Salih BİLGİN, Hasan HAMZAÇEBİ, Meftun ÜNSAL, Saliha ERCAN, Servet KAYHAN

Prevalence of asthma and respiratory symptoms by age, gender and smoking behaviour in Samsun, North Anatolia Turkey

Astım, tüm dünyada olduğu gibi ülkemizde de bilinen önemli sağlık problemlerinden birisidir. Türkiye’nin Orta Karadeniz bölgesinin bir ili olan Samsun’da, yetişkinlerdeki astım prevalansını saptayan bir çalışma yapılmamıştır. Çalışmamızın amacı bölgemizdeki astım prevalansı, astım benzeri semptomlar, bunların yaş, cins ve sigara içme alışkanlıklarıyla ilişkilerini araştırmaktır. Kasım-Aralık 2002 tarihleri arasında “European Respiratory Community Health Survey (ERCHS)” sorularından yararlanılarak hazırladığımız anket formu, seçilen kişilere yüz-yüze görüşme metoduyla sağlık ocağı çalışanları tarafından uygulandı. Çalışma Samsun merkez ilçede yaşayan 15 yaş ve üstündeki 1916 kişiye uygulandı. Bunlardan 810 (%42.3)’u erkek, 1106 (%57.7)’sı kadın idi. Çalışmaya katılanların yaş ortalaması 37.8 ± 15.5 yıl idi. Astım tanısı %2.7, astım için ilaç kullanımı %2.2, son 12 ay içinde wheezing %15.5, son 12 ay içinde nefessizlikle beraber wheezing oranı %11.6 olarak bulundu. Yaş grubu arttıkça semptom görülme oranları artmakta idi (p< 0.0001). Tanı konulmuş astım prevalansı, kadınlarda erkeklere göre daha yüksek (χ2= 5.16 p< 0.05) idi. Sabah öksürüğü, gün boyu öksürük, kronik öksürük, balgamlı öksürük ve öksürükle uyanma erkeklerde daha fazla saptandı (p< 0.01). Astım semptomlarının görülme sıklığı, sigara içenlerde içmeyenlere göre anlamlı derecede yüksek bulundu (p< 0.001). Sonuç olarak çalışmamızda, astım tanı ve tedavi prevalansının düşük olduğu ve astımla ilişkili semptomların fazla olduğu gözlendi. Sigara içiminin bu semptomları arttırdığı belirlendi.

Kuzey Anadolu’da bulunan Samsun’da sigara, cins ve yaşa göre solunumsal semptomlar ve astımın prevalansı

Asthma is a major health problem worldwide. This is the first study determining the prevalence of asthma among adults in Samsun which is situated in the centre of the Black Sea region of Turkey. The aim of our study was to assess the prevalence of asthma and asthmatic symptoms, and the relationships of these with age, gender and smoking behaviour in this region. A questionnaire interview adapted from the European Respiratory Community Health Survey (ERCHS) was performed by health centre officers with selected people between November-December, 2002. The study population included a total of 1.916 [810 men (42.3%) and 1.106 women (57.7%)] inhabitants of Samsun city center, aged 15 years of age or above. The mean age was 37.8 years ± 15.5, the prevalence of asthma was 2.7%, receiving asthma medicine was 2.2%, the prevalence of wheezing in the last 12 months was 15.5% and shortness of breath with wheezing was 11.6%. The frequency of symptoms was higher among the elderly population when compared to other groups (p< 0.0001). Asthma diagnosis by a physician was more frequent among women (χ2= 5.16, p< 0.05). Morning cough, day time cough, chronic cough, phlegmy cough and waking up with cough symptoms were more frequent among the smokers (p< 0.001). Asthma diagnosis and asthma treatment are at a very low level compared to reported asthma related symptoms.

