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Himamoni Deka, 1 Putul Mahanta, 2 Sultana Jesmin Ahmed, 3 Madhab Ch Rajbangshi, 4 Ranjumoni Konwar, 5 Bharati Basumatari51 Ishami rya Anatomy, Ishuri Rikuru ry’Ubuvuzi rya Guwahati, Assam, Ubuhinde, 2 Dib, Assam, Ishami ry’ubuvuzi bw’ubucamanza n’uburozi, Assam Medical College, Rugar;Ishami ry'ubuvuzi rusange, Ishuri Rikuru ry'Ubuvuzi rya Assam, Dibrugarh, Assam, Ubuhinde;4 Tezpur College of Medicine and Surgery Hospital, Tezpur, Assam, Ubuhinde;Ishami rya Radiologiya, Fakhruddin Ali Ahmed Medical College n’ibitaro, Barpeta, Assam, mu Buhinde Umwanditsi wandikiraga: Putul Mahanta, ishami ry’ubuvuzi bw’ubucamanza n’uburozi, Ishuri rikuru ry’ubuvuzi n’ibitaro, Dibrugarh, Assam, 786002, Ubuhinde, tel.+919435017802, imeri [imeri irinzwe] inzitizi yumuyaga.Ibintu byombi bikomoka ku bidukikije no ku bidukikije bigira uruhare runini kuri asima.Icyari kigamijwe muri ubu bushakashatsi kwari ugusuzuma ibintu bitandukanye by’imibereho-demokarasi n’ibidukikije bigira ingaruka kuri etiologiya ya asima yo mu bwana ku barwayi berekana ishami ry’abana ry’ishuri rikuru ry’ubuvuzi rya Gauhati n’ibitaro (GMCH) muri Assam.Ibikoresho nuburyo.Abarwayi 150 barwaye asima basuzumwe n’amavuriro batoranijwe ku kigereranyo cya 1: 1 hagati y’abantu bafite imyaka 3-12 n’abarwayi bo mu kigero kimwe badafite uburwayi bw’ubuhumekero ndetse n’amateka ya asima nk'ubugenzuzi.Amakuru yakusanyijwe hifashishijwe uburyo bwateguwe kandi bwabanje kugeragezwa, kandi uruhushya rwanditse rwabimenyeshejwe rwabonetse kubashinzwe amategeko bose bitabiriye amahugurwa.Amakuru yasesenguwe na chi-kare yikizamini hamwe na binary logistic regression ukoresheje SPSS V20 yahinduwe kuri p-gaciro.Ibisubizo: Abana bo mumijyi nabagabo wasangaga bafite ibyago byinshi byo kurwara asima.Abana bo mu mijyi (OR = 4, 53; 95% CI: 1.57-13.09; ppppppp Umwanzuro: Abana bakunze kwibasirwa na asima iterwa n’ibidukikije Kumenyekanisha no gukumira indwara birakenewe mu kugenzura no kugabanya umutwaro wa asima mu bana Amagambo y'ingenzi: asima, ibintu bidukikije, abana, allergie, atopic
Indwara ya asima n'indwara idakira y'ibihaha irangwa no guhagarika inzira ihumeka iterwa no gutwika umwuka uhumeka mu bihaha no kwikuramo imitsi.Amabwiriza aheruka gutangwa na Global Initiative kuri Asima (GINA) asobanura asima nk "indwara itavukanye akenshi irangwa no gutwika indwara zidakira".Ibimenyetso byubuhumekero nko gutontoma, guhumeka neza, kwifata mu gatuza no gukorora, kimwe no guhindagurika kw’imitsi, ni ibimenyetso bya asima.imwe
Ku bantu barwaye asima, ibimenyetso bikomeye birashobora kugaragara bitewe nimpamvu zitandukanye, nk'itabi nubundi bwoko bwitabi, ifu, amabyi, umukungugu, dander yinyamaswa, imyitozo ngororamubiri, umwuka ukonje, ibikomoka mu rugo ninganda, kwanduza ikirere, no kwandura.2 Ihuriro ryibintu bikomoka ku bidukikije no ku bidukikije bisobanura indwara ya asima mu baturage bamwe.Akenshi, ibyo bindi bintu bishobora kugira uruhare mubitandukaniro, ubwoko cyangwa ubwoko nibyo bintu byoroshye kumenyekana hagati yitsinda ryabantu.3
Gupima asima ni ivuriro kuko nta bisobanuro bisanzwe byerekana ubwoko, ubukana, cyangwa inshuro y'ibimenyetso.Asima ya Bronchial nindwara isanzwe itera umutwaro munini mubikorwa rusange byubuvuzi no mubitaro.4 Nubwo gusuzuma asima mubana ndetse nabakuze bifite byinshi bisa, kwisuzumisha bitandukanye, inzira karemano yo kuzunguruka, ubushobozi bwo gutanga imiti yihariye, nagaciro kayo ko kwisuzumisha biterwa nimyaka.
