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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, Assagarm Medical College;I-3 iSebe lezoNyango zikaRhulumente, iKholeji yezoNyango yase-Assam, i-Dibrugarh, i-Assam, i-Indiya;I-4 Tezpur College of Medicine kunye noTyando lweZibhedlele, eTezpur, eAssam, eIndiya;I-5 iSebe le-Radiology, i-Fakhruddin Ali Ahmed College yezoNyango kunye neSibhedlele, i-Barpeta, i-Assam, i-Indiya Umbhali ohambelanayo: uPutul Mahanta, iSebe le-Forensic Medicine kunye ne-Toxicology, i-Assam Medical College kunye neSibhedlele, i-Dibrugarh, i-Assam, i-786002, i-Indiya, i-tel.+919435017802, i-imeyile [i-imeyile ekhuselweyo] isithintelo somoya.Zombini izinto zofuzo kunye nokusingqongileyo zinegalelo kumazinga aphezulu e-asthma.Injongo yolu phononongo yayikukuvavanya izinto ezahlukeneyo zentlalo yoluntu kunye nokusingqongileyo ezichaphazela i-etiology ye-asthma yobuntwana kwizigulana ezinikezela kwisebe labantwana kwiKholeji yezoNyango yaseGauhati kunye neSibhedlele (GMCH) e-Assam.Impahla nenkqubo.I-totali yezigulane ze-150 ezine-asthma ezifunyenwe kwiklinikhi zikhethwe kwi-1: umlinganiselo we-1 phakathi kwamatyala aneminyaka eyi-3-12 iminyaka kunye nezigulane zeqela elifanayo elingenalo isifo sokuphefumula kunye nembali ye-asthma njengolawulo.Idatha iqokelelwe kusetyenziswa ifomathi eyenziwe ngaphambili kunye nokuvavanya kwangaphambili, kwaye imvume ebhaliweyo ebhaliweyo ifunyenwe kubo bonke abagcini bomthetho babathathi-nxaxheba.Idatha yahlalutywa ngovavanyo lwe-chi-square kunye nokuhlehliswa kokubini kusetyenziswa i-SPSS V20 elungelelaniselwe amaxabiso e-p.Iziphumo: Abantwana basezidolophini nabangamadoda bafunyenwe besengozini enkulu yokuba nesifuba somoya.Abantwana basezidolophini (OKANYE = 4, 53; 95% CI: 1.57-13.09; ppppppp Izigqibo: Abantwana banokuchaphazeleka kwi-asthma ebangelwa yindalo Ukwaziswa kunye nokuthintela amanyathelo afunekayo ukulawula nokunciphisa umthwalo we-asthma kubantwana Amagama angundoqo: i-asthma, izinto zokusingqongileyo, abantwana, i-allergies, a
Umbefu sisifo semiphunga esingapheliyo esiphawulwa kukuthintelwa kwendlela yomoya okubuyisela umva okubangelwa kukudumba kweendlela zomoya emiphungeni kunye nokuxinezeleka kwezihlunu ezingqongileyo.Izikhokelo zamva nje ezivela kwi-Global Initiative kwi-Asthma (GINA) ichaza i-asthma "njengesifo esingaqhelekanga esihlala sibonakala ngokuvutha okungapheliyo kwiindlela zomoya".Iimpawu zokuphefumla ezinje ngokuphefumla, ukuphefumla nzima, ukuxinezeleka kwesifuba kunye nokukhohlela, kunye nokuguquguquka kokuqukuqela kokuqukuqela kokuphefumla, ziimpawu zesifuba.Nye
Kubantu abane-asthma, iimpawu ezinzima zingenzeka ngenxa yezinto ezahlukeneyo ezibangela, ezifana ne-cigarettes kunye nezinye iintlobo zokutshaya, i-mold, i-pollen, uthuli, uthuli lwezilwanyana, ukuzivocavoca, umoya obandayo, iimveliso zasekhaya kunye nezoshishino, ukungcoliseka komoya kunye nokusuleleka.2 Intlanganisela yofuzo kunye nemiba yokusingqongileyo icacisa izehlo eziphezulu ze-asthma kwezinye iindawo.Ngokufuthi, ezi ezinye izinto zinokufak’ isandla kwiyantlukwano, ngobuhlanga okanye ubuzwe bezona zinto zichongiweyo ngokulula phakathi kwamaqela ahlukeneyo abantu.3
Ukuxilongwa kwe-asthma yiklinikhi kuba akukho nkcazo esemgangathweni yohlobo, ubukhali, okanye ukuphindaphinda kweempawu.I-asthma ye-Bronchial sisifo esiqhelekileyo esibeka umthwalo omkhulu kunyango jikelele kunye nokulaliswa esibhedlele.I-4 Nangona ukuxilongwa kwe-asthma kubantwana nakubantu abadala kuneendlela ezininzi ezifanayo, ukuxilongwa kokwahlukana, ikhosi yendalo yokuphefumula, ukukwazi ukubonelela unyango oluthile, kunye nexabiso layo lokuxilonga lixhomekeke kwiminyaka yobudala.
