[Time trends in prevalence of symptoms of allergic rhinitis in 13-14 year-old schoolchildren in 8 areas of Spain between 1993-1994 and 2001-2002 according to the International Study of Asthma and Allergies in Childhood (ISAAC)]

Prevalence and time trends of symptoms of allergic rhinitis and rhinoconjunctivitis in Spanish children: Global Asthma Network (GAN) study

INTRODUCTION

The time trends of the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy previously described in the ISAAC (International Study of Asthma and Allergies in Childhood) in 2002 are unknown; or if the geographical or age differences in Spain persist.

OBJECTIVE

To describe the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy in different Spanish geographical areas and compare them with those of the ISAAC.

METHODS

Cross-sectional study of the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy, carried out in 2016-2019 on 19943 adolescents aged 13-14 years and 17215 schoolchildren aged 6-7 years from six Spanish areas (Cartagena, Bilbao, Cantabria, La Coruña, Pamplona, and Salamanca), through a questionnaire based on the Global Asthma Network (GAN) protocol.

RESULTS

The prevalences of recent rhinitis and rhinoconjunctivitis (last 12 months), and nasal allergy/hay fever were 35.1%, 17.6%, and 14.6% in the adolescents and 20%, 8.5%, and 8.9% in the schoolchildren, respectively, with rhinoconjunctivitis in adolescents varying from 20.9% in Bilbao to 13.4% in Cartagena; and in schoolchildren, from 9.8% in La Coruña to 6.4% in Pamplona. These prevalences of rhinoconjunctivitis and nasal allergy in adolescents were higher than those described in the ISAAC (16.3% and 13%) and similar in schoolchildren to the ISAAC (9% and 9.4%).

CONCLUSIONS

There has been a stabilisation of rhinitis, rhinoconjunctivitis and nasal allergy in schoolchildren that slows the previous upward trend of ISAAC; and a slight non-significant increase in rhinoconjunctivitis and nasal allergy in adolescents. The variability found in adolescents would require local research to be better understood.

[A Study of the Prevalence of Asthma in the General Population in Spain]

Introduction

Asthma is a disease with high prevalence, which affects all age groups and generates high health and social care costs. Studies carried out in a number of populations show great variability in its prevalence, even in geographically close populations, with data suggesting a relevant influence of socio-economic factors. At present, we do not have reliable data on the prevalence of this disease in the adult population of Spain. The objectives of this study are to estimate the prevalence of asthma in the Spanish population for those aged 18-79, to describe the variability between autonomous communities, to estimate the prevalence of under and overdiagnosis, to analyse the prevalence of uncontrolled asthma and steroid-dependent asthma, to evaluate the health care cost, to identify the most frequent phenotypes and to establish a starting point to evaluate the temporal trend with subsequent studies.

Methods

A cross-sectional, two-stage study will be carried out, including patients from 50 catchment areas. The study will be carried out in 3 phases: 1) screening and confirmation in the clinical history, in which patients with a previously correctly established diagnosis of asthma will be identified; 2) diagnosis of asthma to evaluate patients without a confirmed or excluded diagnosis; 3) characterization of asthma, where the characteristics of the asthmatic patients will be analysed, identifying the most frequent phenotypes.

Discussion

It seems necessary and feasible to carry out an epidemiological study of asthma in Spain to identify the prevalence of asthma, to optimize healthcare planning, to characterize the most frequent phenotypes of the disease, and to evaluate inaccurate diagnoses.

Cross-cultural adaptation of the sinus and nasal quality of life survey (SN-5) to Spanish

OBJECTIVE

There is a high prevalence for rhinitis with an increasing trend. However, there is a lack of specific quality of life pediatric questionnaires for sinonasal symptoms. The Sinus and Nasal Quality of Life Survey (SN-5) is the only validated instrument specifically designed with this objective. In this work we have translated and validated the Spanish version of the SN5 questionnaire.

METHODS

The SN5 was translated according to the World Health Organization recommendation for the translation and adaptation of instruments. The final version of the Sp-SN5 was administered twice (day 0 and day 7) to 137 participants with and without sinonasal symptoms. Reliability was measured with Cronbach α, temporal stability was measured with intraclass correlation coefficient. External validity was assessed with a ROC curve comparing a cohort of cases (children going to turbinate radiofrequency ablation) and controls (asymptomatic children).