Kw'isi yose, abantu barenga miliyoni 300 barwaye asima.Mu bana, asima iri mu ndwara 20 zambere zidakira mu myaka y’ubuzima bwahinduwe n’ubumuga ku isi, aho impfu zingana na 0.0-0.7 ku bantu 100.000.5.Indwara ya asima mu Buhinde yavuzwe ko iri hagati ya 2% na 23%, bikaba bishoboka ko biterwa n’igihugu kinini cy’imiterere n’ibidukikije.6 Mu bushakashatsi buherutse gukorwa, wasangaga iyi mibare ari 10.4% muri Assam.7
Asima mu bana itera ibimenyetso byubuhumekero bigaruka nko guhina, gukorora, guhumeka cyane, no gukomera mu gatuza, iyo bidakozwe neza, bishobora gutera asima idakira.Asima yo mu bwana irashobora kwangiza cyane imibereho yabana barwaye mukwongera kudahari no kugabanya uruhare rugaragara mubikorwa.
Nubwo hari ubumenyi buhanitse hamwe n’ingamba zo kuvura, habaye ubwiyongere bukabije bw’ubwiyongere, indwara n’impfu za asima ku bana mu myaka yashize8,9, kandi birakenewe ko dusobanukirwa n’indwara ya asima kugira ngo bivure neza asima.Mugihe ubushakashatsi bwinshi burimo gukorwa mubice bitandukanye byu Buhinde, bike cyane byakozwe muri kariya karere kataratera imbere mu majyaruguru yuburasirazuba bwu Buhinde.
Ubu bushakashatsi bwakorewe muri leta y’amajyaruguru y’amajyaruguru ya Assam, mu Buhinde.Abaturage ba Assam bagizwe n'amoko atandukanye, muri bo 12.45% ni abo mu moko nka Bodo, Khachari, Karbi, Miri, Mishimi, Rabah, n'ibindi. Icyaro gikwirakwijwe mu turere twinshi two mu karere.Leta izwiho ibinyabuzima bitandukanye.Ubuhinzi, cyane cyane umuceri, icyayi na pulses, bingana na kimwe cya gatatu cy’amafaranga yinjira muri Assam kandi akoresha abakozi bagera kuri 69 ku ijana.Leta itanga 50% by'icyayi cy'Ubuhinde.Ibindi bigo byunguka byunguka harimo ubworozi bwingurube, ubworozi bwamata nuburobyi byitabiriwe nabaturage bo mucyaro.Ubuhinzi, icyayi, peteroli na gaze, amakara na hekeste ninganda nyamukuru.Itandukaniro rinini ry’amoko n’akarere muri leta ahanini biterwa ningaruka zitandukanye hamwe nindwara zindwara.
GMCH nicyo kigo kiyobora kaminuza nkuru mu karere, kivura abarwayi baturutse mu majyaruguru y'uburasirazuba bw'Ubuhinde, harimo abatuye mu cyaro ndetse no mu mijyi.Benshi mu barwayi bari bafite imibereho mike mu bukungu no mu rwego rwo hasi rw'uburezi.Asima ya Bronchial mubana nikibazo gikunze kugaragara mubuvuzi bwabana bato.
Ubu bushakashatsi bwari bugamije gusuzuma ibintu bitandukanye by’imibereho-demokarasi n’ibidukikije bigira ingaruka kuri etiologiya ya asima yo mu bwana ku barwayi bafite imyaka 3-12 berekana umuganga w’abana ba GMCH.