Ehlabathini lonke, bangaphezu kwezigidi ezingama-300 abantu abaphethwe sisifuba.Ebantwaneni, i-asthma iphakathi kwezifo eziphezulu ze-20 ezingapheliyo kwiminyaka yokuphila yokukhubazeka kwihlabathi jikelele, kunye nezinga lokufa kwe-0.0-0.7 kubantu abayi-100,000.5.Ukuxhaphaka kwesifo sombefu e-Indiya kuxelwe ukuba kususela kwi-2% ukuya kwi-23%, mhlawumbi kungenxa yokungafani kwelizwe kunye nokusingqongileyo.6 Kuphononongo lwakutsha nje, eli nani lifunyenwe liyi-10.4% kwi-Assam.7
Isifuba somoya ebantwaneni sibangela iimpawu zokuphefumla eziphinda-phindayo ezinje ngokuphefumla, ukukhohlela, ukuphefumla nzima, kunye nokuxineka kwesifuba, okuthi, ukuba asinyangwanga kakuhle, kunokukhokelela kwisifuba esingapheliyo.Isifuba somoya sabantwana sinokuphazamisa kakhulu umgangatho wobomi babantwana abagulayo ngokwandisa ukungabikho emsebenzini kunye nokunciphisa ukuthatha inxaxheba ngokubonakalayo emsebenzini.
Nangona ulwazi oluphambili kunye nezicwangciso zonyango, kukho ukwanda okuphawulekayo kokuxhaphaka, ukugula kunye nokufa kwe-asthma kubantwana kwiminyaka yamuva nje8,9, kunye nokuqonda ngakumbi i-pathogenesis ye-asthma iyadingeka ukuze uphathe ngokufanelekileyo i-asthma.Ngoxa kusenziwa uphando oluninzi kwimimandla eyahlukahlukeneyo yaseIndiya, kuncinane kakhulu okwenziwayo kulo mmandla ungaphuhlanga kangako kumntla-mpuma weIndiya.
Olu phononongo lwenziwe kumntla-mpuma welizwe lase-Assam, eIndiya.Abemi base-Assam benziwe ngamaqela eentlanga ezahlukeneyo, apho i-12.45% ingamalungu ezizwe ezifana neBodo, Khachari, Karbi, Miri, Mishimi, Rabah, njl.Urhulumente waziwa ngeentlobo-ntlobo zezinto eziphilayo.EzoLimo, ikakhulu irayisi, iti kunye neepulses, zenza ngaphezu kwesinye kwisithathu sengeniso ye-Assam kwaye iqeshe malunga neepesenti ze-69 zabasebenzi.Urhulumente uvelisa i-50% yemveliso yeti yaseIndiya.Amanye amashishini ezolimo anengeniso aquka ukufuya iihagu, ukufuya ubisi nokuloba ngokuthatha inxaxheba kwabemi basemaphandleni.Ezolimo, iti, i-oyile negesi, amalahle kunye nelitye likalikamestone ngawona mashishini aphambili.Umahluko omkhulu wobuhlanga kunye nejografi kurhulumente ubukhulu becala kubangelwa kukuguquguquka okuguquguqukayo kunye ne-pathogenesis yesi sifo.
I-GMCH lelona ziko liphambili lokuthunyelwa kumaziko emfundo ephakamileyo kulo mmandla, linyanga izigulana ezisuka kuwo wonke umntla-mpuma weIndiya, kuquka nabantu basemaphandleni nabasezidolophini.Uninzi lwezigulane zinemeko ephantsi yentlalo-qoqosho kunye nenqanaba eliphantsi lemfundo.I-asthma ye-Bronchial kubantwana yingxaki eqhelekileyo kwi-inpatient pediatrics.
Olu phononongo lujolise ekuvavanyeni imiba eyahlukeneyo yentlalo yoluntu kunye nendalo echaphazela i-etiology ye-asthma yabantwana kwizigulana ezineminyaka eyi-3-12 ezinikezela kugqirha wabantwana we-GMCH.