PDF

___

1. Upton MN, McConnachie A, McSharry C, et al. Intergenerational 20 year trends in prevalence of asthma and hay fever in adults: The Midspan family study surveys of parents and offspring. BMJ 2000; 321: 88-92.
2. Hansen EF, Rappeport Y, Vestbo J, Lange P. Increase in prevalence and severity of asthma in young adults in Copenhagen. Thorax 2000; 55: 833-6.
3. Kalyoncu AF, Türktaş H (editörler). Ulusal Verilerle Astma Epidemioloji. Ankara: Kent Matbaacılık, 1999: 8-39.
4. Burney PGJ. Variations in the prevalence of respiratory symptoms, self reported asthma attacks and use of asthma medications in the European Community Respiratory Health Survey (ECRHS). Eur Respir J 1996; 9: 687-95.
5. Manfreda J, Becklake MR, Sears MR, et al. Prevalence of asthma symptoms among adults aged 20-44 years in Canada. CMAJ 164: 995-1001.
6. Chan-Yeung M, Zhang LX, Tu DH, et al. The prevalence of asthma and asthma- like symptoms among adults in rural Beijing, China. Eur Respir J 2002; 19: 853-8.
7. Magnus P, Jaakkola JJ. Secular trends in the occurrence of asthma among children and young adults: Critical appraisal of repeated cross sectional surveys. BMJ 1997; 314: 1795-9.
8. Haahtela T, Lindholm H, Björksten F, et al. Prevalence of asthma in Finnish young men. BMJ 1990; 301: 266-8.
9. Papageorgiou N, Gaga M, Marossis C, et al. Prevalence of asthma and asthma-like symptoms in Athens, Greece. Respir Med 1997; 91: 83-8.
10. Saraçlar Y, Çetinkaya F, Tuncer A, et al. The prevalence of self-reported asthma and respiratory symptoms in Ankara, Turkey. Respir Med 1997; 1: 461-3.
11. Özlü T, Çan G, Torun P, TEPAP Çalışma Grubu. Trabzon’da erişkin popülasyonda astma prevalansı. Tüberküloz ve Toraks Dergisi 1999; 47: 65-7.
12. Akkurt I, Sumer H, Ozsahin SL, et al. Prevalence of asthma and related symptoms in Sivas, Central Anatolia. J Asthma 2003; 40: 551-6.
13. Eagan TML, Bakke PS, Eide GE, Gulsvik A. Incidence of asthma and respiratory symptoms by sex, age and smoking in a community study. Eur Respir J 2002; 19: 599-605.
14. Samsun City Health Management Registrations 2002.
15. European Community Respiratory Health Survey. Variations in the prevalence of respiratory symptoms, self-reported asthma attacks, and use of asthma medication in the European Community Respiratory Health Survey (ECRHS). Eur Respir J 1996; 9: 687-95.
16. Magnus P, Jaakkola JJ. Secular trends in the occurrence of asthma among children and young adults: Critical appraisal of repeated cross sectional surveys. BMJ 1997; 314: 1795-9.
17. Brogger J, Bakke P, Eide GE, et al. Long-term changes in adult asthma prevalence. Eur Respir J 2003; 21: 468-72.
18. Kalyoncu AF. Ülkemizde bronş astması epidemiyolojisi. Bronş Astması 2001. Ankara: Atlas Kitapçılık, 2001: 1-14.
19. Abramson M, Matheson M, Wharton C, et al. Prevalence of respiratory symptoms related to chronic obstructive pulmonary disease and asthma among middle-aged and older adults. Respirology 2002; 7: 325-31.
20. Bjornson CL, Mitchell I. Gender differences in asthma in childhood and adolescence. J Gend Specif Med 2000; 3: 57-61.
21. Woods RK, Walters EH, Wharton C, et al. The rising prevalence of asthma in young Melbourne adults is associated with improvement in treatment. Ann Allergy Asthma Immunol 2001; 87: 117-23.
22. Thomson NC, Chaudhuri R, Livingston E. Active cigarette smoking and asthma. Clin Exp Allergy 2003; 33: 1471-5.
23. Althuis MD, Sexton M, Prybylski D. Cigarette smoking and asthma symptom severity among adult asthmatics. J Asthma 1999; 36: 257-64.
24. Langhammer A, Johnsen R, Holmen J, Gulsvik A, Bjermer. Cigarette smoking gives more respiratory symptoms among women than among men. The Nord-Trondelag Health Study (HUNT). J Epidemiol Community Health 2000; 54: 917-22.
25. Godtfredsen NS, Lange P, Prescott E, et al. Changes in smoking habits and risk of asthma: A longitudinal population based study. Eur Respir J 2001; 18: 549-54.