I-Javascript ayisebenzi okwangoku kwisiphequluli sakho. Ezinye iimpawu zale webhusayithi azizukusebenza ukuba i-JavaScript ayisebenzi.
Bhalisa ngeenkcukacha zakho ezithile kunye neyeza elithile elinomdla, kwaye siya kuthelekisa ulwazi olunika lona namanqaku akwisiseko sethu sedatha esibanzi size sikuthumelele ikopi yePDF nge-imeyile ngoko nangoko.
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, Assagarm Medical College; I-3 iSebe lezoNyango zikaRhulumente, iKholeji yezoNyango yase-Assam, i-Dibrugarh, i-Assam, i-Indiya; I-4 Tezpur College of Medicine kunye noTyando lweZibhedlele, eTezpur, eAssam, eIndiya; I-5 iSebe le-Radiology, i-Fakhruddin Ali Ahmed College yezoNyango kunye neSibhedlele, i-Barpeta, i-Assam, i-Indiya Umbhali ohambelanayo: uPutul Mahanta, iSebe le-Forensic Medicine kunye ne-Toxicology, i-Assam Medical College kunye neSibhedlele, i-Dibrugarh, i-Assam, i-786002, i-Indiya, i-tel. +919435017802, i-imeyile [i-imeyile ekhuselweyo] isithintelo somoya. Zombini izinto zofuzo kunye nokusingqongileyo zinegalelo kumazinga aphezulu e-asthma. Injongo yolu phononongo yayikukuvavanya izinto ezahlukeneyo zentlalo-nezoluntu kunye nokusingqongileyo ezichaphazela imvelaphi yesifo sombefu sabantwana kwizigulana eziza kwicandelo labantwana leGauhati Medical College and Hospital (GMCH) e-Assam. Izixhobo kunye neendlela. Izigulane ezili-150 ezinesifo sombefu esichongiweyo ngokwezonyango zikhethwe ngomlinganiselo we-1:1 phakathi kwamatyala aneminyaka emi-3-12 kunye nezigulana zeqela elifanayo leminyaka ezingenaso isifo sokuphefumla kunye nembali yesifo sombefu njengezilawuli. Idatha yaqokelelwa kusetyenziswa ifomathi eyilwe kwangaphambili nevavanyiweyo kwangaphambili, kwaye imvume ebhaliweyo enolwazi yafunyanwa kubo bonke abagcini bomthetho babathathi-nxaxheba. Idatha yahlalutywa ngovavanyo lwe-chi-square kunye nohlengahlengiso lwe-binary logistic kusetyenziswa i-SPSS V20 ehlengahlengisiweyo kwii-p-values. Iziphumo: Abantwana basezidolophini nabesilisa bafunyenwe besengozini enkulu yokuhlaselwa sisifo sombefu. Abantwana abakwiindawo zasezidolophini (OR = 4, 53; 95% CI: 1.57-13.09; pppppp Izigqibo: Abantwana basengozini yesifo sesifuba esibangelwa yindalo Ukuphakamisa ulwazi kunye namanyathelo okuthintela ayadingeka ukulawula nokunciphisa umthwalo wesifo sesifuba ebantwaneni Amagama angundoqo: isifuba, izinto ezingqongileyo, abantwana, ii-allergies, i-atopic
Isifo sesifuba sisifo semiphunga esingapheliyo esibonakaliswa kukuthinteleka komoya okubangelwa kukudumba kweendlela zomoya emiphungeni kunye noxinzelelo lwemisipha olujikelezileyo. Izikhokelo zamva nje ezivela kwiGlobal Initiative on Asthma (GINA) zichaza isifo sesifuba “njengesifo esahlukileyo esidla ngokubonakala kukudumba okungapheliyo kwendlela yomoya”. Iimpawu zokuphefumla ezifana nokuphefumla, ukuphefumla okufutshane, ukuqina kwesifuba kunye nokukhwehlela, kunye nokuguquguquka kokuhamba komoya, ziimpawu zesifo sesifuba.