Ukususela ngo-Apreli 2013 ukuya ku-Matshi 2017, uphando lwe-case-control control-case-retrospective luqhutywe kwiSebe le-Anatomy ngokubambisana ne-Pediatrics Assam GMCH ukuphanda i-socio-demographic kunye nemiba yokusingqongileyo ye-asthma yabantwana kubantwana abaneminyaka eyi-3-12 iminyaka.
Kwisifundo esingazange sibonwe ngaphambili, iimeko ze-150 kunye nolawulo lwe-150 zikhethwe kwi-1: umlinganiselo we-1 wokufunda izinto ezahlukeneyo kwi-asthma yobuntwana.Izigulane ezine-asthma ezifunyanwe ngokweklinikhi ezineminyaka eyi-3 ukuya kwi-12 iminyaka enikezela kwiiklinikhi zabantwana zangaphandle kunye nezangaphakathi zikhethwe njengeemeko, ngelixa ulawulo yayizizigulane zeqela elifanayo leminyaka, ngokufanelekileyo ukuhlala kwiimeko ezifanayo ngaphandle kweengxaki zokuphefumla.imbali yesifo kunye nesifuba.
Ubungakanani besampulu bunqunywe kusetyenziswa iWinPepi version 11.65.Idatha evela kuphononongo lwangaphambili ibonisa ukuba ukuxhaphaka kwe-asthma phakathi kwabantwana baseNdiya ukusuka kwi-1% ukuya kwi-4%.Ngoko ke, ukuthatha umlinganiselo we-1% wabantwana abane-asthma kunye nesigulane esilinganayo kunye nobukhulu beqela lokulawula, isifundo sidinga ubungakanani besampulu epheleleyo yabantu abangama-274 ukufikelela kwi-80% yamandla okufumana i-4% yokwahlukana komsila phakathi kweebini..Omabini amaqela anenqanaba lokubaluleka le-5%.
Ukongeza, kucingelwa ukuba malunga ne-10% yabangaphenduli ngenxa yelahleko elandelayo okanye ukungabambeleli, kunengqiqo ukuzoba isampuli yabantu be-300 (ebandakanya iimeko ze-150 kunye nolawulo lwe-150).
Sebenzisa iifomathi zokuqokelelwa kwedatha esele ziyilwe kwaye zavavanywa.Imvume ebhaliweyo enolwazi ifunyenwe kubo bonke abagcini basemthethweni babathathi-nxaxheba kuphando.Idatha yaqokelelwa kwiintlobo ngeentlobo zentlalo-demografi kunye nokusingqongileyo.Uhlobo lwendlu luchazwa njenge
Indlu yePucca, ukuba iindonga kunye nophahla zenziwe ngezitena, i-samente kunye nelitye;indlu yaseKatcha yenziwe ngamaplanga, umhlaba, iindiza kunye namagqabi omileyo ukuba indlu yenziwe ngeendonga zezitena kunye neendonga ze-adobe ezinophahla lwengca okanye lwenkcenkce kunye nekhonkrithi.imigangatho Ukuba igqityiwe, le yindlu yeSemi pucca.Ubume bezentlalo zentlalo buhlolwe kusetyenziswa isikali se-Kuppuswami esilungisiweyo (2014).
Indlela yokunikezelwa kwabathathi-nxaxheba, imbali yokuzalwa kwe-asphyxia, uhlobo lokutyisa, imbali yokungalungi ukutya, imbali yomama wokulutha, imbali yentsapho ye-asthma, imbali ye-atopy okanye i-allergies, kunye nembali yentsapho yokutshaya okanye umsi wecuba nazo zabhalwa.Nawaphi na amalungu entsapho ahlala kwindawo enye ayegqalwa njengentshayi kwimbali yosapho.Ngokutsho kweGINA Epidemiological and Clinical Trial Participant Image Guidelines, ubunzima besifo bahlelwa ngokwamanyathelo onyango amiselweyo, kuthathelwa ingqalelo ukuba izigulane ezabelwe kwisigaba se-2 zine-asthma epholileyo, kwaye izigulane ezabelwe isigaba 3-4 zine-asthma epholileyo.babene-asthma ephakathi kwaye babelwa isigaba-5.unyango lwesifuba esinzima.
