New cases of acute childhood asthma decline
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《英国医生杂志》
The number of new cases of acute childhood asthma being seen by GPs has declined dramatically over the past decade, new research shows.
The number of cases is less than half that being seen at the peak of the epidemic in the spring of 1993, according to data collected by researchers at the Birmingham research unit of the Royal College of General Practitioners.
The researchers say that many other studies that have shown that the number of cases is still increasing use cumulative prevalence data rather than measuring active disease.
"Everyone keeps saying it is increasing, but they are using cumulative prevalence figures. They ask people if they have ever wheezed, and more and more people say they have. I believe that the annual prevalence is the most important statistic because it shows the number of people with active disease. It is quite clear from our research that the number of attacks of asthma presenting for clinical care has been falling quite significantly," said Dr Douglas Fleming, director of the unit and one of the authors of a report in the Archives of Disease in Childhood (2004;89:282-5).
In the study, researchers looked at GP consultations for new attacks of asthma over two decades for cases of acute asthma in young children. They used a network of GP practices showing weekly contacts in a population of 110 000 children. The authors plotted the data for two age groups, the under 5s and the 5-14s.
The results show that, for the under 5s, the number of cases rose from around 30 per 100 000 in 1980 to almost 160 in 1993. Since 1993 there has been a steady decline to around 60 cases per 100 000 in 2002. In 1994, there were 6576 cases in children aged under 4; in 1997, 4962; and in 2000, 3075.
The report says that the downward trend since 1993 was consistent in both boys and girls and preschool and school age children; in all regions of the country; and during all seasons.
The researchers say that the drop cannot be explained by changes in management or clinical practice and that the findings are more consistent with a notable change in the cause of asthma.
"It could reasonably be asked why this decline in acute asthma episodes has not been reported previously. We initially considered that the reversal in trend may be temporary and only published after the trend was well established," says the report.
Just why there should have been such a decline is not known, but the drop in smoking rates, smaller families, less overcrowding, and better living conditions, are among theories being put forward.
"Perhaps most significantly there have been similar levels of reduction in the incidence of respiratory infections presenting to GPs," said Dr Fleming.(Abergavenny Roger Dobson)
The number of cases is less than half that being seen at the peak of the epidemic in the spring of 1993, according to data collected by researchers at the Birmingham research unit of the Royal College of General Practitioners.
The researchers say that many other studies that have shown that the number of cases is still increasing use cumulative prevalence data rather than measuring active disease.
"Everyone keeps saying it is increasing, but they are using cumulative prevalence figures. They ask people if they have ever wheezed, and more and more people say they have. I believe that the annual prevalence is the most important statistic because it shows the number of people with active disease. It is quite clear from our research that the number of attacks of asthma presenting for clinical care has been falling quite significantly," said Dr Douglas Fleming, director of the unit and one of the authors of a report in the Archives of Disease in Childhood (2004;89:282-5).
In the study, researchers looked at GP consultations for new attacks of asthma over two decades for cases of acute asthma in young children. They used a network of GP practices showing weekly contacts in a population of 110 000 children. The authors plotted the data for two age groups, the under 5s and the 5-14s.
The results show that, for the under 5s, the number of cases rose from around 30 per 100 000 in 1980 to almost 160 in 1993. Since 1993 there has been a steady decline to around 60 cases per 100 000 in 2002. In 1994, there were 6576 cases in children aged under 4; in 1997, 4962; and in 2000, 3075.
The report says that the downward trend since 1993 was consistent in both boys and girls and preschool and school age children; in all regions of the country; and during all seasons.
The researchers say that the drop cannot be explained by changes in management or clinical practice and that the findings are more consistent with a notable change in the cause of asthma.
"It could reasonably be asked why this decline in acute asthma episodes has not been reported previously. We initially considered that the reversal in trend may be temporary and only published after the trend was well established," says the report.
Just why there should have been such a decline is not known, but the drop in smoking rates, smaller families, less overcrowding, and better living conditions, are among theories being put forward.
"Perhaps most significantly there have been similar levels of reduction in the incidence of respiratory infections presenting to GPs," said Dr Fleming.(Abergavenny Roger Dobson)