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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, Ikolishi Lezokwelapha i-Assagam; 3 Umnyango Wezokwelapha Zomphakathi, i-Assam Medical College, i-Dibrugarh, i-Assam, i-India; I-4 Tezpur College of Medicine and Hospital Surgery, Tezpur, Assam, India; 5 Umnyango Wezokwelapha Ze-Radiology, u-Fakhruddin Ali Ahmed Ikolishi Lezokwelapha Nesibhedlela, i-Barpeta, i-Assam, i-India Umbhali ohambelanayo: u-Putul Mahanta, uMnyango we-Forensic Medicine kanye ne-Toxicology, i-Assam Medical College kanye neSibhedlela, i-Dibrugarh, i-Assam, i-786002, i-India, ucingo. +919435017802, i-imeyili [i-imeyili ivikelwe] ukuvinjwa kwendlela yomoya. Zombili izici zofuzo nezemvelo zinomthelela emazingeni aphezulu esifuba somoya. Inhloso yalolu cwaningo kwakuwukuhlola izici ezahlukahlukene zezenhlalo-zomphakathi kanye nezemvelo ezithonya imbangela yesifo sofuba ebuntwaneni ezigulini ezifika emnyangweni wezingane weGauhati Medical College and Hospital (GMCH) e-Assam. Izinto zokwakha kanye nezindlela. Iziguli ezingu-150 ezinesifo sofuba esitholakale sitholakale emtholampilo zikhethwe ngesilinganiso esingu-1:1 phakathi kwamacala aneminyaka engu-3-12 kanye neziguli zeqembu elifanayo leminyaka ezingenaso isifo sokuphefumula kanye nomlando wesifo sofuba njengezilawuli. Idatha yaqoqwa kusetshenziswa ifomethi eklanywe kusengaphambili futhi yahlolwa kusengaphambili, futhi kwatholakala imvume ebhaliwe evela kubo bonke abanakekeli abasemthethweni babahlanganyeli. Idatha yahlaziywa ngokuhlolwa kwe-chi-square kanye nokubuyiselwa kwe-binary logistic kusetshenziswa i-SPSS V20 elungiselelwe amanani e-p. Imiphumela: Izingane zasemadolobheni nezabesilisa zatholakala zisengozini enkulu yokuthola isifo sofuba. Izingane ezisezindaweni zasemadolobheni (OR = 4, 53; 95% CI: 1.57-13.09; pppppp Iziphetho: Izingane zisengozini yesifo sofuba esibangelwa imvelo Kudingeka izinyathelo zokukhulisa ulwazi kanye nokuvimbela ukuze kulawulwe futhi kuncishiswe umthwalo wesifo sofuba ezinganeni Amagama ayisihluthulelo: i-asthma, izici zemvelo, izingane, ukungezwani komzimba, i-atopic
I-asthma yisifo samaphaphu esingamahlalakhona esibonakaliswa ukuvinjelwa komoya okungenakuguqulwa okubangelwa ukuvuvukala kwemigudu yomoya emaphashini kanye nokucindezeleka kwemisipha ezungezile. Iziqondiso zakamuva ezivela ku-Global Initiative on Asthma (GINA) zichaza i-asthma “njengesifo esingavamile esivame ukubonakala ngokuvuvukala okungapheli kwemigudu yomoya”. Izimpawu zokuphefumula ezifana nokuphefumula, ukuphefumula okufushane, ukuqina kwesifuba nokukhwehlela, kanye nokuguquguquka komkhawulo womoya ophumayo, kuyizimpawu ze-asthma.
Kubantu abane-asthma, izimpawu ezinzima zingavela ngenxa yezinto ezahlukahlukene ezibangela lokhu, njengogwayi nezinye izinhlobo zokubhema, isikhunta, impova, uthuli, ukungcola kwezilwane, ukuzivocavoca, umoya obandayo, imikhiqizo yasekhaya neyezimboni, ukungcola komoya, kanye nokutheleleka. 2 Inhlanganisela yezici zofuzo kanye nezemvelo ichaza ukwanda okuphezulu kwe-asthma kweminye imiphakathi. Ngokuvamile, lezi ezinye izici zingaba nomthelela ekwehlukeni, uhlanga noma ubuzwe kuyizinto ezibonakala kalula phakathi kwamaqembu ahlukene abantu. 3
Ukuxilongwa kwe-asthma kungokwezokwelapha ngoba ayikho incazelo ejwayelekile yohlobo, ubukhulu, noma ukuvama kwezimpawu. I-asthma ye-bronchial yisifo esivamile esibeka umthwalo omkhulu emisebenzini yezokwelapha evamile kanye nokulaliswa esibhedlela. 4 Nakuba ukuxilongwa kwe-asthma ezinganeni nakubantu abadala kunezinto eziningi ezifanayo, ukuxilongwa okuhlukile, indlela yemvelo yokuphefumula, ikhono lokunikeza ukwelashwa okuthile, kanye nenani laso lokuxilonga kuncike eminyakeni yobudala.
