Wyniki wyszukiwania - Biblioteka Nauki

1

Środowiskowe uwarunkowania niedodiagnozowania astmy wieku dziecięcego

100%

Smółka I. , Zejda J. E.

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tom 64

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nr 3-4

71-75

EN

Underdiagnosis of childhood asthma is a well known problem in many countries. In Poland the estimated occurrence of this problem reaches 50% and is similar to fi ndings published in foreign literature. The causes of the problem are not unequivocally recognized and are addressed by few authors. Among potential causes there are circumstances related to organization and practice of pediatric health care, including application of standard diagnostic criteria of asthma, availability of diagnostic tests, nozologic preferences, etc. Another category of circumstances in charge of underdiagnosis of childhood asthma stems from environmental infl uences, including family-related factors. Findings published in foreign literature show that underdiagnosis is more frequent in children of low socio-economic status, in rural setting or in families burdened by stress. Evidence however is far from being complete. There is a lack of Polish data on the subject and it remains unknown to what extent underdiagnosis of childhood asthma in this country is related to the above mentioned factors. Scientifi c investigation into the problem is necessary for a number of reasons and justifi es implementation of subject-oriented epidemiological studies. Identifi cation of factors associated with an increased probability of underdiagnosis of childhood asthma should facilitate planning of proper preventive measures, above all involving screening programs addressed to selected groups of population.

PL

Niedodiagnozowanie astmy oskrzelowej u dzieci jest dobrze znanym problemem w wielu krajach. W Polsce oszacowana częstość tego problemu sięga 50% i jest podobna do danych cytowanych w zagranicznej literaturze. Przyczyny tego zjawiska nie są jednoznacznie ustalone i podejmowane przez niewielu autorów. Wśród potencjalnych przyczyn można wymienić okoliczności związane z organizacją i praktyką pediatrycznej ochrony zdrowia, w tym niekompletne rozpowszechnienie kryteriów diagnostycznych astmy, ograniczoną dostępność testów diagnostycznych, preferencje nozologiczne, itp. Drugą grupę okoliczności potencjalnie odpowiedzialnych za niedodiagnozowanie astmy u dzieci stanowią uwarunkowania środowiskowe, zwłaszcza czynniki rodzinne. Opublikowane w czasopismach zagranicznych dane wykazują, że niedodiagnozowanie astmy wieku dziecięcego jest częstsze w rodzinach odznaczających się niskim poziomem społeczno-ekonomicznym, w rodzinach mieszkających na wsi lub dotkniętych obecnością sytuacji stresowych. Informacje nie są kompletne. Brak jest krajowych danych na ten temat i nie wiadomo, w jakim stopniu za niedodiagnozowanie astmy u dzieci odpowiedzialne są wymienione okoliczności. Naukowe rozpoznanie tego problemu jest wskazane z wielu względów i uzasadnia wdrożenie stosownych badań epidemiologicznych. Identyfi kacja okoliczności zwiększających prawdopodobieństwo niedodiagnozowania astmy wieku dziecięcego powinna ułatwić racjonalne planowanie działań profi laktycznych, przede wszystkim poprzez adresowane do wybranych grup populacyjnych programy badań przesiewowych tej choroby.

2

Effect of residential proximity to traffic on respiratory disorders in school children in upper Silesian Industrial Zone, Poland

80%

Skrzypek M. , Zejda J. E. , Kowalska M. , Czech E. M.

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nr 1

83-91

EN

Objective: A number of studies show an association between traffi c-related air pollution and adverse respiratory health effects in children. However, most evidence relates to the regions with low or moderate levels of ambient air pollution. The study was undertaken to assess the impact of traffi c-related air pollution on respiratory health status in children living in the area of high levels of industrial and municipal ambient air pollution. Materials and Methods: Analyses involved data obtained from cross-sectional study on respiratory health in children (N = 5733), conducted between 2003–2004 in Bytom, one of the largest cities of Silesian Metropolis (Poland). Exposure to traffic-related air pollution was assessed by means of geographic information system and expressed as several measures of potential exposure to traffic-related air pollution, involving residential distance to major road and traffic density in the residential area. Logistic regression was used to examin association between reported respiratory health and traffic measures. Results: Statistically signifi cant association was found between doctor-diagnosed asthma and residential proximity to traffic. Results of multivariate logistic regression (logOR; 95%CI) confi rmed the effect of living in an area of a city with high-traffic-density on childhood asthma: 1.60 (1.07–2.39). Similar effects were found in case of allergic rhinitis and rhinitis symptoms, but the observed associations were not statistically signifi cant. Conclusion: The study fi ndings suggest that even in an area with poor regional ambient air quality, adverse respiratory health outcomes are more frequent in children living in a proximity to the high vehicle traffic flow

3

Underdiagnosis of childhood asthma: A comparison of survey estimates to clinical evaluation

80%

Brożek G. M. , Farnik M. , Lawson J. , Zejda J. E.

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nr 6

900-909

EN

Objectives: Diagnostic patterns play a role in asthma prevalence estimates and could have implications for disease management. We sought to determine the extent to which questionnaire-derived estimates of childhood asthma reflect the disease's true occurrence. Materials and Methods: Children aged 6-12 years from Katowice, Poland, were recruited from a crosssectional survey (N = 1822) via primary schools. Students were categorized into three mutually exclusive groups based on survey responses: "Asthma" (previously diagnosed asthma); "Respiratory symptoms" (no previous diagnosis of asthma and one or more respiratory symptoms during last year), "No respiratory symptoms" (no previous diagnosis of asthma or respiratory symptoms). A sample of children from each group (total N = 456) completed clinical testing to determine asthma presence according to GINA recommendations. Results: Based on the survey, 5.4% of children were classified with asthma, 27.9% with respiratory symptoms, and 66.7% with no respiratory symptoms or asthma. All previously known 41 cases of asthma were confirmed. New diagnoses of asthma were made in 21 (10.9%) and 8 (3.6%) of subjects from the "Respiratory symptoms" (N = 192) and "No respiratory symptoms" (N = 223) groups, respectively. The overall prevalence of childhood asthma, incorporating the results of clinical examination, was 10.8% (95% CI: 9.4-12.2), compared to the questionnaire-derived figure of 5.4% (95% CI: 4.4-6.5%) and affected females more than males. Conclusions: Asthma prevalence was underestimated in this population possibly resulting from under-presentation or under-diagnosis. This could have potential implications for proper management and well-being of children. Questionnaire estimates of prevalence should be considered carefully in the context of regional diagnostic patterns.