Kubantu abane-asthma, iimpawu ezinzima zinokwenzeka ngenxa yezinto ezahlukeneyo ezibangela oku, ezinje ngeecuba kunye nezinye iintlobo zokutshaya, ukungunda, ipollen, uthuli, i-dander yezilwanyana, umthambo, umoya obandayo, iimveliso zasekhaya nezemizi-mveliso, ungcoliseko lomoya, kunye nosulelo. 2 Indibaniselwano yezinto zemfuza kunye nemeko-bume ichaza ukwanda kwesifo se-asthma kwezinye iindawo. Rhoqo, ezi zinto zinokuba negalelo kumahluko, apho uhlanga okanye uhlanga lunokuba zezona zinto zichongwa lula phakathi kwamaqela ahlukeneyo abantu. 3
Ukuxilongwa kwesifo sombefu kuxhomekeke kwiklinikhi kuba akukho nkcazo imiselweyo yohlobo, ubukhali, okanye ukuphindaphindeka kweempawu. Isifo sombefu sisifo esiqhelekileyo esibeka umthwalo omkhulu kunyango ngokubanzi kunye nokulaliswa esibhedlele. 4 Nangona ukuxilongwa kwesifo sombefu ebantwaneni nakubantu abadala kufana kakhulu, ukuxilongwa okwahlukileyo, indlela yendalo yokuphefumla, ukukwazi ukubonelela ngonyango oluthile, kunye nexabiso laso lokuxilonga kuxhomekeke kwiminyaka.
Ehlabathini lonke, abantu abangaphezu kwezigidi ezingama-300 banesifo se-asthma. Kubantwana, isifo se-asthma siphakathi kwezifo ezingama-20 eziphambili kwiminyaka yobomi ehlengahlengiswayo kwihlabathi liphela, kunye nezinga lokufa eliphakathi kwe-0.0-0.7 kubantu abayi-100,000.5. Ukuxhaphaka kwesifo se-asthma eIndiya kuye kwaxelwa ukuba kususela kwi-2% ukuya kwi-23%, mhlawumbi ngenxa yokungafani okukhulu kweendawo kunye nokusingqongileyo kweli lizwe. 6 Kuphononongo lwakutshanje, eli nani lifunyenwe liyi-10.4% e-Assam. 7
Isifuba somoya ebantwaneni sibangela iimpawu zokuphefumla eziphindaphindayo ezifana nokuphefumla okungapheliyo, ukukhohlela, ukuphefumla okunzima, kunye nokuxinana kwesifuba, okuthi, ukuba akunyangwa kakuhle, kunokubangela isifo somoya esingapheliyo. Isifuba somoya ebantwaneni sinokuphazamisa kakhulu umgangatho wobomi babantwana abagulayo ngokwandisa ukungabikho emsebenzini nokunciphisa ukubandakanyeka ngokukhutheleyo emsebenzini.
Nangona ulwazi oluphucukileyo kunye namaqhinga okunyanga, kubekho ukwanda okukhulu kokuxhaphaka, ukugula kunye nokufa kwesifo sesifuba kubantwana kwiminyaka yakutshanje8,9, kwaye ukuqonda okungakumbi ngemvelaphi yesifo sesifuba kuyadingeka ukuze kunyangwe ngempumelelo isifo sesifuba. Nangona uphando oluninzi lwenziwa kwiindawo ezahlukeneyo zaseIndiya, kuncinci kakhulu okwenziweyo kule ndawo ingaphuhliswanga kakuhle kumntla-mpuma weIndiya.
Olu phononongo lwenziwe kwilizwe lase-Assam elikumntla-mpuma, eIndiya. Abemi base-Assam bakhiwe ngamaqela eentlanga ezahlukeneyo, apho i-12.45% iphuma kwiindawo zezizwe ezifana neBodo, Khachari, Karbi, Miri, Mishimi, Rabah, njl. Iindawo zasemaphandleni zisasazeke kulo lonke eli phondo. Eli lizwe laziwa ngobuninzi bezinto eziphilayo. Ezolimo, ikakhulu irayisi, iti kunye nemifuno, zithatha ngaphezulu kwesithathu semali engenayo yase-Assam kwaye ziqesha malunga nama-69 ekhulwini abasebenzi. Eli lizwe livelisa ama-50% emveliso yeti yaseIndiya. Amanye amashishini ezolimo anenzuzo aquka ukufuya iihagu, ukufuya ubisi kunye nokuloba ngokuthatha inxaxheba kwabemi basemaphandleni. Ezolimo, iti, ioyile kunye negesi, amalahle kunye nelitye lekalika zezona mboni ziphambili. Umahluko omkhulu phakathi kobuhlanga kunye neendawo kweli lizwe ubangelwa kakhulu ziindlela ezahlukeneyo kunye ne-pathogenesis yesi sifo.
I-GMCH liziko eliphambili lokudlulisela ulwazi kwizikolo eziphakamileyo kulo mmandla, linyanga izigulana ezivela kulo lonke elasempuma-mpuma yeIndiya, kuquka abemi basemaphandleni nasezidolophini. Uninzi lwezigulana belunesimo esiphantsi kwezentlalo nezoqoqosho kunye nenqanaba eliphantsi lemfundo. Isifuba somphunga ebantwaneni yingxaki eqhelekileyo kwizigulane zabantwana ezilaliswayo.