Iikhrayitheriya zokubandakanywa kunye nokukhutshwa: Uncwadi lucebisa ukuba iimeko zabantwana kufuneka zifakwe kwisifundo ukuya kwi-18 yeminyaka ubudala.Nangona kunjalo, kwi-GMCH, uninzi lwabantwana abathunyelwayo bangaphantsi kweminyaka eyi-12. Ukongezelela, iziganeko ze-asthma zabantwana zigqithise ukuxhaphaka kwesifo ngaphambi nangemva kokufikisa.Ke ngoko, iqela leminyaka ukusuka kwi-3 ukuya kwi-12 leminyaka likhethwe kwisifundo.Uphononongo lubandakanya izigulane ezine-asthma ye-bronchial ezifunyanwe ngokweklinikhi ezineminyaka eyi-3 ukuya kwi-12 iminyaka eyavuma ukuthatha inxaxheba kuphononongo.Abantwana abaneminyaka eyi-3 ukuya kwiminyaka eyi-12 abavuma ukuthatha inxaxheba kwisifundo ngaphandle kwesifo sokuphefumula, ngokukhethekileyo ukuhlala kwiimeko ezifanayo, bakhethwa njengeqela lokulawula.
Abantwana abaneminyaka eyi-0-3 ubudala babengabandakanywanga kwisifundo kuba ukuvuthuza kweli qela leminyaka kwakunganelanga ukuxilonga i-asthma.Ukongezelela, abantwana abakumaqela afanelekileyo eminyaka kunye nabagcini babo abangazange bavume ukuthatha inxaxheba kuphononongo abazange bafakwe.
Uhlalutyo lwamanani.Umahluko kwimilinganiselo yahlalutywa kusetyenziswa uvavanyo lwe-χ.I-binary logistic regression isetyenziselwe imilinganiselo yokubaluleka kuhlalutyo olungaguquguqukiyo, kwaye uvavanyo luka-Wald lwe-χ 2 lwasetyenziselwa ukulinganisa igalelo elizimeleyo lonyango.
Ukuvunywa kokuziphatha: Ngaphambi kokuqokelelwa kwedatha, ukuvunywa kokuziphatha kwafunyanwa kwiiKomiti zeMigaqo yeZiko leZiko, oko kukuthi iiKomiti zeMigaqo yeZiko le-GMCH, iGuwahati, i-Assam ne-India, iRef: No: 233/2018/215.
Kwizigulana ezingama-112,323 ezizimase iyunithi yabantwana ngexesha lophononongo, i-18.88% yayizizigulane zokuphefumla.Phakathi kwabantwana abakwiqela leminyaka eyi-3-12, i-2.96% yahlushwa yi-asthma ye-bronchial.Uninzi lweziganeko ze-asthma ebuntwaneni zenzeke ekwindla kaSeptemba no-Oktobha (Umfanekiso 1).
Olu pho nonongo lubandakanya abantwana be-150 abane-asthma kunye nolawulo lwe-150.Umyinge (± SD) ubudala wabathathi-nxaxheba kuphando yayiyi-8.38 (± 2.69) iminyaka.Ukukhohlela kunye nokuphefumula okufutshane yayiyeyona mpawu ziqhelekileyo zekliniki kwiimeko.Uninzi (77.3%) lwamatyala aye ahlaselwa yi-episodic asthma kwaye kuphela yi-8.7% yeemeko ezine-asthma enzima.Ukuxhaphaka kwamatyala kuye kwaqatshelwa ekwindla (30%).Phantse kwi-38% yamatyala, iimpawu zichazwe ebusuku (Itheyibhile 1).
Ngokutsho kwabaphenduli, iziselo ezibandayo (82.7%), i-ayisikrimu (71.6%) kunye nokuvezwa kothuli (35%) zizinto eziqhelekileyo ezibangela i-asthma.Phantse i-19.3% yamatyala achaza ukungabikho emsebenzini ngenxa yokugula.
Ubudala obuqhelekileyo (ukutenxa okuqhelekileyo) kwabathathi-nxaxheba kwakuyi-8.34 (2.69) iminyaka.Uninzi lwamatyala ayekwiqela leminyaka eyi-7-12 kwaye ayengamadoda.Abathathi-nxaxheba kuphononongo ubukhulu becala ibingamaHindu kwaye bengezozizwe.
