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Secular trends in consultations for asthma in early childhood, the 16 administrative regions of Morocco, 2004–2012
BACKGROUND: Little is known about asthma trend in Morocco, particularly in early childhood. Furthermore, when dealing with asthma related environmental risk factors in Morocco, decision-making focus is in one region R9, while 16 regions make up the country. This work aims at studying 9-year trends i...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574130/ https://www.ncbi.nlm.nih.gov/pubmed/26381603 http://dx.doi.org/10.1186/s12889-015-2262-8 |
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author | Sadeq, Mina Abouqal, Redouane ElMarnissi, Abdelilah |
author_facet | Sadeq, Mina Abouqal, Redouane ElMarnissi, Abdelilah |
author_sort | Sadeq, Mina |
collection | PubMed |
description | BACKGROUND: Little is known about asthma trend in Morocco, particularly in early childhood. Furthermore, when dealing with asthma related environmental risk factors in Morocco, decision-making focus is in one region R9, while 16 regions make up the country. This work aims at studying 9-year trends in consultations for asthma in under-5 children in the 16 individual regions with respect to area and age group. METHODS: Direct method use, based on the only available national data from the open access files of the ministry of health, standardizing data for three age groups (0–11 ; 12–23 and 24–59 months). We compared age-adjusted rates, stratified by area (urban and rural areas) within each region (Wilcoxon's signed ranks test), and between all regions emphasizing on R9. Secular trends are examined (Kendall's rank correlation test). We also compared directly standardized rates as a rate ratio for two study populations (that of R9 and any region with highest rates). We finally compared rates by age group in selected regions. RESULTS: Secular increase in prevalence rates was shown in both urban and rural Morocco, particularly in urban areas of R10, R14, R16 and R5, and in rural areas of R14 and R16. In urban area of R10 (the highest age-adjusted prevalence rates area) the rates showed secular increase from 6.82 at 95 % CI = [6.44 to 7.19] per 1000 childhood population in 2004 to 20.91 at 95 % CI = [20.26 to 21.56] per 1000 childhood population in 2012 (P = 0.001). Rates were higher in urban than rural Morocco, particularly in R8, R9, R10, R14, R15 ; R6 was an exception. Rates in R10 were 1.63 higher than that in R9 in 2004 and rose to be 2.55 higher in 2012 ; rates in urban area of R14, about 3 times lower than that in R9 in 2004, increased to be similar in 2012. The highest-prevalence age group varied according to region and area. DISCUSSION: The regions that worth decision making attention are the urban areas of R10 (the highest prevalence rates Moroccan area, showing continuous increase), of R9, of R14 and the rural area of R6. The rates in the urban area of R9 (a current continuous decision making focus) remained high but stable within the study period and less important than those in R10. Environmental factors (biological particules, non-biological particules or gazes) are suspected.The potential unavailability of treatment at regular basis at the primary health care centers may reduce frequency of consultations for asthma in early childhood : outpatients may consult only if asthma causes problems in an attempt to get free medicines ; chances of outpatients' follow-up by the primary health care center's physicians are therefore reduced and optimal asthma control is not achieved. CONCLUSION: Social, health care policy and environmental factors, to which decision-making has to be responsive, are suspected to be affecting both frequency of and time secular trend in consultations for asthma in early childhood in Morocco. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-015-2262-8) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4574130 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-45741302015-09-19 Secular trends in consultations for asthma in early childhood, the 16 administrative regions of Morocco, 2004–2012 Sadeq, Mina Abouqal, Redouane ElMarnissi, Abdelilah BMC Public Health Research Article BACKGROUND: Little is known about asthma trend in Morocco, particularly in early childhood. Furthermore, when dealing with asthma related environmental risk factors in Morocco, decision-making focus is in one region R9, while 16 regions make up the country. This work aims at studying 9-year trends in consultations for asthma in under-5 children in the 16 individual regions with respect to area and age group. METHODS: Direct method use, based on the only available national data from the open access files of the ministry of health, standardizing data for three age groups (0–11 ; 12–23 and 24–59 months). We compared age-adjusted rates, stratified by area (urban and rural areas) within each region (Wilcoxon's signed ranks test), and between all regions emphasizing on R9. Secular trends are examined (Kendall's rank correlation test). We also compared directly standardized rates as a rate ratio for two study populations (that of R9 and any region with highest rates). We finally compared rates by age group in selected regions. RESULTS: Secular increase in prevalence rates was shown in both urban and rural Morocco, particularly in urban areas of R10, R14, R16 and R5, and in rural areas of R14 and R16. In urban area of R10 (the highest age-adjusted prevalence rates area) the rates showed secular increase from 6.82 at 95 % CI = [6.44 to 7.19] per 1000 childhood population in 2004 to 20.91 at 95 % CI = [20.26 to 21.56] per 1000 childhood population in 2012 (P = 0.001). Rates were higher in urban than rural Morocco, particularly in R8, R9, R10, R14, R15 ; R6 was an exception. Rates in R10 were 1.63 higher than that in R9 in 2004 and rose to be 2.55 higher in 2012 ; rates in urban area of R14, about 3 times lower than that in R9 in 2004, increased to be similar in 2012. The highest-prevalence age group varied according to region and area. DISCUSSION: The regions that worth decision making attention are the urban areas of R10 (the highest prevalence rates Moroccan area, showing continuous increase), of R9, of R14 and the rural area of R6. The rates in the urban area of R9 (a current continuous decision making focus) remained high but stable within the study period and less important than those in R10. Environmental factors (biological particules, non-biological particules or gazes) are suspected.The potential unavailability of treatment at regular basis at the primary health care centers may reduce frequency of consultations for asthma in early childhood : outpatients may consult only if asthma causes problems in an attempt to get free medicines ; chances of outpatients' follow-up by the primary health care center's physicians are therefore reduced and optimal asthma control is not achieved. CONCLUSION: Social, health care policy and environmental factors, to which decision-making has to be responsive, are suspected to be affecting both frequency of and time secular trend in consultations for asthma in early childhood in Morocco. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-015-2262-8) contains supplementary material, which is available to authorized users. BioMed Central 2015-09-17 /pmc/articles/PMC4574130/ /pubmed/26381603 http://dx.doi.org/10.1186/s12889-015-2262-8 Text en © Sadeq et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Sadeq, Mina Abouqal, Redouane ElMarnissi, Abdelilah Secular trends in consultations for asthma in early childhood, the 16 administrative regions of Morocco, 2004–2012 |
title | Secular trends in consultations for asthma in early childhood, the 16 administrative regions of Morocco, 2004–2012 |
title_full | Secular trends in consultations for asthma in early childhood, the 16 administrative regions of Morocco, 2004–2012 |
title_fullStr | Secular trends in consultations for asthma in early childhood, the 16 administrative regions of Morocco, 2004–2012 |
title_full_unstemmed | Secular trends in consultations for asthma in early childhood, the 16 administrative regions of Morocco, 2004–2012 |
title_short | Secular trends in consultations for asthma in early childhood, the 16 administrative regions of Morocco, 2004–2012 |
title_sort | secular trends in consultations for asthma in early childhood, the 16 administrative regions of morocco, 2004–2012 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574130/ https://www.ncbi.nlm.nih.gov/pubmed/26381603 http://dx.doi.org/10.1186/s12889-015-2262-8 |
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