo, vana vanobva kumhuri dzine nhoroondo yekurwara nechirwere cheallergy uye asthma (p-value<0.05) vaive nedambudziko guru rekuwana chirwere ichi. Также высокой склонностью к заболеванию отличались дети из семей с анамнезом аллергии и астмы (значение p<0,05). Uyewo, vana vanobva kumhuri dzine nhoroondo yeallergies uye asthma vaive nechirwere ichi zvakanyanya (p<0.05).此外，來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，來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. Pamusoro pezvo, vana vanobva kumhuri dzine nhoroondo yekurwara neallergies uye asthma (p-value <0.05) vaive panjodzi huru yechirwere ichi. Kusvuta fodya pasina kushandisa vamwe vanhu vemumhuri kwakawedzerawo mukana wekuti vana vawane asthma wakapetwa kasere (p-value<0.05). Kusvuta fodya pasina kushandisa vamwe vanhu vemumhuri kwakawedzerawo mukana wekuti vana vawane asthma wakapetwa kasere (p-value<0.05). Пассивное курение через других членов семьи также увеличивает риск развития астмы у детей почти в восемь раз (значение p<0,05). Kusvuta fodya pasina kushandisa vamwe vanhu vemumhuri kunowedzerawo njodzi yekubatwa neasthma muvana kanoda kusvika kasere (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 Пассивное курение через других членов семьи также увеличивало риск развития астмы у детей почти в 8 раз (p-значение <0,05). Kusvuta fodya pasina kushandisa vamwe vanhu vemumhuri kwakawedzerawo njodzi yekubatwa neasthma muvana kanoda kusvika kasere (p-value <0.05).(tafura 5)
Kuongororwa kwezvekudya zvakasiyana-siyana kwakaratidza kuti vana vari mumaguta, munzvimbo dzine hunyoro, mamiriro ehupfumi asina kunaka, mhuka dzinovaraidza, nhoroondo yemhuri yeatopy/allergies, nhoroondo yemhuri yekusvuta/kusvuta fodya zvisina kurongwa, uye kudya kwakasiyana-siyana ndizvo zvakakonzera njodzi huru. Zvinhu zvinokonzera asthma yevana (Tafura 6).
Tafura 6 Kuongororwa kwekuongorora kwekugadzirisa zvinhu zvakawanda kuti uongorore zvinhu zvakakosha zvinokanganisa asthma yevana
Mumakore makumi maviri kusvika makumi matatu apfuura, huwandu hwezvirwere zveatopic hwakawedzera, zvichikonzera hurukuro yakawanda pamusoro pekuchinja kwezvakatipoteredza, kusvibiswa, uye mhinduro dzemuviri kuzvirwere zvinotapukira. Kusangana nezvakatipoteredza uye kushaya simba kwemuviri uye kwemajini zvinoita basa guru mukukura kweasthma.
Muchidzidzo ichi, 2.96% yevarwere vari muboka rezera re3 kusvika ku12 vakataura nezveasthma yevana. Zvisinei, zvimwe zvidzidzo zvekare zvakashuma marudzi akasiyana-siyana easthma yevana muvana vekuIndia. 6,10-12 Kusiyana kwenzvimbo nenzvimbo muIndia kunokanganisa zvakananga zvinhu zvine njodzi zvine chekuita neasthma. 6 Saka, kuti chirwere ichi chidzivirirwe uye chive nenguva, kuongororwa kwenzvimbo kwezvinhu zvikuru zvinokonzera asthma yevana kunodiwa.
Vana vane makore 7-12, varume nevana vanogara mumaguta vari panjodzi huru yekubatwa neasthma muvana. Kuwanda kwevanhu mumaguta nevarume muasthma kwakaonekwa muchidzidzo chakaitwa muIndia, zvakafanana nezvatakawana. Zvisinei, hukama uhwu hwaive hwakakosha chete kana tichitarisa nzvimbo yatinogara.