Abantwana kunye namadoda aneminyaka eyi-7 ukuya kwe-12 babenezinga eliphezulu lezehlo, nangona umbutho wawungabalulekanga ngokwezibalo. Kwakhona, i-asthma yobuntwana yayinxulumene kakhulu ne-BMI (p-value <0.05). Kwakhona, i-asthma yobuntwana yayinxulumene kakhulu ne-BMI (p-value <0.05). Кроме того, детская астма была значительно связана с ИМТ (значение р<0,05). Ukongezelela, i-asthma yobuntwana yayinxulumene kakhulu ne-BMI (p value <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). Ukongezelela, i-asthma yobuntwana yayinxulumene kakhulu ne-BMI (ixabiso le-p <0.05).Amathuba okuba nomzimba ogqithiseleyo (OKANYE = 2.22, 95% CI: 1.17-4.18) kunye nokutyeba (OKANYE = 2.72, 95% CI: 1.46-5.09) yayingaphezu kokuphindwe kabini xa kuthelekiswa nabantwana abanobunzima obuqhelekileyo.Abantwana basezidolophini abahlala kwiintsapho ekwabelwana ngazo, iijunkyards, kunye neendawo zokuhlala ezifumileyo, ezingangeni moya ngokwaneleyo banomngcipheko omkhulu wokuba sesi sifo. Kwiikhikhini eziqhotyoshelweyo, iifutha ezivelisa umsi ngaphandle kwe-LPG, izigxothi zeengcongconi, i-Dhuna, njl., nazo zihambelana kakhulu ne-asthma yobuntwana (p-value <0.05). Kwiikhikhini eziqhotyoshelweyo, iifutha ezivelisa umsi ngaphandle kwe-LPG, izigxothi zeengcongconi, i-Dhuna, njl., nazo zihambelana kakhulu ne-asthma yobuntwana (p-value <0.05). В примыкающих кухнях использование значительно выделяющего дым топлива, кроме сжиженного нефтяного газа, репеллентов от, репеллентов от.д., также связано с детской астмой (значение p<0,05). Kwiikhikhini ezidityanisiweyo, ukusetyenziswa kwamafutha avelisa umsi kakhulu ngaphandle kwe-LPG, izinto zokugxotha iingcongconi, i-Dhuna, njl., iphinda idibaniswe ne-asthma yobuntwana (ixabiso 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). Amafutha avelisa umsi ngaphandle kwe-LPG, into yokugxotha iingcongconi, i-Dhuna, njl.Kwaye kwaphawulwa ukuba abantwana abanezilwanyana ezifuywayo babenamathuba e-8 amathuba okuba bahlakulele i-asthma (Itheyibhile 2).
Njengoko kubonisiwe kwiThebhile 3, ama-46.7% amatyala ayezeentsapho ezikwimeko ephantsi yentlalo noqoqosho. Imfundo yoomama nayo yayiphantsi phakathi kwamatyala (p-value<0.05). Imfundo yoomama nayo yayiphantsi phakathi kwamatyala (p-value<0.05). Материнское образование также было ниже среди случаев (значение p<0,05). Imfundo yoomama nayo ibiphantsi phakathi kwamatyala (p value<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）. Матери в этих случаях также были менее образованными (значение p <0,05). Oomama kwezi meko nabo babengafundanga kangako (p value <0.05).
Abantwana abazelwe ngotyando (caesarean section) (CS) okanye ezinye iindlela zokubeleka, kwanabantwana abanembali yokuzalwa bengafixisi, basengozini enkulu yesi sifo.Ukongezelela, abantwana abaphezulu / abaxubekileyo babephantse babe ngamahlanu amathuba okuba baphuhlise isifo kunabantwana abancancisayo (Itheyibhile 4).