Kuva muri Mata 2013 kugeza Werurwe 2017, ubushakashatsi bwakozwe mu kugenzura ibibazo byakozwe mu ishami rya Anatomy ku bufatanye n’abana bato Assam GMCH kugira ngo hakorwe iperereza ku mibereho-demokarasi n’ibidukikije biterwa na asima yo mu bwana ku bana bafite hagati y’imyaka 3-12.
Mu bushakashatsi butigeze bubaho, ubushakashatsi bwakozwe, 150 hamwe n’ubugenzuzi 150 byatoranijwe ku kigereranyo cya 1: 1 kugira ngo bige ku bintu bitandukanye muri asima yo mu bwana.Abarwayi bafite asima yasuzumwe na clinique bafite hagati yimyaka 3 na 12 berekana abana bo hanze ndetse n’amavuriro yo mu rugo batoranijwe nk’imanza, mu gihe igenzura ryari abarwayi bo mu kigero kimwe, byaba byiza babayeho mu bihe bisa nta kibazo cy’ubuhumekero.amateka yindwara na asima.
Ingano yicyitegererezo yagenwe hakoreshejwe WinPepi verisiyo 11.65.Imibare yavuye mu bushakashatsi bwambere yerekana ko ubwinshi bwa asima mu bana b'Abahinde buri hagati ya 1% na 4%.Kubwibyo, ukurikije igipimo cya 1% cyabana bafite asima hamwe n’abarwayi bangana kandi bakagenzura ingano y’itsinda, ubushakashatsi busaba urugero rw’icyitegererezo cy’abantu 274 kugira ngo bagere kuri 80% imbaraga zo kumenya itandukaniro rya 4% ry’imirizo ibiri hagati yabo..Amatsinda yombi afite urwego rwingenzi rwa 5%.
Byongeye kandi, tuvuze ko hafi 10% yabatitabye biterwa nigihombo cyakurikiyeho cyangwa kutubahiriza, birakwiye gushushanya icyitegererezo cyabantu 300 (gikubiyemo imanza 150 nubugenzuzi 150).
Koresha uburyo bwateguwe kandi bwageragejwe bwo gukusanya amakuru.Uruhushya rwanditse rwabonetse kubashinzwe amategeko bose bitabiriye kwiga.Amakuru yakusanyirijwe kumibereho itandukanye-demokarasi n’ibidukikije.Ubwoko bwinzu busobanuwe nk
Inzu ya Pucca, niba inkuta nigisenge bikozwe mumatafari, sima namabuye;inzu ya Katcha ikozwe mu biti, isi, ibyatsi n'amababi yumye niba inzu ikozwe mu rukuta rw'amatafari n'inkuta za adobe zifite igisenge kibisi cyangwa amabati hamwe na beto.amagorofa Niba yarangiye, iyi ni inzu ya Semi pucca.Imibereho yubukungu yasuzumwe hifashishijwe igipimo cya Kuppuswami (2014).
Uburyo bw'abitabiriye kubyara, amateka yo kuvuka kwa asphyxia, ubwoko bwo kugaburira, amateka ya allergie y'ibiryo, amateka y'ababyeyi y’ibiyobyabwenge, amateka y’umuryango wa asima, amateka ya atopi cyangwa allergie, n'amateka yo kunywa itabi cyangwa umwotsi w’itabi.Abagize umuryango bose babana munzu imwe bafatwaga nkabanywa itabi mumateka yumuryango.Dukurikije amabwiriza ngenderwaho ya GINA Epidemiologiya na Clinical Trial yitabiriye amashusho, ubukana bw’indwara bwashyizwe mu byiciro hakurikijwe intambwe zateganijwe zo kuvura, urebye ko abarwayi bo mu cyiciro cya 2 bafite asima yoroheje, naho abarwayi bo mu cyiciro cya 3-4 bakaba bafite asima yoroheje.yari afite asima yoroheje kandi bahabwa icyiciro-5.kuvura asima ikabije.
