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      Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities

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          Abstract

          Background

          Chronic sinusitis (CRS) is a common otorhinolaryngologic disease that is frequently encountered in everyday practice, but there is a lack of precise data regarding the prevalence of CRS in developing countries. We performed a national investigation in China to determine the prevalence and associated factors of CRS.

          Methods

          We conducted a cross-sectional investigation in 2012. A stratified four-stage sampling method was used to select participants randomly from seven cities in mainland China. All participants were interviewed face-to-face via a standardized questionnaire. Unconditional logistic regression analyses were conducted to examine the association between smoking and sinusitis after adjusting for socio-demographic factors.

          Results

          This study included a total of 10 636 respondents from seven cities. The overall prevalence of CRS was 8.0% and ranged from 4.8% to 9.7% in seven centres. Chronic sinusitis affected approximately 107 million people in mainland China. Chronic sinusitis was particularly prevalent among people with specific medical conditions, including allergic rhinitis, asthma, chronic obstructive pulmonary disease and gout. The prevalence was slightly higher among males (8.79%) than females (7.28%) ( P = 0.004), and the prevalence varied by age group, ethnicity and marital status and education ( P < 0.05), but not by household per capita income or living space ( P > 0.05). Both second-hand tobacco smoke and active smoking were independent risk factors for CRS ( P = 0.001).

          Conclusions

          Chronic sinusitis is an important public health problem in China. Our study provides important information for the assessment of the economic burden of CRS and the development and promotion of public health policies associated with CRS particularly in developing countries.

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          Most cited references34

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          European position paper on rhinosinusitis and nasal polyps 2007.

          Rhinosinusitis is a significant and increasing health problem which results in a large financial burden on society. This evidence based position paper describes what is known about rhinosinusitis and nasal polyps, offers evidence based recommendations on diagnosis and treatment, and considers how we can make progress with research in this area. Rhinitis and sinusitis usually coexist and are concurrent in most individuals; thus, the correct terminology is now rhinosinusitis. Rhinosinusitis (including nasal polyps) is defined as inflammation of the nose and the paranasal sinuses characterised by two or more symptoms, one of which should be either nasal blockage/obstruction/congestion or nasal discharge (anterior/posterior nasal drip), +/- facial pain/pressure, +/- reduction or loss of smell; and either endoscopic signs of polyps and/or mucopurulent discharge primarily from middle meatus and/or; oedema/mucosal obstruction primarily in middle meatus, and/or CT changes showing mucosal changes within the ostiomeatal complex and/or sinuses. The paper gives different definitions for epidemiology, first line and second line treatment and for research. Furthermore the paper describes the anatomy and (patho)physiology, epidemiology and predisposing factors, inflammatory mechanisms, evidence based diagnosis, medical and surgical treatment in acute and chronic rhinosinusitis and nasal polyposis in adults and children. Evidence based schemes for diagnosis and treatment are given for the first and second line clinicians. Moreover attention is given to complications and socio-economic cost of chronic rhinosinusitis and nasal polyps. Last but not least the relation to the lower airways is discussed.
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            The epidemiology of chronic rhinosinusitis in Canadians.

            To study the prevalence of chronic rhinosinusitis and its risk factors among Canadians. Complex survey design incorporating stratification, multiple stages of selection, and unequal probabilities of selection of respondents. We used the cross-sectional data from 73,364 subjects (34,241 male and 39,123 female subjects) 12 years of age or older who participated in the second cycle of the National Population Health Survey, which was conducted from 1996 to 1997. All these individuals were asked whether they had certain chronic health conditions that had lasted or were expected to last 6 months or longer, including rhinosinusitis. The prevalence of rhinosinusitis was higher in female (5.7%) than in male (3.4%) subjects. The sex difference was consistent across age groups. The prevalence increased with age and leveled off after the age of 60 years. In female but not in male subjects, the prevalence was slightly higher among those living the eastern region or among native Canadians as compared with those living in the central or western regions or immigrants. Cigarette smoking and low income were associated with a higher prevalence of rhinosinusitis in both sexes. The smoking effect was modified by allergy history in male subjects. Rhinosinusitis was more common among subjects with allergy history, asthma, or chronic obstructive pulmonary disease. The prevalence of rhinosinusitis was similar in subjects with or without reporting regular alcohol drinking and exercise. Previous data indicating an increased susceptibility of women to asthma and chronic obstructive pulmonary disease, together with the similar finding for rhinosinusitis, suggest that women have a general increase in susceptibility to respiratory tract disease.
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              Epidemiology and economic impact of rhinosinusitis.

              Rhinosinusitis is highly prevalent in the United States, affecting an estimated 16% of the adult population annually. The prevalence of the illness is increased in women and, relative to other US regions, in individuals living in the South. The direct costs associated with chronic rhinosinusitis are higher than the background costs in managed care patients because of increased office visits and medication prescriptions, and the indirect costs due to restricted activity days are enormous. Rhinosinusitis poses an immense economic burden in the United States. Data concerning the epidemiology and economic impact of the disease are reviewed.
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                Author and article information

                Journal
                Allergy
                Allergy
                all
                Allergy
                Blackwell Publishing Ltd (Oxford, UK )
                0105-4538
                1398-9995
                May 2015
                04 March 2015
                : 70
                : 5
                : 533-539
                Affiliations
                [1 ]Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University Guangzhou, China
                [2 ]Department of Otorhinolaryngology, The First Affiliated Hospital, Xinjiang Medical University Urumqi, China
                [3 ]Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University Nanjing, China
                [4 ]Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, China
                [5 ]Department of Otolaryngology Head and Neck, China-Japan Union Hospital, Jilin University Changchun, China
                [6 ]Department of Otolaryngology, Peking Union Medical College Hospital Beijing, China
                [7 ]Department of Otorhinolaryngology, West China Hospital of Medicine, Sichuan University Chengdu, China
                [8 ]Department of Otorhinolaryngology, Affiliated Huai'an First People's Hospital, Nanjing Medical University Huaian, China
                [9 ]State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University Guangzhou, China
                Author notes
                Prof. Geng Xu, MD, Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University 58 Zhongshan Road II, Guangzhou, Guangdong 510080, China. Tel.: +86 20 87333733 Fax: +86 20 87333733 E-mail: entxgfess@ 123456163.com and Dr. Chun-Quan Ou, State Key Laboratory of Organ Failure Research, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China. Tel.: +86 20 61360456 Fax: +86 20 61648319 E-mail: ouchunquan@ 123456hotmail.com
                [*]

                These authors contributed equally to this work.

                Article
                10.1111/all.12577
                4409092
                25631304
                4e7df96a-ad12-4243-85cb-535ab9827196
                © 2015 The Authors. Allergy Published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 15 January 2015
                Categories
                Original Articles

                Immunology
                china,chronic sinusitis,prevalence,smoking,socio-demographic
                Immunology
                china, chronic sinusitis, prevalence, smoking, socio-demographic

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