Questionnaire-based survey of allergic diseases among children aged 0 - 14 years in the downtown of Beijing, Chongqing and Guangzhou / 中华儿科杂志

<p><b>OBJECTIVE</b>In recent years, the incidence of allergic diseases in China is increasing. With serious influence on the patients' quality of life and even life-threatening, now allergic diseases have become an important public health problem in our country. This survey aimed to obtain a general epidemic outline of children's major allergic diseases, i.e., childhood asthma, allergic rhinitis and eczema in the downtown of Beijing, Chongqing and Guangzhou.</p><p><b>METHOD</b>Childhood asthma questionnaire was established by Delphi method based on guidelines for childhood asthma diagnosis and prevention made by Chinese medical association in 2008 with reference to the International Study of Asthma and Allergies in Childhood questionnaire (ISAAC). This study was carried out from Oct. 2008-Mar. 2009, in Beijing, Chongqing and Guangzhou by a multi-stage sampling method, covering a sample of 24 290 children aged 0 - 14 years by a multi-stage sampling method, the population of children surveyed in the downtown of Beijing Chongqing and Guangzhou was 10 372, 9874 and 4072 respectively; of whom males were 5545, 5258, 2159, and females were 4917, 4588, 1877; the ratio of males to females in the three cities were 1.11:1, 1.15:1, 1.15:1; the average age of surveyed children were 7.63, 8.74 and 8.30 years old. All the questionnaire was filled in by the parents of children or other guardian of children.</p><p><b>RESULT</b>The self-reported prevalence of asthma in Beijing, Chongqing and Guangzhou was 3.15%, 7.45%, 2.09%, the self-reported prevalence of allergic rhinitis was 14.46%, 20.42%, 7.83%, and the prevalence of eczema was 20.64%, 10.02%, 7.22%. In the survey, asthma combined with allergic rhinitis had the highest rate, 49.54%, 50.14%, 34.83%, respectively in the 3 cities. The self-reported prevalence of asthma and allergic rhinitis was significantly higher in male than female. Besides, the self-reported prevalences of asthma and allergic rhinitis were relatively lower in children under 1 year and over 10 years of age.</p><p><b>CONCLUSION</b>The prevalence of asthma, allergic rhinitis and eczema and other allergic diseases in children 0 - 14 years of age in the three cities gradually increased, and the prevalence of allergic diseases in Chongqing was relatively higher.</p>

Current trends of the prevalence of childhood asthma in three Chinese cities: a multicenter epidemiological survey / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To analyze the prevalence of asthma and asthma related symptoms among children aged 0-14 years in three Chinese cities and to obtain a crude estimation of the trend of childhood asthma prevalence in China.</p><p><b>METHODS</b>A cross-sectional, population-based survey of prevalence of asthma was conducted in children aged from 0 to 14 years in 3 major cities of China (Beijing, Chongqing, and Guangzhou) with different geographic locations. All the subjects were randomly selected by a multi-stage sampling method. Three to five schools and kindergartens in 2 urban districts in each city were randomly selected for the survey, and a validated questionnaire that included the core questions of the International Study of Asthma and Allergies in Childhood, Phase III questionnaire and several additional questions were used. All questionnaires were completed by parents or guardians of the selected children. Children whose parents responded affirmatively to the question "Has your child ever been diagnosed as asthma by a doctor" were recognized as victims of asthma.</p><p><b>RESULTS</b>The prevalence of asthma in Beijing, Chongqing, and Guangzhou was 3.15%, 7.45%, and 2.09%, respectively. These values were significantly higher than those obtained 10 years ago in the national epidemiological survey in 2000 which used the same method of investigation and the same diagnotic criteria (χ²=3.938, P=0.047; χ²=73.506, P≤0.001; χ²=11.956, P=0.001, in each city). Of the asthmatic children 57.21%, 69.91%, and 60.00% had their first attack before the age of 3 in Beijing, Chongqing, and Guangzhou, respectively. Wheezing was the primary clinical manifestation for all asthmatic children, followed by persistent cough and repeated respiratory infections. Both the prevalence of asthma and asthma-related symptoms were statistically higher in males than in females.</p><p><b>CONCLUSION</b>The prevalence of childhood asthma is statistically higher than that 10 years ago in the three Chinese cities.</p>

Simultaneous treatment of asthma and allergic rhinitis in children with a nasally inhaled glucocorticosteroid / 中华儿科杂志