Emhlabeni jikelele, abantu abangaphezu kwezigidi ezingu-300 bahlushwa yi-asthma. Ezinganeni, i-asthma iphakathi kwezifo ezingama-20 ezingapheli eziphezulu eminyakeni yokuphila eguquliwe emhlabeni wonke yokukhubazeka, ngesilinganiso sokufa esingu-0.0-0.7 kubantu abayi-100,000.5. Ukusabalala kwe-asthma eNdiya kubikwe ukuthi kuphakathi kuka-2% kuya ku-23%, cishe ngenxa yokungafani okukhulu kwendawo kanye nemvelo yezwe. 6 Ocwaningweni lwamuva nje, lesi sibalo sitholakale singama-10.4% e-Assam. 7
I-asthma ezinganeni ibangela izimpawu zokuphefumula eziphindaphindayo njengokuphefumula, ukukhwehlela, ukuphefumula okunzima, kanye nokuqina kwesifuba, okungathi uma kungelashwa kahle, kuholele ku-asthma engapheli. I-asthma yezingane ingalimaza kakhulu ikhwalithi yokuphila kwezingane ezigulayo ngokwandisa ukungabikho emsebenzini nokunciphisa ukuhlanganyela okusebenzayo emsebenzini.
Naphezu kolwazi oluthuthukisiwe namasu okwelapha, kube nokwanda okukhulu kokusabalala, ukugula kanye nokufa kwe-asthma ezinganeni eminyakeni yamuva8,9, futhi ukuqonda okwengeziwe nge-pathogenesis ye-asthma kuyadingeka ukuze kwelashwe ngempumelelo i-asthma. Nakuba kwenziwa ucwaningo oluningi ezingxenyeni ezahlukene ze-India, kuncane kakhulu okwenziwe kulesi sifunda esingakathuthuki kahle enyakatho-mpumalanga ye-India.
Lolu cwaningo lwenziwe esifundazweni sase-Assam esisenyakatho-mpumalanga, eNdiya. Inani labantu base-Assam lakhiwe amaqembu ahlukahlukene ezinhlanga, lapho u-12.45% wabo emiphakathini yezizwe ezifana neBodo, Khachari, Karbi, Miri, Mishimi, Rabah, njll. Izindawo zasemakhaya zisakazeke kulo lonke isifunda. Lesi sifundazwe saziwa ngokuhlukahluka kwezinhlobo zezinto eziphilayo. Ezolimo, ikakhulukazi ilayisi, itiye kanye ne-pulses, zithatha ingxenye engaphezu kwengxenye yesithathu yemali engenayo yase-Assam futhi ziqasha cishe amaphesenti angu-69 abasebenzi. Lesi sifundazwe sikhiqiza u-50% womkhiqizo wetiye waseNdiya. Amanye amabhizinisi ezolimo anenzuzo afaka phakathi ukufuya izingulube, ukufuya ubisi kanye nokudoba ngokuhlanganyela kwabantu basemakhaya. Ezolimo, itiye, uwoyela negesi, amalahle kanye ne-limestone yizona zimboni eziyinhloko. Ukungafani okukhulu ngokohlanga kanye nendawo esifundazweni kubangelwa kakhulu yizinguquko ezahlukene kanye nokuqala kwalesi sifo.
I-GMCH iyisikhungo sokudlulisela esihamba phambili esifundeni, selapha iziguli ezivela kulo lonke elasenyakatho-mpumalanga yeNdiya, okuhlanganisa abantu basemakhaya nabasemadolobheni. Iningi leziguli lalinesimo esiphansi kwezomnotho kanye nezinga eliphansi lemfundo. I-asthma ye-bronchial ezinganeni iyinkinga evamile ezinganeni ezilaliswa esibhedlela.
Lolu cwaningo luhlose ukuhlola izici ezahlukahlukene zezenhlalo nezenhlalo ezithonya imbangela yesifo sofuba ebuntwaneni ezigulini ezineminyaka engu-3-12 ezifika kudokotela wezingane we-GMCH.
