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Objective: The prevalence of asthma in children age 0-14 years in Fuzhou, a city in Southeast China, was 1.57% in 1990 and 3.28% in 2000. The aim of this study was to investigate the asthma prevalence and risk factors in children in the same city in 2010. Methods: This was a cross-sectional study with a two-stage, clustered, stratified random sample design. Parents of 12 235 children 0-14 years of age in Fuzhou were surveyed using a questionnaire. Children with history and/or symptoms of asthma were then interviewed by pediatricians in a nearby clinic to confirm the diagnosis of asthma, and a second questionnaire listing reported risk factors of asthma was completed by the parents in the clinic. Results: About 11 738 questionnaires were completed with a response rate of 95.9%. Among the responders, 648 children had history and/or symptoms of asthma but only 485 (4.13%) were confirmed with asthma. The prevalence was 1.83%, 7.64% and 6.27% in the age groups of 0-1 years, 3-4 years and 13-14 years, respectively. The most significant (binary logistic regression test) factors associated with asthma were presence of atopic or allergic diseases (OR = 21.5, 95% CI: 12-38.5), family history of allergy or asthma (OR = 29.4, 95% CI: 12.6-68.6), use of at least one course of antibiotics in the first year of life (OR = 7.61, 95% CI: 3.4-17.06), supplementary protein feedings before 6 months (OR = 1.90, 95% CI: 1.23-2.95). Natural ventilation at home (versus frequent use of air-conditioning) appeared to be a protective factor (OR = 0.5, 95% CI: 0.3-0.8). Conclusion: The prevalence of asthma in childhood has increased significantly during the past 20 years in Fuzhou. [ABSTRACT FROM AUTHOR]