Ibipimo byo kwinjiza no guhezwa: Ubuvanganzo bwerekana ko ibibazo by’abana bigomba gushyirwa mu bushakashatsi kugeza ku myaka 18.Nyamara, muri GMCH, umubare munini woherejwe ku bana bari munsi y’imyaka 12. Byongeye kandi, indwara ya asima yo mu bwana yarenze ubwiyongere bw'indwara mbere na nyuma y'ubugimbi.Kubwibyo, itsinda ryimyaka kuva 3 kugeza 12 ryatoranijwe kugirango ryige.Ubushakashatsi bwarimo abarwayi bafite asima ya bronchial asima bafite imyaka 3 kugeza 12 bemeye kugira uruhare muri ubwo bushakashatsi.Abana bafite hagati yimyaka 3 na 12 bemeye kugira uruhare muri ubwo bushakashatsi nta ndwara z’ubuhumekero, byaba byiza babayeho mu bihe bisa, batoranijwe nk'itsinda rishinzwe kugenzura.
Abana bafite imyaka 0-3 ntibakuwe mubushakashatsi kuko gutontoma muri iri tsinda ntabwo byari bihagije kugirango bamenye asima.Byongeye kandi, abana bo mu kigero cy’imyaka ikwiye hamwe n’abarezi babo batemeye kugira uruhare muri ubwo bushakashatsi.
Isesengura mibare.Itandukaniro mubipimo ryasesenguwe hakoreshejwe χ ikizamini.Binary logistic regression yakoreshejwe kubipimo byingenzi mubisesengura rimwe, naho ikizamini cya Wald χ 2 cyakoreshejwe mugupima uruhare rwigenga rwo kuvura.
Kwemeza imyitwarire: Mbere yo gukusanya amakuru, kwemeza imyitwarire byabonetse muri komite ishinzwe imyitwarire yinzego yikigo, ni ukuvuga komite ishinzwe imyitwarire yinzego za GMCH, Guwahati, Assam n'Ubuhinde, Ref: No: 233/2018/215.
Mu barwayi 112.323 bitabira ishami ry’abana mu gihe cy’inyigisho, 18,88% ni abarwayi b’ubuhumekero.Mu bana bari mu kigero cy'imyaka 3-12, 2,96% barwaye asima ya bronchial.Indwara nyinshi za asima zo mu bwana zabaye mu gatasi ka Nzeri na Ukwakira (Ishusho 1).
Ubu bushakashatsi bwo kugenzura ibibazo bwarimo abana 150 barwaye asima na 150 barwanya.Ikigereranyo (± SD) imyaka y'abitabiriye kwiga cyari imyaka 8.38 (± 2.69).Inkorora no guhumeka neza ni ibimenyetso byakunze kugaragara mu mavuriro.Umubare munini (77.3%) wanduye indwara ya asima episodic naho 8.7% gusa ni bo bafite asima ikabije.Ubwiyongere bw'imanza bwagaragaye mu gihe cy'izuba (30%).Hafi ya 38% by'imanza, ibimenyetso byagaragaye nijoro (Imbonerahamwe 1).
Ababajijwe bavuga ko ibinyobwa bikonje (82.7%), ice cream (71,6%) hamwe n’umukungugu (35%) ni indwara ya asima.Hafi ya 19.3% by'imanza zagaragaje ko zidahari kubera uburwayi.
Imyaka mike (gutandukana bisanzwe) abitabiriye yari imyaka 8.34 (2.69).Abenshi mu manza bari mu kigero cy’imyaka 7-12 kandi bari abagabo.Abitabiriye ubushakashatsi bari biganjemo Abahindu n'abatari ubwoko.