Olu phononongo lujolise ekuvavanyeni izinto ezahlukeneyo zentlalo-yabantu kunye nokusingqongileyo ezichaphazela imvelaphi yesifo sombefu kubantwana kwizigulana ezineminyaka emi-3 ukuya kweli-12 ubudala eziya kugqirha wezingane we-GMCH.
Ukususela ngo-Epreli 2013 ukuya kuMatshi 2017, uphando olujonga emva lwenziwe kwiSebe le-Anatomy ngokubambisana ne-Pediatrics Assam GMCH ukuphanda izinto zentlalo-nezentlalo kunye nokusingqongileyo kwesifo sesifuba sabantwana kubantwana abaneminyaka emi-3 ukuya kweli-12 ubudala.
Kwisifundo solawulo lweemeko esingazange sibonwe ngaphambili, iimeko ezili-150 kunye nezilawuli ezili-150 zikhethwe ngomlinganiselo we-1:1 ukuze kufundwe izinto ezahlukeneyo kwisifo sombefu ebantwaneni. Izigulana ezine-asthma ezichongiweyo ngokwezonyango ezineminyaka emi-3 ukuya kweli-12 ubudala eziya kwiikliniki zabantwana zangaphandle nezangaphakathi zikhethwe njengamatyala, ngelixa izilawuli yayizizigulane zeqela elifanayo leminyaka, kungcono ukuba zihlale kwiimeko ezifanayo ngaphandle kweengxaki zokuphefumla.
Ubungakanani besampulu buchongiwe kusetyenziswa inguqulelo yeWinPepi 11.65. Idatha evela kuphando lokuqala ibonisa ukuba ukuxhaphaka kwesifo sesifuba phakathi kwabantwana baseIndiya kususela kwi-1% ukuya kwi-4%. Ke ngoko, xa sicinga ukuba i-1% yabantwana abane-asthma kunye nobukhulu obulinganayo bezigulane kunye namaqela olawulo, uphando lufuna ubungakanani besampulu iyonke yabantu abangama-274 ukuze bafumane amandla angama-80% okufumanisa umahluko we-4% phakathi kwababini. . Omabini amaqela anenqanaba lokubaluleka le-5%.
Ukongeza, xa sicinga ukuba malunga ne-10% yabantu abangaphenduliyo babangelwa kukulahlekelwa okanye ukungathobeli okulandelayo, kusengqiqweni ukuzoba isampulu yabantu abangama-300 (equka amatyala ali-150 kunye nolawulo oluli-150).
Sebenzisa iifomathi zokuqokelela idatha eziyilwe kwangaphambili nezivavanyiweyo. Imvume ebhaliweyo enolwazi ifunyenwe kubo bonke abagcini bomthetho babathathi-nxaxheba kolu phando. Idatha iqokelelwe kwiinguqu ezahlukeneyo zentlalo-yabantu kunye nokusingqongileyo. Uhlobo lwendlu luchazwa njengo
Indlu yasePucca, ukuba iindonga nophahla zenziwe ngezitena, isamente kunye namatye; indlu yaseKatcha yenziwe ngomthi, umhlaba, ingca kunye namagqabi omileyo ukuba indlu yenziwe ngodonga lwezitena kunye nodonga lwe-adobe olunophahla lwengca okanye lwetini kunye nekhonkrithi. Ukuba igqityiwe, le yindlu yeSemipucca. Imeko yezentlalo noqoqosho ivavanyiwe kusetyenziswa isikali seKuppuswami esilungisiweyo (2014).
Indlela yokuzala yabathathi-nxaxheba, imbali yokuzalwa bengenamdla wokutya, uhlobo lokutya, imbali yokunganyamezelani kokutya, imbali yomama yokulutha, imbali yosapho yesifuba, imbali yokunganyamezelani okanye ukunganyamezelani, kunye nembali yosapho yokutshaya okanye ukutshaya umsi osetyenziswa ngomnye umntu nayo yarekhodwa. Nawaphi na amalungu osapho ahlala kwindlu enye ayethathwa njengabatshayi kwimbali yosapho. Ngokwezikhokelo zeGINA Epidemiological and Clinical Trial Participant Image Guidelines, ubunzima besifo bahlulwe ngokwamanyathelo onyango amiselweyo, kuthathelwa ingqalelo ukuba izigulana ezabelwe kwinqanaba lesi-2 zazinesifuba esincinci, kwaye izigulana ezabelwe kwinqanaba lesi-3 ukuya kwelesi-4 zazinesifuba esincinci kwaye zabelwe unyango lwesifuba esinzima kwinqanaba lesi-5.
