Background: To investigate the prevalence and indoor environmental influencing factors of wheezing and asthma among preschool children in Urumqi, Xinjiang, China to provide a strong basis for prevention and control. Methods: In August 2019, a cross-sectional epidemiological study involving 8153 preschool children was conducted in 60 kindergartens in Urumqi. The mean age of the children who participated in the survey was 5.27 ± 1.10 years. Additionally, 51.9% were boys, 86.9% were Han Chinese, and an 81.53% survey response rate was observed. The childhood wheeze and asthma survey used was the ALLHOME-2 questionnaire, and the childhood home dwelling and living environment survey used was the DBH questionnaire. Partial adjustments were made according to the geographical environment of Urumqi and the living habits of the residents.Results: The prevalence of wheezing and asthma in children was 4.7% and 2.0%, respectively. Multivariate unconditional logistic regression results suggested that ethnicity (odds ratio (OR)=1.39, 95% confidence interval (95%CI)=1.05–1.84), birth pattern (OR=1.24, 95%CI=1.00–1.53), family history of asthma (OR=5.00, 95%CI=3.36–7.44), carpet or floor bedding at home (OR=1.40, 95%CI=1.05–1.87), purchasing new furniture in the mother’s residence during pregnancy (OR=1.58,95%CI=1.06–2.36), pet keeping in the residence at age 0–1 (OR=1.55, 95%CI=1.13–2.13), passive smoking in the child's residence (OR=1.35, 95%CI=1.01–1.80), and having mould or hygroma in the child's residence at age 0–1 (OR=1.72, 95%CI=1.12–2.64) were risk factors for wheezing. In addition, sex (OR=0.73, 95%CI=0.59-0.90) was a protective factor for wheezing. Birth pattern (OR=1.46, 95%CI=1.06–2.00), family history of asthma (OR=7.06,95%CI=4.33–11.53), carpet or floor bedding at home (OR=2.20, 95%CI=1.50–3.23), and pet keeping in the residence at age 0–1 (OR=1.64, 95%CI=1.04–1.83) were risk factors for asthma, whereas gender (OR=0.58, 95% CI=0.42–0.80) was a protective factor for asthma. Conclusion: This survey indicates that preschool children in Urumqi have a higher risk of wheezing and asthma. Risk factors that may cause an elevated risk of wheezing or asthma have also been identified.

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To investigate the prevalence and indoor environmental influencing factors of wheeze and asthma among preschool children in Urumqi, Xinjiang, China to provide a strong basis for prevention and control. In August 2019, a cross-sectional study involving 8153 preschool children was conducted in 60 kindergartens in Urumqi. The ALLHOME-2 questionnaire was used for childhood wheeze and asthma survey, and the dampness in buildings and health (DBH) questionnaire was used for the childhood home dwelling and living environment survey. Multivariate unconditional logistic regression was then used to analyze the potential influencing factors of childhood asthma and wheeze. The prevalence of wheeze and asthma in children was 4.7% and 2.0%, respectively. Multivariate unconditional logistic regression results suggested that ethnicity other than the Han Chinese (odds ratio (OR) 1.39, 95% confidence interval (CI) 1.05–1.84), caesarean section (OR 1.24, 95% CI 1.00–1.53), family history of asthma (OR 5.00, 95% CI 3.36–7.44), carpet or floor bedding at home (OR 1.40, 95% CI 1.05–1.87), purchasing new furniture in the mother’s residence during pregnancy (OR 1.58, 95% CI 1.06–2.36), pet keeping in the residence at aged 0–1 year (OR 1.55, 95% CI 1.13–2.13), passive smoking by child in the current residence (OR 1.35, 95% CI 1.01–1.80), and having mould or hygroma in the child's residence at aged 0–1 year (OR 1.72, 95% CI 1.12–2.64) were risk factors for wheeze. In addition, Girls (OR 0.73, 95% CI 0.59–0.90) was a protective factor for wheeze. Caesarean section (OR 1.46, 95% CI 1.06–2.00), family history of asthma (OR 7.06, 95% CI 4.33–11.53), carpet or floor bedding at home (OR 2.20, 95% CI 1.50–3.23), and pet keeping in the residence at aged 0–1 year (OR 1.64, 95% CI 1.04–1.83) were risk factors for asthma, whereas Girls (OR 0.58, 95% CI 0.42–0.80) was a protective factor for asthma. This survey indicates that the purchase of new furniture, the placement of carpet or floor bedding in the child's residence, the pets keeping, room dampness or moldy phenomena, and passive smoking may all contribute to an elevated risk of wheeze or asthma in children.