Zvidzidzo zvakaratidza kuti shanduko dzemahormone dzinoenderana nebonde dzinogona kukanganisa asima, sezvo vakomana vachiwanzobatwa neasima panguva yehudiki. Zvisinei, mufananidzo uyu unochinja mushure mekuyaruka, uye vakadzi vanowanzobatwa nechirwere ichi kupfuura varume. 13-15 Pamusoro pezvo, vakomana vari pasi pemakore gumi vane nzira diki dzekufema kupfuura vasikana vezera rimwe chete, uye kureba kunofungidzirwawo kuti ndicho chikonzero cheasima yevana muvakomana. 16.17
Metro Kamstrup, guta guru reAssam, yakaratidza kukurumidza kukura kwemaguta mumakore achangopfuura. Zvidzidzo zvakawanda zvinoshuma kuti kukura kwemaguta chinhu chinokanganisa kuwanda kweasthma, izvo zvinoenderana nekudzidza kwedu. 18,19 Muchidzidzo chino, logistic regression isina kugadziriswa yakaratidza kuti vana vakafuta nevakafuta vaive nemukana wakapetwa kaviri wekuva neasthma kupfuura vana vane BMI yakajairika, zvichienderana neongororo yazvino. 20 Pamusoro pezvo, mamiriro ehupfumi akaderera chinhu chinogona kukonzera asthma yevana. Vana vanobva kumhuri dzine mamiriro ehupfumi akaderera vari panjodzi huru yekubatwa neasthma nekuda kwekushomeka kwemasoja ekudzivirira muviri uye kushomeka kwezviwanikwa zvehutano. 21-23
Vana vanogara mumhuri imwe chete, dzimba dzekaccha, dzimba dzine hunyoro, mhepo isina kukwana, makicheni akabatana, mafuta anokonzera utsi, mishonga inodzinga umhutu uye Dhuna, nezvimwewo, zvaive zvakabatana zvakanyanya neasthma yevana (p-value<0.05). Vana vanogara mumhuri imwe chete, dzimba dzekaccha, dzimba dzine hunyoro, mhepo isina kukwana, makicheni akabatana, mafuta anokonzera utsi, mishonga inodzinga umhutu uye Dhuna, nezvimwewo, zvaive zvakabatana zvakanyanya neasthma yevana (p-value<0.05).Vana vanogara mumhuri imwe chete, vanotiza pamba, dzimba dzakanyorova, mhepo isina kukwana, makicheni akabatana, mafuta anokonzera utsi, mishonga inodzinga umhutu uye Dhuna nezvimwewo.д., были достоверно связаны с детской астмой (значение р<0,05). e., zvakabatana zvakanyanya neasthma yevana (kukosha 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、产生烟雾的燃和料、驱蚊。等与儿童哮喘显着相关（p 值<0.05）. Vana vanogara mudzimba dzine vanhu vakawanda, dzimba dzekaccha, dzimba dzine hunyoro, mhepo isina kukwana, kicheni yakasungirirwa, mafuta anokonzera utsi, mishonga inodzinga umhutu, uye Dhuna zvine chekuita zvakanyanya neasthma yevana (p value<0.05). Дети в общих домохозяйствах, домах качча, сырых жилищах, неадекватной вентиляции, пристроенных кухнях, задымленном, комаров и Дхуна были в значительной степени связаны с детской астмой (значение p <0,05). Vana vanogara mudzimba dzakabatana, dzimba dzinofambiswa nemhepo, dzimba dzine hunyoro, mhepo isina kukwana, makicheni akakodzera, mafuta anopfungaira, mishonga inodzinga umhutu uye dhuna zvaive zvakabatana zvakanyanya neasthma yevana (p value < 0.05).Ongororo yapfuura yakaratidzawo kuti zvinhu zvakasiyana-siyana zvemukati memba zvinogona kukonzera asthma muvana. 24-27 Kubatana kwezvirwere zvinotapukira mudzimba neasthma yevana kunopesana, sezvo vaongorori vashoma vanotenda kuti kusangana nezvirwere zvinotapukira muvana vasati vasvika kunogona kubatsira mukukura kwekusashivirira. 28
Ongororo dzakawanda dzakaratidza kuti vana vanozvarwa nekuvhiyiwa kwevana vane njodzi yakakura yeasthma yevana vachienzaniswa nekuzvarwa kwakajairika. Izvi zvinoenderana nezvatakawana. 29-32 Vana vane nhoroondo yekushaya mvura yekuzvarwa vanewo njodzi yakakura yekushaya mvura yevana. Asima yevana vakaberekwa vari vacheche inokonzera matambudziko epamuviri akadai se respiratory distress syndrome uye neonatal asphyxia. 33
Sekune zvimwe zvidzidzo, zvakawanikwa pari zvino zvinoratidza kuti nhoroondo yehudiki hwekurwara nechikafu kana atopy kana nhoroondo yemhuri yekurwara nechikafu uye asthma inowedzera zvakanyanya njodzi yeasthma yehudiki. 34,35 Zvichienderana nekudzidza kwedu, zvidzidzo zvekare zvezvizvarwa zvakasiyana-siyana zvakaratidza kuti tsika dzekusvuta dzezvizvarwa zvakasiyana-siyana dzinogona kutungamira kuchinjwa kwemajini mu epigenome izvo zvinowedzera njodzi yeasthma muvana. 36
Mumazuva achangopfuura, kukurumidza kukura kwemaguta kwakakanganisa zvikamu zvese zvevanhu. Nekuda kwenzvimbo dzakasiyana dzekuwana mari nemabasa, vanhu vanosarudza kugara mumaguta saka vanobatwa nezvirwere zvakasiyana-siyana zvinosvibisa nharaunda. Nhengo dzemhuri dzevana vanobatwa nechirwere ichi dzinokurudzirwa kuti dzinyanye kungwarira kudzivirira hunyoro, kusvuta fodya, kuchengeta mhuka dzinovaraidza mumhuri ine allergies/allergies, uye kudzivirira allergies/allergies muvana vane nhoroondo yemhuri yeallergies/allergies. Panofanira kuva neruzivo rwakawanda rwekuyamwisa chete nekuda kwekubatsira kwekuyamwisa mukudzivirira asthma.