Iikhrayitheriya zokubandakanywa kunye nokukhutshwa: Uncwadi lubonisa ukuba amatyala abantwana kufuneka afakwe kolu phando ukuya kuthi ga kwiminyaka eli-18 ubudala. Nangona kunjalo, kwi-GMCH, uninzi lwabantwana abathunyelwayo bangaphantsi kweminyaka eli-12 ubudala. Ukongeza, ukwanda kwesifo sesifuba ebuntwaneni kudlule ukwanda kwesifo ngaphambi nasemva kokufikisa. Ke ngoko, iqela leminyaka eliphakathi kweminyaka emi-3 ukuya kweli-12 lakhethwa kolu phando. Olu phononongo luquke izigulana ezine-asthma ye-bronchial efunyenwe ngokwezonyango ezineminyaka emi-3 ukuya kweli-12 ubudala ezivumile ukuthatha inxaxheba kolu phando. Abantwana abaneminyaka emi-3 ukuya kweli-12 ubudala abavumile ukuthatha inxaxheba kolu phando ngaphandle kwesifo sokuphefumla, okungcono ukuba bahlala kwiimeko ezifanayo, bakhethwa njengeqela lolawulo.
Abantwana abaneminyaka eyi-0-3 ubudala abafakwanga kuphando kuba ukuphefumla kancinci kweli qela leminyaka akwanelanga ukuxilonga isifo sesifuba. Ukongeza, abantwana abakumaqela afanelekileyo eminyaka kunye nabagcini babo abangavumanga ukuthatha inxaxheba kolu phando abafakwanga.
Uhlalutyo lwezibalo. Umahluko kwiimilinganiselo uhlalutywe kusetyenziswa uvavanyo lwe-χ. Uhlengahlengiso lwe-binary logistic lusetyenzisiwe kwiiparameter zokubaluleka kuhlalutyo lwe-univariate, kwaye uvavanyo lukaWald lwe-χ 2 lusetyenzisiwe ukulinganisa igalelo elizimeleyo lonyango.
Ukuvunywa kokuziphatha: Ngaphambi kokuqokelelwa kwedatha, ukuvunywa kokuziphatha kwafunyanwa kwiiKomiti zeMigaqo yeZiko leZiko, oko kukuthi iiKomiti zeMigaqo yeZiko le-GMCH, iGuwahati, i-Assam ne-India, iRef: No: 233/2018/215.
Kwizigulane ezili-112,323 ezazisiya kwicandelo labantwana ngexesha lophando, i-18.88% yayizizigulane zokuphefumla. Phakathi kwabantwana abakwiqela leminyaka emi-3-12 ubudala, i-2.96% yayinesifo se-asthma. Uninzi lweemeko ze-asthma ebuntwaneni zenzeka ekwindla kaSeptemba nango-Okthobha (Umzobo 1).
Olu phononongo lolawulo lweemeko luquke abantwana abali-150 abane-asthma kunye nabalawuli abali-150. Umyinge weminyaka (± SD) yabathathi-nxaxheba kolu phando yayiyiminyaka eyi-8.38 (± 2.69). Ukukhohlela kunye nokuphefumla kancinci zezona mpawu zixhaphakileyo kwezonyango kwezi meko. Uninzi lwamatyala (77.3%) ayene-asthma eyenzeka ngexesha elithile kwaye yi-8.7% kuphela yamatyala ayene-asthma enzima. Ukuxhaphaka kwamatyala kwaphawulwa ekwindla (30%). Phantse kwi-38% yamatyala, iimpawu zaxelwa ebusuku (Itheyibhile 1).
Ngokutsho kwabaphenduli, iziselo ezibandayo (82.7%), i-ayisikhrim (71.6%) kunye nothuli (35%) zezona zinto zixhaphakileyo ezibangela isifo sombefu. Phantse i-19.3% yamatyala axele ukuba abantu abangekho esikolweni ngenxa yokugula.
Ubudala obuphakathi (ukwahluka okuqhelekileyo) kwabathathi-nxaxheba yayiyiminyaka eyi-8.34 (2.69). Uninzi lweemeko zazikwiqela leminyaka eli-7 ukuya kweli-12 kwaye yayingamadoda. Abathathi-nxaxheba bolu phando babengabantu bamaHindu nabangengabo abohlanga.