Abana n'abagabo bafite imyaka 7-12 bafite umubare munini w'abanduye, nubwo ishyirahamwe ritari rifite imibare. Nanone, asima yo mu bwana yari ifitanye isano cyane na BMI (p-agaciro <0.05). Nanone, asima yo mu bwana yari ifitanye isano cyane na BMI (p-agaciro <0.05). Кроме того, детская матма б кон значительно свяаза с ИМТ (значение р <0,05). Mubyongeyeho, asima yo mu bwana yari ifitanye isano cyane na BMI (p agaciro <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 матма б кон значительно свяаза с ИМТ (значение p <0,05). Mubyongeyeho, asima yo mu bwana yari ifitanye isano cyane na BMI (p agaciro <0.05).Ingaruka zo kubyibuha birenze urugero (OR = 2.22, 95% CI: 1.17–4.18) n'umubyibuho ukabije (OR = 2.72, 95% CI: 1.46-5.09) byari hejuru yikubye kabiri ugereranije nabana bafite ibiro bisanzwe.Abana bo mu mijyi baba mu miryango isanganywe, junkyards, hamwe n’amazi, amazu adahumeka adahagije bafite ibyago byinshi byo kwandura iyi ndwara. Mu bikoni bifatanye, ibicanwa bitanga umwotsi usibye LPG, imiti yica imibu, Dhuna, nibindi, bifitanye isano cyane na asima yo mu bwana (p-agaciro <0.05). Mu bikoni bifatanye, ibicanwa bitanga umwotsi usibye LPG, imiti yica imibu, Dhuna, nibindi, bifitanye isano cyane na asima yo mu bwana (p-agaciro <0.05). В прим данющих кухнях использование значительно выделяющего дым топлива, кроме сжиженного кинтяного чиа, реп рентентов от комаров, Дхуна и т.д., также связано с детской шәһәрмой (значение p <0,05). Mu gikoni cyegeranye, gukoresha ibicanwa bitanga umwotsi mwinshi usibye LPG, imiti yica imibu, Dhuna, nibindi, bifitanye isano na asima yo mu bwana (p agaciro <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 与 儿童 哮喘 0.05 0.05 0.05 值 p 值 <0.05）。 Dhuna 等 以外 的 产生 与 儿童 哮喘 显 相关 （p 值 <0.05） 、 Дымооб.д. Umwotsi utanga ibicanwa bitari LPG, umuti wica imibu, Dhuna, nibindi nabyo byari bifitanye isano cyane na asima yo mu bwana mugikoni cyegeranye (p agaciro <0.05).Byagaragaye kandi ko abana bafite amatungo bakubye inshuro 8 kurwara asima (Imbonerahamwe 2).
Nkuko bigaragara mu mbonerahamwe ya 3, 46.7% y’imanza zari iz'imiryango ifite imibereho myiza y’ubukungu. Uburezi bw'ababyeyi nabwo bwari hasi mu manza (p-agaciro <0.05). Uburezi bw'ababyeyi nabwo bwari hasi mu manza (p-agaciro <0.05). Материнское оборование также было ниже с дан случаев (значение p <0,05). Uburezi bw'ababyeyi nabwo bwari hasi mu manza (p agaciro <0.05).病例 中 的 母亲 教育 程度 较低 （p 值 <0.05）。病例 中 的 母亲 教育 程度 较低 （p 值 <0.05）。 Матери в этих случаях также были мнее обованными (значение p <0,05). Abategarugori muribi bihe nabo ntibize cyane (p agaciro <0.05).
Abana bavutse kubice bya cisariya (CS) cyangwa ubundi buryo bwo kubyara, kimwe nabana bafite amateka yo kuvuka kwa asphyxia, bafite ibyago byinshi byindwara.Byongeye kandi, abana bagaburiwe / bavanze-bagaburiwe hafi inshuro eshanu kwandura indwara kurusha abana bonsa (Imbonerahamwe 4).