Vazhinji vevarwere vanouya kuGuwahati Medical College vanobva kuNorth East India yese sezvo Guwahati Medical College iriyo nzvimbo inotungamira yekurapa varwere vepamusoro munharaunda iyi. Vazhinji vevarwere ava vaive nehupfumi hwakaderera uye dzidzo yakaderera. Asthma yebronchial muvana idambudziko rinowanzoitika mudhipatimendi revana muchipatara chedu. Nzira dzakakodzera dzekudzivirira varwere ava vane njodzi huru dzichabatsira kuderedza kurwara uye kuderedza kuwanda kwezvirwere.
Pasinei nekurapwa kwese kweasthma kuripo, varwere vazhinji vanoramba vasina kudzorwa zvakanaka, asi kuzivikanwa kwehuwandu hwevarwere, kusanganisira phenotypes uye endotypes, kunogona kugadzirisa manejimendi avo. Saka, zvidzidzo zvedunhu zvekupararira kweasthma muvana uye zvinhu zvine njodzi zvichabatsira mukurapa kwakanaka kwezvirwere izvi.
Muchidzidzo ichi, vamwe varwere havana kudzoka kuzoongororwa nekuteverwa. Izvi zvinogona kunge zvakakonzerwa nekusaziva zvikonzero nemigumisiro yechirwere ichi. Nekuda kwekusashanda zvakanaka kwekutaurirana, hatina kukwanisa kutevera varwere vese.
Vana vanowanzobatwa neasthma yenharaunda, uye kunzwisisa kwakakodzera kwezvikonzero zveasthma yenharaunda uye zvinhu zvinokonzera allergies kunogona kubatsira kudzora nekuderedza mutoro wechirwere. Mumhuri dzine nhoroondo yeallergies kana asthma, kungwarira kwakakodzera kunofanirwa kutorwa kudzivirira vana vanobatwa neasthma kubva kuzvinhu zvinogona kukonzera chirwere ichi.
Ruzivo rwese rwakachengetwa rwakavanzika uye chidzidzo ichi chakaitwa zvichienderana neChiziviso cheHelsinki.
Tinotenda vanachiremba vevana vese vakabatsira kuunganidza data nekuongorora ruzivo rwavo. Vashandi vese vepadhipatimendi vakatibatsira kuwana mukana wekuwana maraibhurari edhipatimendi nenzvimbo yaro panguva yekudzidza uku vakarumbidzwawo.
Vanyori vese vakapa mipiro yakakosha mubasa remushumo, kungave mukufunga, kugadzira zvidzidzo, kuita, kuunganidzwa kwedata, kuongorora nekududzira, kana zvese izvi; vakatora chikamu mukunyora, kugadzirisa kana kuongorora nyaya yacho zvakadzama. Pedzisa vhezheni yekuburitswa, bvumirana pane dhayari ichaendeswa nyaya yacho, uye bvumirana kuve nemutoro wezvese zvebasa racho.
1. Nzira yepasi rose yekurapa nekudzivirira asthma. Global Asthma Initiative. 2018. Inowanikwa pa: https://ginastma.org/wp-content/uploads/2019/01/2018-GINA.pdf. Kubva musi wa2 Zvita, 2021