Imbali yokwaliwa kokutya kwabantwana kunye ne-atopy iye yanxulunyaniswa kakhulu ne-asthma yabantwana. Kwakhona, abantwana abavela kwiintsapho ezinembali ye-allergies kunye ne-asthma (i-p-value <0.05) babenomdla kakhulu ekufumaneni isifo. Kwakhona, abantwana abavela kwiintsapho ezinembali ye-allergies kunye ne-asthma (i-p-value <0.05) babenomdla kakhulu ekufumaneni isifo. Также высокой склонностью к заболеванию отличались дети из семей с анамнезом аллергии и астмы (значение p<0,05). Kwakhona, abantwana abavela kwiintsapho ezinembali ye-allergies kunye ne-asthma babenomdla ophezulu kwisifo (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 и астмой в анамнезе (р-значение <0,05) были высоко восприимчивы. Ukongezelela, abantwana abavela kwiintsapho ezinembali ye-allergies kunye ne-asthma (i-p-value <0.05) babesengozini kakhulu. Ukuyeka ukutshaya ngamanye amalungu osapho nako kwandisa phantse amaxesha asibhozo ingozi yesifuba phakathi kwabantwana (p-value<0.05). Ukuyeka ukutshaya ngamanye amalungu osapho nako kwandisa phantse amaxesha asibhozo ingozi yesifuba phakathi kwabantwana (p-value<0.05). Пассивное курение через других членов семьи также увеличивает риск развития астмы у детей почти в восемь раз (значение p<0,05). Ukutshaya ukutshaya ngamanye amalungu osapho nako kwandisa umngcipheko wokuhlaselwa sisifuba kubantwana phantse amaxesha asibhozo (p value <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 в 8 раз (p-значение <0,05). Ukutshaya ukutshaya ngamanye amalungu osapho nako kwandisa umngcipheko wokuba nesifuba somoya ebantwaneni phantse ngamaxesha angama-8 (p-value <0.05).(Itheyibhile 5)
Uhlengahlengiso oluninzi lwe-binary logistic regression lubonise ukuba abantwana abasezidolophini, iindawo ezifumileyo, imeko ephantsi yentlalo-ntle, izilwanyana zasekhaya, imbali yosapho ye-atopy/allergies, imbali yosapho yokutshaya/ukungaqhubi, kunye nokutya okuxutyiweyo kube negalelo elikhulu.Imiba esemngciphekweni yesifuba somntwana (iThebhile 6).
Itheyibhile 6 Uhlalutyo lwe-Multivariate logistic regression analysis ukuvavanya izinto ezibalulekileyo ezichaphazela i-asthma yobuntwana.
Kwiminyaka emibini ukuya kwamashumi amathathu edlulileyo, inani lezifo ze-atopic liye landa, likhuthaza ingxoxo eninzi malunga nokutshintsha kwendalo, ungcoliseko, kunye neempendulo ze-immune kwii-pathogens ezosulelayo.Bobabini ukuvezwa kokusingqongileyo kunye nokuba sesichengeni kwebhayoloji nakwimfuzo kudlala indima kuphuhliso lwesifuba.
Kolu phononongo, i-2.96% yezigulane ezikwiqela leminyaka emi-3 ukuya kweli-12 zixele isifo sesifuba somntwana.Nangona kunjalo, ezinye izifundo zangaphambili zichaze iindlela ezahlukeneyo ze-asthma yobuntwana kubantwana baseIndiya.I-6,10-12 Umahluko weJografi kunye nokusingqongileyo eIndiya uchaphazela ngokuthe ngqo kwaye uchaphazele izinto ezinobungozi ezinxulumene nesifo se-asthma.6 Ngaloo ndlela, ukuthintela ngokufanelekileyo kunye nexesha elifanelekileyo lesi sifo, uvavanyo lwengingqi lwezona zinto ziphambili ze-asthma yobuntwana ziyimfuneko.
Abantwana abaneminyaka eyi-7-12 ubudala, amadoda kunye nabantwana abahlala ezidolophini basengozini enkulu ye-asthma yabantwana.Ulawulo lwedolophu kunye nendoda ekuxhatshazweni kwe-asthma yabonwa kuphononongo lwaseIndiya, i-10 efana neziphumo zethu.Nangona kunjalo, olu nxulumano lwalubalulekile kuphela ngokwezibalo kumxholo wendawo yekhaya.