Abantwana namadoda aneminyaka esi-7 ukuya kweli-12 ubudala babenezinga eliphezulu lokwanda kwesi sifo, nangona unxulumano lwalungabalulekanga ngokwezibalo. Kwakhona, isifo sombefu ebuntwaneni sasinxulunyaniswa kakhulu ne-BMI (ixabiso le-p<0.05). Kwakhona, isifo sombefu ebuntwaneni sasinxulunyaniswa kakhulu ne-BMI (ixabiso le-p<0.05). Кроме того, детская астма была значительно связана с ИМТ (значение р<0,05). Ukongeza, i-asthma yabantwana yayinxulunyaniswa kakhulu ne-BMI (ixabiso le-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 астма была значительно связана с ИМТ (значение p <0,05). Ukongeza, i-asthma yobuntwana yayinxulunyaniswa kakhulu ne-BMI (ixabiso le-p <0.05).Amathuba okuba nobunzima obukhulu (OR = 2.22, 95% CI: 1.17–4.18) kunye nokutyeba kakhulu (OR = 2.72, 95% CI: 1.46–5.09) ayengaphezulu ngokuphindwe kabini xa kuthelekiswa nabantwana abanobunzima obuqhelekileyo. Abantwana basezidolophini abahlala kwiintsapho ezihlala kunye, kwiindawo zokugcina izinto ezimdaka, nakwiindawo zokuhlala ezimanzi, ezingenamoya unganeleyo banomngcipheko omkhulu wokufumana esi sifo. Kwiikhitshi eziqhotyoshelweyo, amafutha avelisa umsi ngaphandle kweLPG, izinto zokugxotha iingcongconi, iDhuna, njl.njl., nazo zinxulunyaniswa kakhulu ne-asthma yabantwana (ixabiso le-p<0.05). Kwiikhitshi eziqhotyoshelweyo, amafutha avelisa umsi ngaphandle kweLPG, izinto zokugxotha iingcongconi, iDhuna, njl.njl., nazo zinxulunyaniswa kakhulu ne-asthma yabantwana (ixabiso le-p<0.05). В примыкающих кухнях использование значительно выделяющего дым топлива, кроме сжиженного нефтяного газа, репеллентов от, репеллентов от. д., также связано с детской астмой (значение p<0,05). Kwiikhitshi ezikufutshane, ukusetyenziswa kwezinto ezivelisa umsi kakhulu ngaphandle kweLPG, izinto ezigxotha iingcongconi, iDhuna, njl.njl., kukwanxulunyaniswa ne-asthma yabantwana (ixabiso le-p < 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）、 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). Izinto ezivelisa umsi ngaphandle kwe-LPG, izinto zokugxotha iingcongconi, i-Dhuna, njl. nazo zazinxulunyaniswa kakhulu ne-asthma yabantwana kwiikhitshi ezikufutshane (ixabiso le-p <0.05).Kwakhona kwaphawulwa ukuba abantwana abanezilwanyana zasekhaya banamathuba aphindwe kasibhozo okuba nesifo sesifuba (Itheyibhile 2).
Njengoko kubonisiwe kwiTheyibhile 3, ama-46.7% amatyala ayengawaseentsapho ezinesimo esiphantsi kwezoqoqosho. Imfundo yoomama nayo yayiphantsi phakathi kwamatyala (ixabiso le-p<0.05). Imfundo yoomama nayo yayiphantsi phakathi kwamatyala (ixabiso le-p<0.05). Материнское образование также было ниже среди случаев (значение p<0,05). Imfundo yoomama nayo yayiphantsi phakathi kwamatyala (ixabiso le-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 менее образованными (значение p <0,05). Oomama kwezi meko nabo babengafundanga kangako (ixabiso le-p <0.05).
Abantwana abazelwe ngotyando (CS) okanye ezinye iindlela zokubeleka, kunye nabantwana abanembali yokuzalwa bengenayo i-asphyxia, basengozini enkulu yesi sifo. Ukongeza, abantwana abancanciswa kakhulu/abaxutyiweyo babenamathuba aphindwe kahlanu okufumana esi sifo kunabantwana abancanciswayo (Itheyibhile 4).