<p><b>OBJECTIVE</b>To assess the efficacy of a nasally inhaled corticosteroid (ICS) through a spacer with mask aiming at simultaneous treatment of allergic rhinitis and asthma in children and make an analysis on the costs.</p><p><b>METHOD</b>A total of 72 children with allergic rhinitis (AR) and asthma were randomized into two groups. Experimental group received budesonide inhaler (400 microg/d) through the nose using a spacer attached to a face mask, control group children orally inhaled budesonide dry powder (400 microg/d) plus a nasal spray of budesonide aquae (256 microg/d).</p><p><b>RESULT</b>The patients were observed for 12 weeks. The symptom scores of rhinitis of both experimental group and control group declined (F=6.529 and 7.014, all P<0.01), symptom scores of asthma in both group were also reduced (F=4.132 and 4.950, P<0.01). The pulmonary function PEF (L/min) in both groups continuously increased (F=2.750 and 3.282, P<0.05). But the clinical scores, PEF value and FEV1 all did not differ between the two groups at admission or at nearly all follow-up visits (P>0.05 for all). The proportion of dry nose was lower in experimental group than in the control group (5.6% vs. 19.4%), but the difference was not statistically significant. The cost in the experimental group was lower than that in the control group (P<0.01).</p><p><b>CONCLUSION</b>Nasal inhalation of ICS provides a therapeutic strategy for controlling AR and asthma in children, especially it result in higher compliance, lower costs, and fewer side effects.</p>

Relationship between the efficacy of inhaled corticosteroids and the leukotriene expression in children with asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the relationship between leukotriene expression in blood polymorphonuclear leukocytes (PMNL) and the efficacy of inhaled corticosteroids (ICS) in children with asthma.</p><p><b>METHODS</b>Thirty-two children with asthma (5-12 years) and ten healthy children (control group) were enrolled. The asthmatic children were subdivided into ICS well-controlled and ICS poorly-controlled groups based on their clinical symptoms and lung function. The level of leukotriene C4 synthase (LTC4S) mRNA in PMNL was detected by fluorescence quantitative polymerase chain reaction. The level of LTC4S mRNA was expressed by the value of qCt, and the value of qCt was diversely correlated with the level of LTC4S mRNA expression. The concentration of urinary leukotriene E4 (LTE4) was measured using ELISA.</p><p><b>RESULTS</b>The expression of LTC4S mRNA in PMNL was significantly higher in children with asthma (qCt: 1.12+/-0.27) than that in the control group (qCt: 1.42+/-0.12; P< 0.05). The expression of LTC4S mRNA in PMNL in the ICS poorly-controlled group (qCt: 1.03+/-0.17) was significantly higher than that in the ICS well-controlled group (qCt: 1.24+/-0.33; P< 0.05) and the control group(1.42+/-0.12; P< 0.01). There was no significant difference in the level of urinary LTE4 among the the ICS poorly-controlled, the ICS well-controlled and the control groups.</p><p><b>CONCLUSIONS</b>LTC4S mRNA expression in PMNL in asthmatic children increases, and the LTC4S mRNA expression in the ICS poorly-controlled group is higher than that in the ICS well-controlled group. This suggests that an increased leukotriene expression might be associated with poorly-controlled asthma.</p>

Therapeutic efficacy and follow-up study of inhaled corticosteroids vs. oral montelukast in treatment of cough variant asthma / 中华儿科杂志

<p><b>OBJECTIVE</b>To compare the effects of inhaled corticosteroids (ICS) and oral leukotriene modifier (LTM) montelukast on the prognosis of children with cough variant asthma (CVA), and to identify the related risk factors for the development of classic asthma in children with CVA.</p><p><b>METHODS</b>Eighty-four children with CVA (2 - 6 yrs) were randomized to receive inhaled beclomethasone dipropionate 200 microg/d through pressurized metered-dose inhaler (MDI) plus spacer with mask or oral montelukast 5 mg, once at bedtime for 6 months, then followed by 18 months observation period after the end of the study medication.</p><p><b>RESULTS</b>There was no significant difference in antitussive days between the two groups (ICS group: 14 +/- 9 days, LTM group: 13 +/- 9 days, Z = 1.12, P = 0.25). Wheezing developed in 7.1% of the children in ICS group during 24 months follow-up period, which was significantly lower than that in LTM group (33.3%, chi2 = 8.92, P = 0.003). The prevalence of eczema or allergic rhinitis was higher in children who developed wheezing than those who did not develop wheezing (eczema: 47.1% vs. 19.4%, chi(2) = 4.16, P = 0.042; allergic rhinitis: 58.8% vs. 31.3%, chi2 = 4.40, P = 0.036). Logistic regression analysis confirmed that eczema and allergic rhinitis were risk factors for wheezing development in children with CVA, the odds ratio was 7.668 and 3.855 respectively (P < 0.05 for all). But administration of ICS was negatively correlated with the development of wheezing by an odds ratio of 0.128 (P = 0.008).</p><p><b>CONCLUSIONS</b>Children with CVA may progress to classic asthma; eczema and allergic rhinitis are two risk factors for wheezing development in children with CVA. Both ICS and LTM are effective antitussive treatment, but ICS may be more effective than LTM on preventing the progression of CVA to classic asthma.</p>