Uphononongo lubonise ukuba utshintsho lwehomoni ngokwesini lunokuthi lube nefuthe kwi-asthma, njengoko amakhwenkwe kunokwenzeka ukuba abe ne-asthma ngexesha lobuncinci.Nangona kunjalo, lo mfanekiso utshintsha emva kokufikisa, kwaye abafazi bahlakulela isifo ngokuphindaphindiweyo kunamadoda.I-13-15 Ukongeza, amakhwenkwe angaphantsi kweminyaka eyi-10 aneendlela zomoya ezincinci kunamantombazana akwiminyaka efanayo, kwaye ubude bucingelwa ukuba bungunobangela wesifuba somntwana kumakhwenkwe.16.17
IMetro Kamstrup, ikomkhulu lase-Assam, ibonise ukufudukela kwabantu ezidolophini ngokukhawuleza kwiminyaka yakutshanje.Uphononongo oluninzi lunika ingxelo yokuba ukufudukela kwabantu ezidolophini yeyona nto ichaphazela isifo sombefu, nto leyo engqinelanayo nophononongo lwethu.I-18,19 Kuphononongo lwangoku, ukuhlengahlengiswa kwezinto ezingalungiswanga kubonise ukuba abantwana abatyebileyo kunye nabatyebe kakhulu babengaphezulu ngokuphindwe kabini amathuba okuba bahlakulele i-asthma kunabantwana abane-BMI eqhelekileyo, ehambelana nophononongo lwakutsha nje.20 Ukongeza, ubume obuphantsi bezentlalo noqoqosho yinto enokubakho emngciphekweni wesifuba somntwana.Abantwana abasuka kwiintsapho ezikwimeko ephantsi yentlalo-ntle basengozini enkulu yokuba ne-asthma ngenxa yokusabela okuphantsi kwamajoni omzimba kunye nezibonelelo zokhathalelo lwempilo oluphantsi.21-23
Abantwana abahlala kwintsapho edibeneyo, izindlu ze-kaccha, iindawo zokuhlala ezimanzi, ukungena komoya ngokwaneleyo, iikhikhini eziqhotyoshelweyo, izibaso ezivelisa umsi, izinto zokugxotha iingcongconi kunye ne-Dhuna, njl., zazinxulumene kakhulu ne-asthma yobuntwana (p-value <0.05). Abantwana abahlala kwintsapho edibeneyo, izindlu ze-kaccha, iindawo zokuhlala ezimanzi, ukungena komoya ngokwaneleyo, iikhikhini eziqhotyoshelweyo, izibaso ezivelisa umsi, izinto zokugxotha iingcongconi kunye ne-Dhuna, njl., zazinxulumene kakhulu ne-asthma yobuntwana (p-value <0.05).Abantwana abahlala kwintsapho edibeneyo, ababalekayo ekhaya, izindlu ezifumileyo, ukungena komoya okunganelanga, iikhitshi ezincanyathiselweyo, amafutha avelisa umsi, izinto zokugxotha iingcongconi kunye neDhuna njl.njl.д., были достоверно связаны с детской астмой (значение р<0,05). e., zazinxulumene kakhulu ne-asthma yobuntwana (ixabiso 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、驱公密、驱副下、驱公寓显着相关(p 值<0.05). Abantwana abakwimizi ekwabelwana ngayo, izindlu ze-kaccha, izindlu ezifumileyo, ukungena komoya ngokwaneleyo, ikhitshi elincamatheleyo, amafutha okuvelisa umsi, izinto zokugxotha iingcongconi, kunye neDhuna zinxulumene kakhulu nesifo sombefu wabantwana (p value<0.05). Дети в общих домохозяйствах, домах качча, сырых жилищах, неадекватной вентиляции, пристроенных кухнях, задымленко, задымленном, уна были в значительной степени связаны с детской астмой (значение p <0,05). Abantwana abahlala kwimizi ekwabelwana ngayo, ukuqhutywa kwezindlu, izindlu ezifumileyo, ukungena komoya ngokwaneleyo, iikhitshi ezifakelweyo, amafutha omsi, izinto zokugxotha iingcongconi kunye ne-dhuna zayanyaniswa kakhulu nesifo sombefu wabantwana (p value <0.05).Uphando lwangaphambili luye lwabonisa ukuba izinto ezahlukeneyo zokusingqongileyo zangaphakathi zinokubangela i-asthma ebantwaneni.I-24-27 Unxulumano lwezilwanyana ezifuywayo zangaphakathi kunye ne-asthma yabantwana iyaphikisana, njengoko abaphandi abambalwa bakholelwa ukuba ukuvezwa kwangaphambili kwi-allergener kunokufaka isandla ekuphuhliseni ukunyamezela.28
Uphononongo oluninzi lubonise ukuba abantwana abazalwa ngoqhaqho banomngcipheko owonyukileyo we-asthma yabantwana xa kuthelekiswa nokuzalwa kwesiqhelo.Oku kuhambelana neziphumo zethu.29-32 Abantwana abanembali yokuzalwa kwe-asphyxia nabo banomngcipheko ophezulu wokuhlaselwa sisifuba.Isifuba somoya kamama sinegalelo elibalulekileyo kwiingxaki zokukhulelwa ezifana ne-respiratory distress syndrome kunye ne-neonatal asphyxia.33
Njengolunye uphononongo, iziphumo zangoku zibonisa ukuba imbali yobuntwana yokutya okanye i-atopy okanye imbali yosapho ye-allergies kunye ne-asthma yonyusa kakhulu umngcipheko we-asthma yobuntwana.I-34,35 Ngokuhambelana nesifundo sethu, izifundo zangaphambili ze-multi-generational zibonise ukuba imikhwa yokutshaya i-intergenerational ingakhokelela ekutshintsheni kofuzo kwi-epigenome eyandisa ingozi ye-asthma kwinzala.36
Kule mihla, ukufudukela kwabantu ezidolophini ngokukhawuleza kuye kwachaphazela onke amacandelo oluntu.Ngenxa yemithombo eyahlukeneyo yengeniso kunye nemisebenzi, abantu bakhetha ukuhlala ezixekweni kwaye ngaloo ndlela bachanabeke kwizinto ezahlukeneyo ezingcolisa indalo.Amalungu osapho lwabantwana abasesichengeni acetyiswa ukuba anike ingqwalasela ethe kratya ekuthinteleni ukufuma, ukutshaya, ukugcina izilwanyana zasekhaya kusapho ezinee-allergies/allergies, kunye nokuphepha izinto ezikwaliwayo/izinto ezibangela ukwaliwa kubantwana abanembali yosapho ye-allergies/aleji.Kufuneka kubekho ulwazi olwandisiweyo lokuncancisa ibele kuphela ngenxa yeenzuzo zokuncancisa kuthintelo lombefu.