Imbali yokunganyamezelani nokutya kwabantwana kunye nokunganyamezelani kokutya kuye kwanxulunyaniswa kakhulu nesifuba somoya ebuntwaneni. Kwakhona, abantwana abavela kwiintsapho ezinembali ye-allergies kunye ne-asthma (p-value<0.05) babenokuchaphazeleka kakhulu sesi sifo. Kwakhona, abantwana abavela kwiintsapho ezinembali ye-allergies kunye ne-asthma (p-value<0.05) babenokuchaphazeleka kakhulu sesi sifo. Также высокой склонностью к заболеванию отличались дети из семей с анамнезом аллергии и астмы (значение p<0,05). Kwakhona, abantwana abavela kwiintsapho ezinembali ye-allergies kunye ne-asthma babenesimo esiphezulu sokufumana esi sifo (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. Ukongeza, abantwana abavela kwiintsapho ezinembali ye-allergies kunye ne-asthma (ixabiso le-p <0.05) babesengozini enkulu. Ukutshaya ngaphandle kokutshaya ngamanye amalungu osapho nako kwandisa phantse amaxesha asibhozo umngcipheko we-asthma phakathi kwabantwana (ixabiso le-p<0.05). Ukutshaya ngaphandle kokutshaya ngamanye amalungu osapho nako kwandisa phantse amaxesha asibhozo umngcipheko we-asthma phakathi kwabantwana (ixabiso le-p<0.05). Пассивное курение через других членов семьи также увеличивает риск развития астмы у детей почти в восемь раз (значение p<0,05). Ukutshaya ngaphandle kokutshaya ngamanye amalungu osapho nako kwandisa umngcipheko wokuba nesifo sesifuba ebantwaneni phantse ngokuphindwe kasibhozo (ixabiso le-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 Пассивное курение через других членов семьи также увеличивало риск развития астмы у детей почти в 8 раз (p-значение <0,05). Ukutshaya ngaphandle kokutshaya ngamanye amalungu osapho nako kwandisa umngcipheko wokuba nesifo sesifuba ebantwaneni phantse izihlandlo ezisi-8 (ixabiso le-p <0.05).(Itheyibhile 5)
Ukubuyela umva kwezinto ezimbini ezimbini kubonise ukuba abantwana abakwiindawo zasezidolophini, iindawo ezifumileyo, imeko ephantsi yezentlalo nezoqoqosho, izilwanyana zasekhaya, imbali yentsapho ye-atopy/allergies, imbali yentsapho yokutshaya/ukutshaya ngaphandle kokutshaya, kunye nokutya okuxutyiweyo kube negalelo elikhulu. Izinto ezibangela umngcipheko we-asthma yabantwana (Itheyibhile 6).
Itheyibhile 6 Uhlalutyo lwe-Multivariate logistic regression ukuvavanya izinto ezibalulekileyo ezichaphazela i-asthma yabantwana
Kwiminyaka engamashumi amabini ukuya kwamashumi amathathu edlulileyo, inani lezifo ezibangelwa yi-atopic liye landa, nto leyo ebangele ingxoxo eninzi malunga notshintsho kwindalo esingqongileyo, ungcoliseko, kunye neempendulo zomzimba kwizifo ezisulelayo. Ukuchatshazelwa yindalo esingqongileyo kunye nobuthathaka bebhayoloji kunye nobemfuza budlala indima ekuphuhlisweni kwesifo sesifuba.
Kolu phononongo, i-2.96% yezigulana ezikwiqela leminyaka emi-3 ukuya kweli-12 zixele ukuba zine-asthma ebuntwaneni. Nangona kunjalo, ezinye izifundo zangaphambili zixele ngeentlobo ezahlukeneyo ze-asthma ebuntwaneni kubantwana baseIndiya. 6,10-12 Umahluko weendawo kunye nokusingqongileyo eIndiya uchaphazela ngokuthe ngqo kwaye uchaphazela izinto ezinobungozi ezinxulumene nokuxhaphaka kwe-asthma. 6 Ke ngoko, ukuze kuthintelwe esi sifo ngokufanelekileyo nangexesha elifanelekileyo, kufuneka uvavanyo lwengingqi lwezinto eziphambili ze-asthma ebuntwaneni.
Abantwana abaneminyaka esi-7-12 ubudala, amadoda kunye nabantwana abahlala kwiindawo zasezidolophini basengozini enkulu yokuba nesifo sombefu ebantwaneni. Ukwanda kwabantu basezidolophini nabesilisa kubonwe kuphononongo lwaseIndiya,10 olufana nolwethu. Nangona kunjalo, olu nxulumano lwalubaluleke kakhulu ngokwezibalo kuphela kwimeko yendawo yasekhaya.