Kusukela ngo-Ephreli 2013 kuya kuMashi 2017, kwenziwa ucwaningo lokulawula amacala olubheka emuva eMnyangweni Wezokwakheka Kwezinto Eziphilayo ngokubambisana ne-Pediatrics Assam GMCH ukuze kuhlolwe izici zezenhlalo nezenhlalo ze-asthma yezingane ezinganeni ezineminyaka engu-3-12.
Esifundweni sokulawula amacala esingakaze sibonwe ngaphambili, amacala ayi-150 kanye nezilawuli eziyi-150 zakhethwa ngesilinganiso esingu-1:1 ukuze kufundwe izici ezahlukahlukene ze-asthma yezingane. Iziguli ezine-asthma etholakale ukuthi itholakale inesifo sofuba ezineminyaka engu-3 kuya kwengu-12 ezifika emitholampilo yezingane yangaphandle nangaphakathi zakhethwa njengezimo, kuyilapho izilawuli kwakuyiziguli zeqembu elifanayo leminyaka, okungcono ukuthi zihlale ezimweni ezifanayo ngaphandle kwezinkinga zokuphefumula.
Usayizi wesampula unqunywe kusetshenziswa inguqulo ye-WinPepi 11.65. Idatha evela ocwaningweni lokuqala ikhombisa ukuthi ukusabalala kwe-asthma phakathi kwezingane zaseNdiya kusuka ku-1% kuya ku-4%. Ngakho-ke, uma sicabangela ingxenye engu-1% yezingane ezine-asthma kanye nosayizi olinganayo weziguli namaqembu okulawula, ucwaningo ludinga usayizi wesampula ophelele wabantu abangu-274 ukuze kufinyelelwe amandla angu-80% ukuthola umehluko we-4% phakathi kwe-2. . Womabili amaqembu anezinga lokubaluleka elingu-5%.
Ngaphezu kwalokho, uma sicabanga ukuthi cishe u-10% wabantu abangaphenduli ngenxa yokulahlekelwa okulandelayo noma ukunganamatheli, kunengqondo ukudweba isampula yabantu abangu-300 (ehlanganisa amacala angu-150 kanye nezilawuli ezingu-150).
Sebenzisa amafomethi okuqoqwa kwedatha aklanywe futhi ahlolwe kusengaphambili. Imvume ebhaliwe enolwazi yatholakala kubo bonke abanakekeli abasemthethweni babahlanganyeli bocwaningo. Idatha yaqoqwa ngezinhlobo ezahlukene zezenhlalo nezenhlalo. Uhlobo lwendlu luchazwa ngokuthi
Indlu yasePucca, uma izindonga nophahla lwenziwe ngezitini, usimende namatshe; indlu yaseKatcha yenziwe ngokhuni, umhlabathi, utshani namaqabunga omile uma indlu yenziwe ngezindonga zezitini nezindonga ze-adobe enophahla olufulelwe ngotshani noma ngethini kanye nokhonkolo. Uma sekuqediwe, lena yindlu ye-Semipucca. Isimo sezomnotho nezenhlalo sahlolwa kusetshenziswa isikali se-Kuppuswami esiguquliwe (2014).
Indlela yabahlanganyeli yokubeletha, umlando wokuzalwa bephelelwa umoya, uhlobo lokuphakelwa, umlando wokungezwani nokudla, umlando womama wokulutha, umlando womndeni we-asthma, umlando we-atopy noma i-allergy, kanye nomlando womndeni wokubhema noma intuthu ebhemayo nayo yabhalwa phansi. Noma yimaphi amalungu omndeni ahlala endlini efanayo ayebhekwa njengababhemayo emlandweni womndeni. Ngokusho kwe-GINA Epidemiological and Clinical Trial Participant Image Guidelines, ubukhali besifo bahlukaniswa ngokwezinyathelo zokwelapha ezinqunyiwe, kucatshangelwa ukuthi iziguli ezabelwe esigabeni sesi-2 zazine-asthma encane, kanti iziguli ezabelwe esigabeni sesi-3-4 zazine-asthma encane. zazine-asthma ephakathi nendawo futhi zabelwa ukwelashwa kwe-asthma enzima esigabeni sesi-5.