Amateka yibiribwa byo mu bwana allergie na atopy bifitanye isano ahanini na asima yo mu bwana. Nanone, abana bo mumiryango ifite amateka ya allergie na asima (p-agaciro <0.05) bakunze kwandura indwara. Nanone, abana bo mumiryango ifite amateka ya allergie na asima (p-agaciro <0.05) bakunze kwandura indwara. Также высокой склонносту к заболеванию отличались дети из семей с анамнезом аллергии и матми (значение p <0,05). Nanone, abana bo mu miryango ifite amateka ya allergie na asima bari bafite amahirwe menshi yo kurwara (p <0.05).此外 ， 来自 有 过敏 和 哮喘病 史 0.05 （p 值 <0.05） 的 儿童 极易 患病。此外 ， 来自 有 过敏 和 哮喘病 史 0.05 （p 值 <0.05） 的 儿童 极易 患病。 Кроме того, дети из семей с аллергией и аммой в анамнезе (р-значение <0,05) были высоко восприимчивы. Byongeye kandi, abana bo mumiryango ifite amateka ya allergie na asima (p-agaciro <0.05) baribasiwe cyane. Kunywa itabi byoroshye binyuze mu bandi bagize umuryango nabyo byiyongereyeho inshuro umunani ibyago byo kurwara asima mu bana (p-agaciro <0.05). Kunywa itabi byoroshye binyuze mu bandi bagize umuryango nabyo byiyongereyeho inshuro umunani ibyago byo kurwara asima mu bana (p-agaciro <0.05). Пасвирное курение через других членов семьи также увеличивает риск развития матми у детей поти восемь раз (значение p <0,05). Kunywa itabi byoroshye binyuze mu bandi bagize umuryango nabyo byongera ibyago byo kurwara asima mu bana inshuro umunani (p agaciro <0.05).通过 其他 家庭 成员 被动吸烟 也 使 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 近 近 近 近 近 近 8 Пасвирное курение через других членов семьи также увеличивало риск развития матми у детей поти в 8 раз (p-значение <0,05). Kunywa itabi byoroshye binyuze mu bandi bagize umuryango nabyo byongereye ibyago byo kurwara asima mu bana inshuro 8 (p-agaciro <0.05).(imbonerahamwe 5)
Kwisubiramo kwinshi kwa binary byerekanaga ko abana mumijyi, ibidukikije bitose, imibereho yubukungu bwifashe nabi, amatungo, amateka yumuryango wa atopy / allergie, amateka yumuryango w itabi / kunywa itabi gusa, hamwe nimirire ivanze bagize uruhare runini.Impamvu zishobora gutera asima yo mu bwana (Imbonerahamwe 6).
Imbonerahamwe 6 Isesengura ryinshi ryo gusubira inyuma kugirango harebwe ibintu byingenzi bigira ingaruka kuri asima yo mu bwana
Mu myaka 20 cyangwa itatu ishize, umubare w’indwara ziterwa na Atopic wariyongereye, bituma havugwa byinshi ku bijyanye n’imihindagurikire y’ibidukikije, umwanda, hamwe n’ubudahangarwa bw'umubiri wanduye virusi.Ibidukikije byangiza ibidukikije ndetse n’ibinyabuzima byangiza umubiri bigira uruhare mu iterambere rya asima.
Muri ubu bushakashatsi, 2,96% by'abarwayi bo mu kigero cy'imyaka 3 kugeza 12 bavuze ko asima yo mu bwana.Nyamara, ubushakashatsi bumwe bwibanze bwerekanye uburyo butandukanye bwa asima yo mu bwana mu bana b'Abahinde.6,10-12 Itandukaniro ry’imiterere n’ibidukikije mu Buhinde bigira ingaruka ku buryo butaziguye kandi bigira ingaruka ku ngaruka ziterwa na asima.6 Rero, kugirango hakumirwe neza kandi mugihe gikwiye, hakenewe isuzumabumenyi ryakarere ku bintu nyamukuru bya asima yo mu bwana.
Abana bafite imyaka 7-12, abagabo nabana baba mumijyi bafite ibyago byinshi byo kurwara asima.Igisagara nigitsina gabo byiganje muri asima byagaragaye mubushakashatsi bwakozwe mubuhinde, 10 bisa nibyo twabonye.Ariko, iri shyirahamwe ryari rifite imibare gusa muburyo bw'urugo.