Izifundo zibonise ukuba utshintsho oluthile kwiihomoni lunokuchaphazela isifo sesifuba, njengoko abafana benamathuba amaninzi okufumana isifo sesifuba ngexesha lobuntwana. Nangona kunjalo, le mfanekiso iyatshintsha emva kokufikisa, kwaye abafazi badla ngokuba nesifo rhoqo kunamadoda. 13-15 Ukongeza, abafana abangaphantsi kweminyaka eli-10 ubudala baneendlela zomoya ezincinci kunamantombazana aneminyaka efanayo, kwaye ubude bukwacingelwa ukuba buyimbangela yesifo sesifuba sabantwana kumakhwenkwe. 16.17
IMetro Kamstrup, ikomkhulu lase-Assam, ibonakalise ukukhula ngokukhawuleza kwezixeko kwiminyaka yakutshanje. Izifundo ezininzi zixela ukuba ukukhula kwezixeko yinto echaphazela ukwanda kwesifo sesifuba, nto leyo ehambelana nophando lwethu. 18,19 Kolu phononongo, ukubuyela umva kwezinto okungalungiswanga kubonise ukuba abantwana abatyebileyo nabatyebileyo babenamathuba aphindwe kabini okuba nesifo sesifuba kunabantwana abane-BMI eqhelekileyo, ngokuhambelana nophononongo lwakutshanje. 20 Ukongeza, imeko ephantsi yezentlalo noqoqosho yinto enokubangela umngcipheko wesifo sesifuba sabantwana. Abantwana abavela kwiintsapho ezinesimo esiphantsi sezentlalo noqoqosho basengozini enkulu yokuba nesifo sesifuba ngenxa yempendulo ephantsi yomzimba kunye nezibonelelo zonyango eziphantsi. 21-23
Abantwana abahlala kusapho olunye, izindlu ze-kaccha, izindlu ezifumileyo, umoya ongangeniyo ngokwaneleyo, iikhitshi ezinamatheleyo, amafutha avelisa umsi, izinto zokugxotha iingcongconi kunye ne-Dhuna, njl.njl., zazinxulunyaniswa kakhulu ne-asthma yabantwana (ixabiso le-p<0.05). Abantwana abahlala kusapho olunye, izindlu ze-kaccha, izindlu ezifumileyo, umoya ongangeniyo ngokwaneleyo, iikhitshi ezinamatheleyo, amafutha avelisa umsi, izinto zokugxotha iingcongconi kunye ne-Dhuna, njl.njl., zazinxulunyaniswa kakhulu ne-asthma yabantwana (ixabiso le-p<0.05).Abantwana abahlala kusapho olunye, ababalekayo emakhaya, izindlu ezifumileyo, umoya ongangeni kakuhle, iikhitshi ezinamatheleyo, ipetroli evelisa umsi, izinto zokugxotha iingcongconi kunye neDhuna njl.д., были достоверно связаны с детской астмой (значение р<0,05). e., zazinxulunyaniswa kakhulu ne-asthma yabantwana (ixabiso 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). Abantwana abahlala kumakhaya ahlala abantu abaninzi, izindlu ze-kaccha, izindlu ezifumileyo, umoya ongangeniyo ngokwaneleyo, ikhitshi elinamatheleyo, ipetroli evelisa umsi, izinto zokugxotha iingcongconi, kunye ne-Dhuna zinxulumene kakhulu ne-asthma yabantwana (ixabiso le-p<0.05). Дети в общих домохозяйствах, домах качча, сырых жилищах, неадекватной вентиляции, пристроенных кухнях, задыпленвентом комаров и Дхуна были в значительной степени связаны с детской астмой (значение p <0,05). Abantwana abahlala kumakhaya ahlala kunye, izindlu ezisetyenziswa ngabantu abaninzi, izindlu ezifumileyo, umoya ongangeniyo ngokwaneleyo, iikhitshi ezifakelweyo, ipetroli etshayayo, izinto zokugxotha iingcongconi kunye ne-dhuna zinxulunyaniswa kakhulu ne-asthma yabantwana (ixabiso le-p < 0.05).Uphando lwangaphambili lukwabonise ukuba izinto ezahlukeneyo ezingaphakathi endlini zinokubangela isifo sombefu ebantwaneni. 24-27 Unxulumano lwezinto ezibangela i-allergies kwizilwanyana zasekhaya kunye nesifo sombefu ebantwaneni luyinto ephikisanayo, njengoko bambalwa abaphandi abakholelwa ukuba ukuvezwa kwangethuba kwi-allergies kunokubangela ukunyamezelana. 28
Izifundo ezininzi zibonise ukuba abantwana abazelwe ngotyando lotyando basengozini enkulu yokuba nesifo sombefu ebuntwaneni xa kuthelekiswa nokuzalwa okuqhelekileyo. Oku kuyahambelana neziphumo zethu. 29-32 Abantwana abanembali yokuzalwa benesifo sombefu basengozini enkulu yokuba nesifo sombefu. Isifo sombefu sikamama sinegalelo elibalulekileyo kwiingxaki zokukhulelwa ezifana nesifo sokuphefumla kunye ne-neonatal asphyxia. 33
Njengakwezinye izifundo, iziphumo zangoku zibonisa ukuba imbali yobuntwana yokunganyamezelani nokutya okanye i-atopy okanye imbali yosapho yokunganyamezelani kunye ne-asthma iyandisa kakhulu umngcipheko we-asthma yobuntwana. 34,35 Ngokuhambelana nophando lwethu, izifundo zangaphambili zezizukulwana ezininzi zibonise ukuba imikhwa yokutshaya phakathi kwezizukulwana ingakhokelela kutshintsho lwezakhi zofuzo kwi-epigenome oluyandisa umngcipheko we-asthma kwinzala. 36
Kule mihla yakutshanje, ukwanda ngokukhawuleza kwabantu abahlala ezidolophini kuye kwachaphazela onke amacandelo oluntu. Ngenxa yemithombo eyahlukeneyo yengeniso nemisebenzi, abantu bakhetha ukuhlala ezidolophini kwaye ngaloo ndlela bachaphazeleka zizinto ezahlukeneyo ezingcolisayo kokusingqongileyo. Amalungu osapho lwabantwana abasengozini ayacetyiswa ukuba anikele ingqalelo engakumbi ekuphepheni ukufuma, ukutshaya, ukugcina izilwanyana zasekhaya kusapho olune-allergies/allergies, kunye nokuphepha i-allergies/izinto ezibangela i-allergies kubantwana abanembali yentsapho ye-allergies/allergies. Kufuneka kubekho ulwazi olwandisiweyo ngokuncancisa kuphela ngenxa yeenzuzo zokuncancisa ekuthinteleni i-asthma.