Izindlela zokufaka kanye nokukhipha: Izincwadi zisikisela ukuthi amacala ezingane kufanele afakwe ocwaningweni kuze kube yiminyaka eyi-18 ubudala. Kodwa-ke, kwa-GMCH, iningi lezingane ezidluliselwayo zingaphansi kweminyaka eyi-12. Ngaphezu kwalokho, ukwanda kwesifo sofuba ebuntwaneni kudlule ukwanda kwalesi sifo ngaphambi nangemva kokuthomba. Ngakho-ke, iqembu leminyaka elisukela eminyakeni emi-3 kuya kweyi-12 lakhethwa ocwaningweni. Ocwaningweni kwakuhlanganisa iziguli ezine-asthma ye-bronchial etholakale ukuthi inesifo sofuba emtholampilo ezineminyaka emi-3 kuya kweyi-12 ezivumile ukuhlanganyela ocwaningweni. Izingane ezineminyaka emi-3 kuya kweyi-12 ezivumile ukuhlanganyela ocwaningweni ngaphandle kwesifo sokuphefumula, okungcono ukuhlala ezimweni ezifanayo, zakhethwa njengeqembu lokulawula.
Izingane ezineminyaka engu-0-3 ubudala azizange zifakwe ocwaningweni ngoba ukukhwehlela kwaleli qembu leminyaka kwakunganele ukuxilonga i-asthma. Ngaphezu kwalokho, izingane ezineminyaka efanele kanye nabanakekeli bazo abangazange bavume ukuhlanganyela ocwaningweni azizange zifakwe ocwaningweni.
Ukuhlaziywa kwezibalo. Umehluko ngezilinganiso uhlaziywe kusetshenziswa isivivinyo se-χ. Ukuhlehliswa kwe-binary logistic kwasetshenziswa kumapharamitha okubaluleka ekuhlaziyweni kwe-univariate, kanti isivivinyo sikaWald se-χ 2 sasetshenziswa ukukala umnikelo ozimele wokwelashwa.
Ukugunyazwa Kwezimiso Zokuziphatha: Ngaphambi kokuqoqwa kwedatha, ukugunyazwa kwezimiso zokuziphatha kwatholwa kumaKomidi Ezimiso Zokuziphatha Esikhungo, okungukuthi Amakomiti Ezimiso Zokuziphatha Esikhungo se-GMCH, Guwahati, Assam and India, Ref: No: 233/2018/215.
Kubantu abangu-112,323 ababesegumbini lezingane ngesikhathi socwaningo, abangu-18.88% babeyiziguli zokuphefumula. Phakathi kwezingane ezineminyaka engu-3-12 ubudala, abangu-2.96% babenesifo sofuba. Iningi lamacala esifo sofuba ebuntwaneni lenzeke ekwindla kaSepthemba no-Okthoba (Isithombe 1).
Lolu cwaningo lokulawula amacala luhlanganise izingane ezingu-150 ezine-asthma kanye nezilawuli ezingu-150. Isilinganiso seminyaka (± SD) sabahlanganyeli ocwaningweni sasiyiminyaka engu-8.38 (± 2.69). Ukukhwehlela kanye nokuphelelwa umoya kwakuyizimpawu ezivame kakhulu zezokwelapha kulezi zimo. Iningi lamacala (77.3%) lalinokuhlaselwa yi-asthma ngezikhathi ezithile kanti angu-8.7% kuphela amacala ayeno-asthma obunzima. Ukusabalala kwamacala kwaphawulwa ekwindla (30%). Cishe ku-38% wamacala, izimpawu zabikwa ebusuku (Ithebula 1).
Ngokusho kwabaphendulile, iziphuzo ezibandayo (82.7%), i-ayisikhilimu (71.6%) kanye nokuchayeka othulini (35%) yizinto ezivame ukubangela i-asthma. Cishe u-19.3% wamacala abike ukungabikho esikoleni ngenxa yokugula.
Isilinganiso seminyaka (ukwehluka okujwayelekile) sabahlanganyeli sasiyiminyaka engu-8.34 (2.69). Iningi lamacala laliseqenjini leminyaka engu-7-12 futhi kwakungabesilisa. Abahlanganyeli ocwaningweni babeyiningi lamaHindu futhi bengebona abesizwe.