Ubushakashatsi bwerekanye ko ihinduka ry’imiterere y’imiterere y’imiterere y’imibonano mpuzabitsina rishobora kugira ingaruka kuri asima, kubera ko abahungu bakunze kurwara asima mu bwana.Nyamara, iyi shusho irahinduka nyuma yubugimbi, kandi abagore barwara indwara kurusha abagabo.13-15 Byongeye kandi, abahungu bari munsi yimyaka 10 bafite umwuka muto ugereranije nabakobwa banganya imyaka, kandi uburebure nabwo butekereza ko ari ibintu bitera asima yo mu bwana ku bahungu.16.17
Metro Kamstrup, umurwa mukuru wa Assam, yerekanye imijyi yihuse mu myaka yashize.Ubushakashatsi bwinshi buvuga ko imijyi ari ikintu kigira ingaruka ku ndwara ya asima, ibyo bikaba bihuye n’ubushakashatsi bwacu.18,19 Muri ubu bushakashatsi, gusubira inyuma kwa logistique kuterekanye ko abana bafite umubyibuho ukabije n’umubyibuho ukabije barenze inshuro ebyiri kwandura asima kurusha abana bafite BMI isanzwe, bihuye n’ubushakashatsi buherutse gukorwa.20 Byongeye kandi, imibereho yubukungu yo hasi ni ibintu bishobora gutera asima yo mu bwana.Abana bo mu miryango ifite imibereho myiza yubukungu bafite ibyago byinshi byo kwandura asima bitewe nubudahangarwa buke bwumubiri hamwe nubushobozi buke bwubuzima.21-23
Abana babana mumuryango uhuriweho, amazu ya kaccha, amazu atose, guhumeka bidahagije, ibikoni bifatanye, ibicanwa bitanga umwotsi, imiti yica imibu na Dhuna, nibindi, byari bifitanye isano cyane na asima yo mu bwana (p-agaciro <0.05). Abana babana mumuryango uhuriweho, amazu ya kaccha, amazu atose, guhumeka bidahagije, ibikoni bifatanye, ibicanwa bitanga umwotsi, imiti yica imibu na Dhuna, nibindi, byari bifitanye isano cyane na asima yo mu bwana (p-agaciro <0.05).Abana baba mumuryango uhuriweho, bahunga urugo, amazu atose, guhumeka bidahagije, igikoni gifatanye, lisansi itanga umwotsi, imiti yica imibu na Dhuna nibindi.д., были достоверно связаны с детской аммой (значение р <0,05). e., byari bifitanye isano cyane na asima yo mu bwana (agaciro p <0.05).共同 家庭 的 儿童 cc kaccha 房屋 、 潮湿 的 住宅 、 通风 h h h h h Dhuna 等 与 儿童 哮喘 显 着 相关 值 p 值 <0.05）。 Abana mu ngo zisangiwe, amazu ya kaccha, amazu atose, guhumeka bidahagije, igikoni gifatanye, lisansi itanga umwotsi, imiti yica imibu, na Dhuna bifitanye isano rya bugufi na asima y'abana (p agaciro <0.05). Дети в общих домохозяствах, домах kaчча, кых жилищах, не чавнной вентиляции, пристроенных кухнях, за адленном топливе, реп адентах от комаров и Дхуна были в зн с с с с Abana baba mu ngo zisangiwe, kwiruka munzu, amazu atose, guhumeka bidahagije, igikoni cyashyizwemo, lisansi yumwotsi, imiti yica imibu na dhuna byari bifitanye isano na asima yo mu bwana (p agaciro <0.05).Ubushakashatsi bwibanze bwerekanye kandi ko ibintu bitandukanye bidukikije mu ngo bishobora gutera asima mu bana.24-27 Ihuriro ry’inyamanswa zo mu nzu hamwe na asima yo mu bwana ntivugwaho rumwe, kubera ko abashakashatsi bake bemeza ko guhura na allergène hakiri kare bishobora kugira uruhare mu iterambere ry’ubworoherane.28
Ubushakashatsi bwinshi bwerekanye ko abana bavutse kubice bya sezariya bafite ibyago byinshi byo kurwara asima yo mu bwana ugereranije no kuvuka bisanzwe.Ibi bihuye nibyo twabonye.29-32 Abana bafite amateka yo kuvuka asphyxia nabo bafite ibyago byinshi byo kurwara asima.Indwara ya asima y'ababyeyi ni umusanzu w'ingenzi mu gutwita nka syndrome de syndrome de respiratory na neonatal asphyxia.33
Kimwe nubundi bushakashatsi, ubushakashatsi bwakozwe bwerekana ko amateka yo mu bwana ya allergie yibiribwa cyangwa atopi cyangwa amateka yumuryango wa allergie na asima byongera cyane ibyago byo kurwara asima.34,35 Dukurikije ubushakashatsi bwacu, ubushakashatsi bwakozwe mu bisekuruza byinshi bwerekanye ko ingeso zinywa itabi zishobora gutuma abantu bahinduka muri epigenome byongera ibyago bya asima mu rubyaro.36
Mu minsi yashize, imijyi yihuse yibasiye inzego zose zabaturage.Bitewe n’amasoko atandukanye yinjiza nakazi, abantu bahitamo gutura mumijyi bityo bakagerwaho n’imyanda ihumanya ibidukikije.Abagize umuryango w’abana bakunze kwibasirwa basabwa kurushaho kwita ku kwirinda ubushuhe, kunywa itabi, kubika amatungo mu muryango ufite allergie / allergie, no kwirinda allergie / imbarutso itera abana bafite amateka y’umuryango ya allergie / allergie.Hagomba kubaho kongera ubumenyi bwonsa gusa kubera inyungu zo konsa mukurinda asima.
