Ten years comparison of diagnosis and treatment of asthma in urban children in China / 中华儿科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To compare the changes of diagnosis, treatment and control of 0-14 years old urban asthma children during 10 years.</p><p><b>METHOD</b>The questionnaires were given to diagnosed asthmatic children during the national epidemiological survey of asthma in children in 2000 and 2010 to understand the diagnosis and treatment of asthma and the status of the disease control. Children with asthma of a total of 36 cities were involved in this study, and the diagnosed asthma children in recent 2 years were 6,128 and 8 174, separately. Data were stored using epi-info software by double entry, V19.0 of SPSS was used to do the statistical analysis , χ(2) test was used.</p><p><b>RESULT</b>The proportion of correct diagnosis of asthma before investigation in 2010 was 64.6%, while it was 70.7% in 2010, which showed a significant increase (χ(2) = 59.3, P < 0.01). Diagnosis rate of asthma onset within 1 year was separately 50.8% and 78.6% in 2000 and 2010. The early diagnostic rate was significantly higher in 2010 than that in 2000 (χ(2) = 817.7, P < 0.01). In 2000 and 2010 children with asthma medication in the use of inhaled corticosteroids was 36.3% and 61.7%, it increased by 0.7 times in 2010 (χ(2) = 907.5, P < 0.01). Systemic corticosteroids utilization rate was separately 74.2% and 39.1% (χ(2) = 1 730.6, P < 0.01). Beta 2 agonists utilization rate was separately 71.8% and 73.4%, showing a slight rise (χ(2) = 4.3, P < 0.05). Antibiotics usage was separately 97.4% and 76.0%, compared to a decrease of 21.4% (χ(2) = 1 274.2, P < 0.01). In the survey of 2000 and 2010, children with acute asthma attacks within recent 1 year were separately 86.3% and 77.0% (χ(2) = 194.0, P<0.01), hospitalizations for asthma attack were separately 54.0% and 47.3% (χ(2) = 61.7, P < 0.01), rate of absence from school due to asthma less than 10 days was separately 47.5% and 71.4% (χ(2) = 682.6, P < 0.01).</p><p><b>CONCLUSION</b>The rates of correct diagnosis and early diagnosis of asthma in urban Chinese children within 1 year had a significant increase compared with a decade ago. Inhaled corticosteroids therapy had increased by 0.7 times than before while systemic corticosteroids utilization rate significantly decreased. Antibiotics usage had a decrease of 22.0% but they were still overused. Asthma control was significantly improved, but acute exacerbations and hospitalizations of asthma children still accounts for a large proportion although they both had a great improvement.</p>