Izingane nabesilisa abaneminyaka engu-7-12 babenezinga eliphezulu lokutheleleka, yize ukuhlangana kwakungabalulekile ngokwezibalo. Futhi, i-asthma yobuntwana yayihlotshaniswa kakhulu ne-BMI (inani le-p<0.05). Futhi, i-asthma yobuntwana yayihlotshaniswa kakhulu ne-BMI (inani le-p<0.05). Кроме того, детская астма была значительно связана с ИМТ (значение р<0,05). Ngaphezu kwalokho, i-asthma yobuntwana yayihlotshaniswa kakhulu ne-BMI (inani 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). Ngaphezu kwalokho, i-asthma yobuntwana yayihlotshaniswa kakhulu ne-BMI (inani le-p <0.05).Amathuba okuba nesisindo esikhulu (OR = 2.22, 95% CI: 1.17–4.18) kanye nokukhuluphala ngokweqile (OR = 2.72, 95% CI: 1.46–5.09) ayephakeme ngokuphindwe kabili uma kuqhathaniswa nezingane ezinesisindo esijwayelekile. Izingane zasemadolobheni ezihlala emindenini ehlanganyelwe, ezindaweni zokugcina udoti, nasezindlini ezimanzi, ezingenamoya owanele zisengozini enkulu yokuthola lesi sifo. Emakhishini anamathele, izinto ezikhipha intuthu ngaphandle kwe-LPG, izinto zokuxosha omiyane, i-Dhuna, njll., nazo zihlotshaniswa kakhulu ne-asthma yabantwana (inani le-p<0.05). Emakhishini anamathele, izinto ezikhipha intuthu ngaphandle kwe-LPG, izinto zokuxosha omiyane, i-Dhuna, njll., nazo zihlotshaniswa kakhulu ne-asthma yabantwana (inani le-p<0.05). В примыкающих кухнях использование значительно выделяющего дым топлива, кроме сжиженного нефтяного газа, репеллентов от, пеллентов от. д., также связано с детской астмой (значение p<0,05). Emakhishini aseduze, ukusetshenziswa kwezinto ezikhipha intuthu kakhulu ngaphandle kwe-LPG, izinto ezixosha omiyane, i-Dhuna, njll., kuhlotshaniswa ne-asthma yezingane (inani 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 ezikhiqiza intuthu ngaphandle kwe-LPG, imithi yokuxosha omiyane, i-Dhuna, njll. nazo zihlotshaniswa kakhulu ne-asthma yabantwana emakhishini aseduze (inani le-p <0.05).Kwaphawulwa nokuthi izingane ezinezilwane ezifuywayo zazinamathuba aphindwe kasishiyagalombili okuthola i-asthma (Ithebula 2).
Njengoba kuboniswe kuThebula 3, ama-46.7% amacala ayengawemindeni enesimo esiphansi kwezomnotho. Imfundo yomama nayo yayiphansi phakathi kwamacala (inani le-p<0.05). Imfundo yomama nayo yayiphansi phakathi kwamacala (inani le-p<0.05). I-Материнское образование также было ниже среди случаев (значение p<0,05). Imfundo yomama nayo yayiphansi phakathi kwamacala (inani 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）。 I-Матери в этих случаях также были менее образованными (значение p <0,05). Omama kulezi zimo nabo babengafundanga kangako (inani le-p <0.05).
Izingane ezizalwa ngokuhlinzwa (CS) noma ezinye izindlela zokubeletha, kanye nezingane ezinomlando wokuzalwa zinenkinga yokuphelelwa umoya, zisengozini enkulu yokuthola lesi sifo. Ngaphezu kwalokho, izingane ezinceliswe kakhulu/ezixubile zazinamathuba acishe abe mahlanu okuthola lesi sifo kunezingane ezinceliswa ibele (Ithebula 4).