Benshi mu barwayi baza mu Ishuri Rikuru ry’Ubuvuzi rya Guwahati ni abo mu majyaruguru y’Uburasirazuba bw’Ubuhinde kuko Ishuri Rikuru ry’Ubuvuzi rya Guwahati n’ikigo cy’inzobere mu rwego rwo hejuru mu karere.Benshi mu barwayi bari bafite imibereho mike mu bukungu no mu rwego rwo hasi rw'uburezi.Asima ya Bronchial mubana nikibazo gikunze kugaragara mubisata byabana byibitaro byacu.Ingamba zikwiye zo gukumira aba barwayi bafite ibyago byinshi bizafasha kugabanya uburwayi no kugabanya inshuro zo kwiyongera.
Nubwo uburyo bwose bwo kuvura asima buboneka, abarwayi benshi bakomeje kugenzurwa nabi, ariko kumenya umubare w’abarwayi runaka, harimo na phenotypes na endotypes, birashobora kunoza imiyoborere yabo.Niyo mpamvu, ubushakashatsi bwakarere bwakwirakwijwe na asima yo mu bwana hamwe nimpamvu zishobora gutera ingaruka zizafasha mugucunga neza izi manza.
Muri ubu bushakashatsi, abarwayi bamwe ntibagarutse kwisuzumisha no kubakurikirana.Ibi birashobora guterwa no kutamenya ibitera n'ingaruka zindwara.Kubera sisitemu mbi yo gutumanaho, ntitwashoboye gukurikirana abarwayi bose.
Abana barashobora kwibasirwa na asima yibidukikije, kandi gusobanukirwa neza ibitera asima ibidukikije na allergens birashobora gufasha kugenzura no kugabanya umutwaro windwara.Mu miryango ifite amateka ya allergie cyangwa asima, hakwiye kwitabwaho kugirango urinde abana byoroshye kwanduza ibintu.
Amakuru yose yabitswe ibanga kandi ubushakashatsi bwakozwe hakurikijwe Itangazo rya Helsinki.
Ndashimira abaganga bose b'abana bafashije gukusanya amakuru no gusuzuma ibikubiye mubumenyi bwabo.Abakozi dukorana bose badufashije kubona amasomero y’ishami n’ibidukikije mu gihe cyo kwiga nabo barashimiwe.
Abanditsi bose bagize uruhare runini mubikorwa bya raporo, haba mubitekerezo, igishushanyo mbonera cyo kwiga, gukora, gukusanya amakuru, gusesengura no gusobanura, cyangwa ibyo byose;bagize uruhare mu gutegura, gusubiramo cyangwa gusubiramo ingingo.Kurangiza verisiyo yo gutangaza, wemeranya n'ikinyamakuru ingingo izashyikirizwa, kandi wemere gushingwa ibintu byose byakazi.
1. Ingamba zisi zose zo kuvura no gukumira asima.Isi yose.2018. Iraboneka kuri: https://ginasthma.org/wp-content/uploads/2019/01/2018-GINA.pdf.Kuva ku ya 2 Ukuboza 2021