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Background Pneumonia is a common disease worldwide in preschool children. Despite its large population size, China has had no comprehensive study of the national prevalence, risk factors, and management of pneumonia among preschool children. We therefore investigated the prevalence of pneumonia among preschool children in Chinese seven representative cities, and explore the possible risk factors of pneumonia on children, with a view to calling the world's attention to childhood pneumonia to reduce the prevalence of childhood pneumonia. Methods Two group samples of 63,663 and 52,812 preschool children were recruited from 2011 and 2019 surveys, respectively. Which were derived from the cross-sectional China, Children, Homes, Health (CCHH) study using a multi-stage stratified sampling method. This survey was conducted in kindergartens in seven representative cities. Exclusion criteria were younger than 2 years old or older than 8 years old, non-permanent population, basic information such as gender, date of birth and breast feeding is incomplete. Pneumonia was determined on the basis of parents reported history of clearly diagnosed by the physician. All participants were assessed with a standard questionnaire. Risk factors for pneumonia, and association between pneumonia and other respiratory diseases were examined by multivariable-adjusted analyses done in all participants for whom data on the variables of interest were available. Disease management was evaluated by the parents’ reported history of physician diagnosis, longitudinal comparison of risk factors in 2011 and 2019. Results In 2011 and 2019, 31,277 (16,152 boys and 15,125 girls) and 32,016 (16,621 boys and 15,395 girls) preschool children aged at 2–8 of permanent population completed the questionnaire, respectively, and were thus included in the final analysis. The findings showed that the age-adjusted prevalence of pneumonia in children was 32.7% in 2011 and 26.4% in 2019. In 2011, girls (odds ratio [OR] 0.91, 95%CI [confidence interval]0.87–0.96; p = 0.0002), rural (0.85, 0.73–0.99; p = 0.0387), duration of breastfeeding ≥ 6 months(0.83, 0.79–0.88; p < 0.0001), birth weight (g) ≥ 4000 (0.88, 0.80–0.97; p = 0.0125), frequency of putting bedding to sunshine (Often) (0.82, 0.71–0.94; p = 0.0049), cooking fuel type (electricity) (0.87, 0.80–0.94; p = 0.0005), indoor use air-conditioning (0.85, 0.80–0.90; p < 0.0001) were associated with a reduced risk of childhood pneumonia. Age (4–6) (1.11, 1.03–1.20; p = 0.0052), parental smoking (one) (1.12, 1.07–1.18; p < 0.0001), used antibiotics (2.71, 2.52–2.90; p < 0.0001), history of parental allergy (one and two) (1.21, 1.12–1.32; p < 0.0001 and 1.33, 1.04–1.69; p = 0.0203), indoor dampness (1.24, 1.15–1.33; p < 0.0001), home interior decoration (1.11, 1.04–1.19; p = 0.0013), Wall painting materials (Paint) (1.16, 1.04–1.29; p = 0.0084), flooring materials (Laminate / Composite wood) (1.08, 1.02–1.16; p = 0.0126), indoor heating mode(Central heating)(1.18, 1.07–1.30, p = 0.0090), asthma (2.38, 2.17–2.61; p < 0.0001), allergic rhinitis (1.36, 1.25–1.47; p < 0.0001), wheezing (1.64, 1.55–1.74; p < 0.0001) were associated with an elevated risk of childhood pneumonia; pneumonia was associated with an elevated risk of childhood asthma (2.53, 2.31–2.78; p < 0.0001), allergic rhinitis (1.41, 1.29–1.53; p < 0.0001) and wheezing (1.64, 1.55–1.74; p < 0.0001). In 2019, girls (0.92, 0.87–0.97; p = 0.0019), duration of breastfeeding ≥ 6 months (0.92, 0.87–0.97; p = 0.0031), used antibiotics (0.22, 0.21–0.24; p < 0.0001), cooking fuel type (Other) (0.40, 0.23–0.63; p = 0.0003), indoor use air-conditioning (0.89, 0.83–0.95; p = 0.0009) were associated with a reduced risk of childhood pneumonia. Urbanisation (Suburb) (1.10, 1.02–1.18; p = 0.0093), premature birth (1.29, 1.08–1.55; p = 0.0051), birth weight (g) < 2500 (1.17, 1.02–1.35; p = 0.0284), parental smoking (1.30, 1.23–1.38; p < 0.0001), history of parental asthma (One) (1.23, 1.03–1.46; p = 0.0202), history of parental allergy (one and two) (1.20, 1.13–1.27; p < 0.0001 and 1.22, 1.08–1.37; p = 0.0014), cooking fuel type (Coal) (1.58, 1.02–2.52; p = 0.0356), indoor dampness (1.16, 1.08–1.24; p < 0.0001), asthma (1.88, 1.64–2.15; p < 0.0001), allergic rhinitis (1.57, 1.45–1.69; p < 0.0001), wheezing (2.43, 2.20–2.68; p < 0.0001) were associated with an elevated risk of childhood pneumonia; pneumonia was associated with an elevated risk of childhood asthma (1.96, 1.72–2.25; p < 0.0001), allergic rhinitis (1.60, 1.48–1.73; p < 0.0001) and wheezing (2.49, 2.25–2.75; p < 0.0001). Conclusions Pneumonia is prevalent among preschool children in China, and it affects other childhood respiratory diseases. Although the prevalence of pneumonia in Chinese children shows a decreasing trend in 2019 compared to 2011, a well-established management system is still needed to further reduce the prevalence of pneumonia and reduce the burden of disease in children.