Umlando wokungezwani nokudla kwasebuntwaneni kanye nokuphelelwa amandla kokudla kuye kwahlotshaniswa kakhulu ne-asthma yasebuntwaneni. Futhi, izingane ezivela emindenini enomlando wokungezwani komzimba kanye ne-asthma (inani le-p<0.05) zazivame kakhulu ukuthola lesi sifo. Futhi, izingane ezivela emindenini enomlando wokungezwani komzimba kanye ne-asthma (inani le-p<0.05) zazivame kakhulu ukuthola lesi sifo. Также высокой склонностью к заболеванию отличались дети из семей с анамнезом аллергии и астмы (значение p<0,05). Futhi, izingane ezivela emindenini enomlando wokungezwani komzimba kanye ne-asthma zazinokuthambekela okukhulu kwalesi 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 and астмой в анамнезе (р-значение <0,05) были высоко восприимчивы. Ngaphezu kwalokho, izingane ezivela emindenini enomlando wokungezwani komzimba kanye ne-asthma (inani le-p <0.05) zazisengozini enkulu. Ukubhema okungenamsebenzi kwamanye amalungu omndeni nakho kwandisa cishe izikhathi eziyisishiyagalombili zengozi ye-asthma phakathi kwezingane (inani le-p<0.05). Ukubhema okungenamsebenzi kwamanye amalungu omndeni nakho kwandisa cishe izikhathi eziyisishiyagalombili zengozi ye-asthma phakathi kwezingane (inani 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). Ukubhema ngaphandle kokusebenzisa amanye amalungu omndeni nakho kwandisa ingozi yokuthola i-asthma ezinganeni cishe ngokuphindwe kasishiyagalombili (inani 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 ku-8 раз (p-значение <0,05). Ukubhema ngaphandle kokusebenzisa amanye amalungu omndeni nakho kwandisa ingozi yokuthola i-asthma ezinganeni cishe izikhathi ezingu-8 (inani le-p <0.05).(ithebula 5)
Ukuhlehla okuningi kwe-binary logistic kubonise ukuthi izingane ezindaweni zasemadolobheni, izindawo ezinomswakama, isimo esiphansi sezomnotho, izilwane ezifuywayo, umlando womndeni we-atopy/allergies, umlando womndeni wokubhema/ukubhema ngaphandle kokusebenzisa izidakamizwa, kanye nokudla okuxubile kwakuyizinto ezibalulekile ezibangela i-asthma yezingane (Ithebula 6).
Ithebula 6 Ukuhlaziywa kokuhlehla kwe-logistic okuningi ukuze kuhlolwe izici ezibalulekile ezithonya i-asthma yengane
Eminyakeni engamashumi amabili kuya kwamashumi amathathu edlule, inani lezifo ezibangelwa yi-atopic liye landa, okubangela ingxoxo enkulu mayelana noshintsho lwemvelo, ukungcola, kanye nezimpendulo zomzimba ezifweni ezithathelwanayo. Kokubili ukuchayeka emvelweni kanye nobuthakathaka bezinto eziphilayo kanye nobezakhi zofuzo kudlala indima ekuthuthukisweni kwesifo sofuba.
Kulolu cwaningo, iziguli ezingu-2.96% eqenjini leminyaka engu-3 kuya kwengu-12 zibike ukuthi zine-asthma yobuntwana. Kodwa-ke, ezinye izifundo zangaphambilini zibike izinhlobo ezahlukene ze-asthma yobuntwana ezinganeni zaseNdiya. 6,10-12 Umehluko wezindawo kanye nemvelo eNdiya uthonya futhi uthinta ngqo izici eziyingozi ezihlobene nokwanda kwe-asthma. 6 Ngakho-ke, ukuze kuvinjelwe lesi sifo ngendlela efanele nangesikhathi, kudingeka ukuhlolwa kwesifunda kwezici eziyinhloko ze-asthma yobuntwana.
Izingane ezineminyaka engu-7-12 ubudala, amadoda nezingane ezihlala ezindaweni zasemadolobheni zisengozini enkulu yokuba ne-asthma ebuntwaneni. Ukudlondlobala kwasemadolobheni nakwabesilisa ekwandeni kwe-asthma kwabonwa ocwaningweni olwenziwe eNdiya,10 olufana nokutholakele kwethu. Kodwa-ke, lokhu kuhlangana kwakubaluleke kakhulu ngokwezibalo kuphela uma kubhekwa indawo yasekhaya.