Uninzi lwezigulana eziza kwiKholeji yezoNyango yaseGuwahati zivela kulo lonke elaseMntla Mpuma India njengoko iKholeji yezoNyango yaseGuwahati lelona ziko liphambili leengcali kulo mmandla.Uninzi lwezigulane zinemeko ephantsi yentlalo-qoqosho kunye nenqanaba eliphantsi lemfundo.I-asthma ye-bronchial ebantwaneni yingxaki eqhelekileyo kwisebe labantwana kwisibhedlele sethu.Izicwangciso ezifanelekileyo zokukhusela ezi zigulana ezinomngcipheko ophezulu ziya kunceda ukunciphisa ukugula kunye nokunciphisa ukuphindaphinda kokunyuka.
Ngaphandle kwalo lonke unyango olukhoyo lwe-asthma, izigulane ezininzi zihlala zilawulwa kakubi, kodwa ukuchongwa kwezigulane ezithile, kuquka i-phenotypes kunye ne-endotypes, kunokwandisa ulawulo lwazo.Ke, izifundo zengingqi zokuxhaphaka kwe-asthma yabantwana kunye nezinto ezinobungozi ziya kunceda kulawulo olusebenzayo lwezi meko.
Kolu phononongo, ezinye izigulane azizange zibuye ukuze ziphinde zihlolwe kwaye zilandelelwe.Oku kunokubangelwa kukungaziqondi izizathu kunye nemiphumo yesi sifo.Ngenxa yeenkqubo zonxibelelwano ezihlwempuzekileyo, asikwazanga ukulandelela zonke izigulane.
Abantwana banokuchaphazeleka kwi-asthma yendalo, kwaye ukuqonda okufanelekileyo kwezinto ezibangela i-asthma yendalo kunye ne-allergens kunokunceda ukulawula nokunciphisa umthwalo wesifo.Kwiintsapho ezinembali ye-allergies okanye i-asthma, inkathalo efanelekileyo kufuneka ithathwe ukukhusela abantwana abasesichengeni kwizinto ezibeka phambili.
Zonke iinkcukacha zagcinwa ziyimfihlo kwaye isifundo senziwe ngokuhambelana neSibhengezo saseHelsinki.
Ndiyabulela kubo bonke oogqirha babantwana abaye bancedisa ukuqokelela idatha kunye nokuvavanya umxholo wolwazi lwabo.Bonke oogxa bethu abasincedileyo ukuba sifikelele kumathala eencwadi kunye nokusingqongileyo kwesebe ngexesha lophando nabo baye bamkelwa.
Bonke ababhali baye benza igalelo elibalulekileyo kumsebenzi wengxelo, nokuba kumbono, ukuyila isifundo, ukubulawa, ukuqokelela idatha, ukuhlalutya kunye nokutolika, okanye zonke ezi ndawo;bathathe inxaxheba ekuyilweni, kuhlaziyo okanye kuphononongo olugxekayo lwenqaku.Gqibezela inguqulelo yokupapashwa, vumelana ngejenali apho inqaku liza kuthunyelwa khona, kwaye uvume ukuba noxanduva kuyo yonke imiba yomsebenzi.
1. Isicwangciso sehlabathi sonyango kunye nokuthintela i-asthma.Inyathelo leGlobal Asthma.2018. Ifumaneka apha: https://ginasthma.org/wp-content/uploads/2019/01/2018-GINA.pdf.Ukusukela nge-2 kaDisemba, 2021