Uninzi lwezigulane eziza kwiGuwahati Medical College zivela kulo lonke elaseMntla Mpuma India njengoko iGuwahati Medical College iliziko eliphambili leengcali kulo mmandla. Uninzi lwezigulane belunesimo esiphantsi kwezentlalo nezoqoqosho kunye nenqanaba eliphantsi lemfundo. Isifuba somqala ebantwaneni yingxaki eqhelekileyo kwicandelo labantwana kwisibhedlele sethu. Amaqhinga okuthintela afanelekileyo kwezi zigulane zisengozini enkulu aya kunceda ukunciphisa ukugula kunye nokunciphisa ukuxhaphaka kokwanda kwezifo.
Nangona kukho unyango lwe-asthma olufumanekayo, uninzi lwezigulane alusalawulwa kakuhle, kodwa ukuchongwa kwamaqela athile ezigulane, kuquka ii-phenotypes kunye ne-endotypes, kunokwenza ngcono ulawulo lwazo. Ngoko ke, izifundo zengingqi malunga nokuxhaphaka kwe-asthma ebuntwaneni kunye nezinto ezinobungozi ziya kunceda ekulawuleni ngempumelelo la matyala.
Kolu phononongo, ezinye izigulana azibuyanga ukuze zihlolwe kwaye zilandelelwe. Oku kusenokuba kungenxa yokungazi kakuhle izizathu kunye nemiphumo yesifo. Ngenxa yeenkqubo zonxibelelwano ezingalunganga, asikwazanga ukulandelela zonke izigulana.
Abantwana basengozini yokufumana isifo sesifuba esingqongileyo, kwaye ukuqonda kakuhle izinto ezibangela isifo sesifuba esingqongileyo kunye nezinto ezibangela i-allergens kunokunceda ukulawula nokunciphisa umthwalo wesifo. Kwiintsapho ezinembali ye-allergies okanye i-asthma, kufuneka kuthathwe unonophelo olufanelekileyo ukukhusela abantwana abasengozini kwizinto ezinokubangela ukuba baphile ubomi obuqhelekileyo.
Lonke ulwazi lugcinwe luyimfihlo kwaye uphando lwenziwe ngokweSibhengezo saseHelsinki.
Enkosi kubo bonke oogqirha babantwana abancedileyo ekuqokeleleni idatha nasekuvavanyeni umxholo wolwazi lwabo. Bonke oogxa bethu kwicandelo abasincedileyo ukufikelela kwiilayibrari zesebe nakwindawo engqongileyo ngexesha lophando nabo bayanconywa.
Bonke ababhali benze igalelo elikhulu kumsebenzi wengxelo, nokuba kukwingcamango, uyilo lwesifundo, ukuphunyezwa, ukuqokelelwa kwedatha, uhlalutyo kunye nokutolikwa, okanye kuzo zonke ezi ndawo; bathathe inxaxheba ekubhalweni, ekuhlaziyweni okanye ekuhlolweni okubalulekileyo kwenqaku. Gqibezela inguqulelo yokupapashwa, vumelana ngejenali eliza kuthunyelwa kuyo inqaku, kwaye uvume ukuba noxanduva lwazo zonke iinkalo zomsebenzi.
1. Icebo lehlabathi lonke lokunyanga nokuthintela isifo sombefu. Iphulo leHlabathi leSifo sombefu. 2018. Ifumaneka apha: https://ginastma.org/wp-content/uploads/2019/01/2018-GINA.pdf. Ukusukela nge-2 kaDisemba 2021