Izifundo zikhombisile ukuthi izinguquko zamahomoni eziphathelene nobulili zingathinta i-asthma, njengoba abafana benamathuba amaningi okuthola i-asthma ngesikhathi sobuntwana. Kodwa-ke, lesi sithombe siyashintsha ngemva kokuthomba, futhi abesifazane bahlakulela lesi sifo kaningi kunabesilisa. 13-15 Ngaphezu kwalokho, abafana abangaphansi kweminyaka eyi-10 banezindlela zokuphefumula ezincane kunamantombazane aneminyaka efanayo, futhi ukuphakama nakho kucatshangwa ukuthi kuyimbangela ye-asthma yasebuntwaneni kubafana. 16.17
I-Metro Kamstrup, inhloko-dolobha yase-Assam, ibonise ukwanda okusheshayo emadolobheni eminyakeni yamuva nje. Izifundo eziningi zibika ukuthi ukufudukela emadolobheni kuyisici esithonya ukwanda kwesifo sofuba, okuhambisana nocwaningo lwethu. 18,19 Kulesi sifundo samanje, ukuhlehla kwe-logistic okungalungisiwe kubonise ukuthi izingane ezikhuluphele kakhulu nezikhuluphele kakhulu zazinamathuba angaphezu kwaphindwe kabili okuthola isifo sofuba kunezingane ezine-BMI evamile, okuhambisana nokubuyekezwa kwamuva nje. 20 Ngaphezu kwalokho, isimo esiphansi sezomnotho nezenhlalo siyisici esingaba yingozi yesifo sofuba ebuntwaneni. Izingane ezivela emindenini enesimo esiphansi sezomnotho nezenhlalo zisengozini enkulu yokuthola isifo sofuba ngenxa yokusabela okuphansi komzimba kanye nezinsizakusebenza zokunakekelwa kwempilo eziphansi. 21-23
Izingane ezihlala emndenini ohlangene, izindlu ze-kaccha, izindlu ezimanzi, umoya onganele, amakhishi anamathele, uphethiloli okhipha intuthu, imithi yokuxosha omiyane kanye ne-Dhuna, njll., zazihlotshaniswa kakhulu ne-asthma yezingane (inani le-p<0.05). Izingane ezihlala emndenini ohlangene, izindlu ze-kaccha, izindlu ezimanzi, umoya onganele, amakhishi anamathele, uphethiloli okhipha intuthu, imithi yokuxosha omiyane kanye ne-Dhuna, njll., zazihlotshaniswa kakhulu ne-asthma yezingane (inani le-p<0.05).Izingane ezihlala emndenini ohlangene, ezibaleka ekhaya, izindlu ezimanzi, umoya onganele, amakhishi anamathele, uphethiloli okhipha intuthu, imithi yokuxosha omiyane kanye ne-Dhuna njll.д., были достоверно связаны с детской астмой (значение р<0,05). e., zazihlotshaniswa kakhulu ne-asthma yobuntwana (inani 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）。 Izingane ezihlala emakhaya ahlanganyelwe, ezindlini ze-kaccha, ezindlini ezimanzi, umoya onganele, ikhishi elixhunywe, uphethiloli okhiqiza intuthu, imithi yokuxosha omiyane, kanye ne-Dhuna zihlobene kakhulu ne-asthma yezingane (inani le-p<0.05). Дети в общих домохозяйствах, домах качча, сырых жилищах, неадекватной вентиляции, пристроенных кухнях, задымленном, задымленном комаров and Дхуна были в значительной степени связаны с детской астмой (значение p <0,05). Izingane ezihlala emakhaya ahlanganyelwe, izindlu ezisebenza ngogesi, izindlu ezimanzi, umoya onganele, amakhishi afakwe kahle, uphethiloli obhemayo, imithi yokuxosha omiyane kanye ne-dhuna zihlotshaniswa kakhulu ne-asthma yezingane (inani le-p < 0.05).Ucwaningo lwangaphambilini luphinde lwabonisa ukuthi izici ezahlukahlukene zemvelo zangaphakathi zingabangela i-asthma ezinganeni. 24-27 Ukuxhumana kwezinto ezibangela ukungezwani kwezilwane ezifuywayo zangaphakathi ne-asthma yasebuntwaneni kuyimpikiswano, njengoba bambalwa abacwaningi abakholelwa ukuthi ukutholakala kusenesikhathi kunezinto ezibangela ukungezwani kungase kube nomthelela ekuthuthukisweni kokubekezelelana. 28
Izifundo eziningi zikhombisile ukuthi izingane ezizalwa ngokuhlinzwa zisengozini enkulu yokuthola i-asthma yobuntwana uma kuqhathaniswa nokuzalwa okuvamile. Lokhu kuhambisana nokutholakele kwethu. 29-32 Izingane ezinomlando wokuzalwa zinenkinga yokuphefumula nazo zisengozini enkulu yokuthola i-asthma. I-asthma yomama inegalelo elibalulekile ezinkingeni zokukhulelwa ezifana ne-respiratory distress syndrome kanye ne-neonatal asphyxia. 33
Njengakwezinye izifundo, okutholakele kwamanje kubonisa ukuthi umlando wobuntwana wokungezwani nokudla noma i-atopy noma umlando womndeni wokungezwani nokudla kanye ne-asthma wandisa kakhulu ingozi ye-asthma yobuntwana. 34,35 Ngokuhambisana nocwaningo lwethu, izifundo zangaphambilini zezizukulwane eziningi zikhombisile ukuthi imikhuba yokubhema yezizukulwane ezahlukene ingaholela ekushintsheni kwezakhi zofuzo ku-epigenome okwandisa ingozi ye-asthma kubantwana. 36
Ezinsukwini zamuva nje, ukusabalala okusheshayo kwasemadolobheni kuthinte yonke imikhakha yomphakathi. Ngenxa yemithombo ehlukene yemali engenayo kanye nemisebenzi, abantu bakhetha ukuhlala emadolobheni futhi ngaleyo ndlela bavezwa ukungcola okuhlukahlukene kwemvelo. Amalungu omndeni wezingane ezisengozini ayelulekwa ukuba anake kakhulu ukugwema umswakama, ukubhema, ukugcina izilwane ezifuywayo emndenini one-allergy/allergy, kanye nokugwema i-allergy/izimbangela ze-allergy ezinganeni ezinomlando womndeni we-allergy/allergy. Kufanele kube nokwaziswa okwengeziwe ngokuncelisa ibele kuphela ngenxa yezinzuzo zokuncelisa ekuvimbeleni i-asthma.
Iningi leziguli eziza eGuwahati Medical College zivela kulo lonke elaseNyakatho-mpumalanga yeNdiya njengoba iGuwahati Medical College iyisikhungo sochwepheshe esihamba phambili esifundeni. Iningi leziguli lalinesimo esiphansi kwezomnotho kanye nezinga eliphansi lemfundo. I-asthma ye-bronchial ezinganeni iyinkinga evamile emnyangweni wezingane esibhedlela sethu. Amasu okuvimbela afanele alezi ziguli ezisengozini enkulu azosiza ekunciphiseni ukugula futhi anciphise ukuvama kokubhebhetheka.
Naphezu kwazo zonke izindlela zokwelapha i-asthma ezitholakalayo, iziguli eziningi azilawulwa kahle, kodwa ukuhlonza iziguli ezithile, okuhlanganisa izinhlobo ze-phenotypes kanye nezinhlobo ze-endotypes, kungenza ngcono ukuphathwa kwazo. Ngakho-ke, izifundo zesifunda zokusabalala kwe-asthma ebuntwaneni kanye nezici eziyingozi zizosiza ekuphathweni okuphumelelayo kwalezi zimo.
Kulolu cwaningo, ezinye iziguli azibuyanga ukuze ziyohlolwa futhi zilandelwe. Lokhu kungenzeka ukuthi kungenxa yokungazi ngezimbangela nemiphumela yalesi sifo. Ngenxa yezinhlelo zokuxhumana ezingezinhle, asikwazanga ukulandelela zonke iziguli.
Izingane zisengozini yokuthola i-asthma yendawo, futhi ukuqonda kahle izinto ezibangela i-asthma yendawo kanye nezinto ezibangela i-allergen kungasiza ekulawuleni nasekunciphiseni umthwalo wesifo. Emindenini enomlando we-allergies noma i-asthma, kufanele kuthathwe ukunakekelwa okufanele ukuze kuvikelwe izingane ezisengozini ezintweni ezingadala i-asthma.
Yonke imininingwane igcinwe iyimfihlo futhi ucwaningo lwenziwa ngokuhambisana neSimemezelo saseHelsinki.
Siyabonga kubo bonke odokotela bezingane abasizile ekuqoqeni idatha nokuhlola okuqukethwe kolwazi lwabo. Bonke ozakwethu bomnyango abasisizile ukufinyelela emitatsheni yezincwadi yomnyango kanye nendawo ezungezile ngesikhathi socwaningo nabo banconywa.
Bonke ababhali benze iminikelo ebalulekile emsebenzini wombiko, kungaba ngokomqondo, ukwakheka kocwaningo, ukwenziwa, ukuqoqwa kwedatha, ukuhlaziywa kanye nokuchazwa, noma zonke lezi zindawo; bahlanganyele ekubhalweni, ekubuyekezweni noma ekubuyekezweni okubucayi kwalesi sihloko. Qedela inguqulo yokushicilelwa, vumelana ngejenali okuzothunyelwa kuyo lesi sihloko, futhi uvume ukuba nesibopho sazo zonke izici zomsebenzi.
1. Isu lomhlaba wonke lokwelapha nokuvimbela i-asthma. I-Global Asthma Initiative. 2018. Itholakala ku: https://ginastma.org/wp-content/uploads/2019/01/2018-GINA.pdf. Kusukela ngomhlaka-2 Disemba 2021