RESULTS

A Spearman correlation between the total result of the Sp-SN-5 questionnaire and the QOL score showed a strong negative correlation in the general sample and all the age subgroups. Internal consistency measured with Cronbach α was 0.87 for 5 items and was still over 0.83 after removing each item of the test. The intraclass correlation coefficient (ICC) for test-retest measurements was 0.94. The receiver operating characteristic (ROC) curve for all the included participants showed a very high area under the curve (0.998).

CONCLUSIONS

The Sp-SN-5 questionnaire was successfully translated and cross-culturally adapted into Spanish, and the translated version exhibited adequate properties. The survey was effective in assessing the quality of life of pediatric patients with sinonasal complaints and can be used for this purpose both in a clinical setting and in future research.

Incidence of allergic rhinitis in a cohort of young adults from 13-15 years old to 23-25 years old in Castellon (Spain)

BACKGROUND

The objective of this study was to estimate the incidence of Allergic Rhinitis (AR) in young adults and its risk or protective factors.

METHODS

A population-based prospective cohort study was carried out in 2012. The cohort participated in the International Study of Asthma and Allergy in Childhood in Castellon in 1994 and 2002. A telephone survey was conducted using the same questionnaires. A new case of AR was defined as the participants free of the disease in 2002, who self-reported suffering from AR or taking medications for AR in the period 2002-2012.

RESULTS

Of the 1805 schoolchildren in the cohort in 2002, 1435 young adults (23-25 years old) participated (follow-up 79.1%) in 2012; 743 were female and 692 male; their mean age was 24.9±0.6 years. Two hundred new cases of AR occurred in 1259 participants free of the disease with an incidence of 17.3 per 1000 person-years, and the incidence increased from 2002 (RR=1.42; 95% CI 1.15-1.75). The risk factors of AR adjusted by age and gender were sinusitis (RR=1.77; 95% CI 1.16-2.68), atopic dermatitis (RR=1.51; 95% CI 1.11-2.06) and constant exposure to truck traffic (RR=1.88; 95% CI 1.12-3.17). For male participants, the risk factors were asthma, sinusitis and atopic dermatitis, and for females bronchitis was a risk factor and presence of older siblings a protective factor.

CONCLUSIONS

An increase in AR incidence was observed. Sinusitis, atopic dermatitis and constant exposure to truck traffic were the risk factors of the AR with some differences by gender.

Sex-Related Allergic Rhinitis Prevalence Switch from Childhood to Adulthood: A Systematic Review and Meta-Analysis

BACKGROUND

A sex-related switch in the prevalence of asthma from childhood (male predominance) to adulthood (female predominance) has been described, but for allergic rhinitis this remains unclear. We aimed to examine sex- and age-group-specific differences in allergic rhinitis prevalence by systematically evaluating studies from across the globe.

METHODS

A systematic search of MEDLINE and Embase for population-based cross-sectional studies was performed regardless of the language of publication. The search was restricted to the present millennium (2000 to June 2014). Study quality was defined by the sampling method, response rate, sample size, and data collection method. To assess sex differences in the prevalence of self- or parent-reported symptoms of rhinitis, calculated pooled estimates of the male-female ratio (MFR) were obtained using random-effects model meta-analyses due to heterogeneity. A meta-regression analysis was also performed.

RESULTS

Out of 6,539 publications identified, 67 cross-sectional population-based studies (291,726 males and 301,781 females) were included in our meta-analysis. In children (<11 years of age) significantly more boys than girls had rhinitis symptoms (MFR 1.21, 95% CI 1.17-1.25), whereas in adolescents (11 to <18 years of age) males were significantly less often affected than females (MFR 0.90, 95% CI 0.85-0.95). No sex-specific prevalence difference was observed in adults (MFR 0.96, 95% CI 0.83-1.17). These findings were consistent in all continents except in Asia, where the male predominance remained beyond childhood.

CONCLUSIONS

The male predominance of rhinitis prevalence in childhood changed towards a female predominance in adolescence across the globe, except in Asia. Longitudinal studies are needed to confirm these cross-sectional data and examine possible determinants and underlying mechanisms.

Relationship Between Allergic Rhinitis and Mental Health in the General Korean Adult Population

PURPOSE

This study was conducted to evaluate the association between AR and mental health status in the general Korean adult population and to investigate the relative burden of AR on mental health using the Allergic Rhinitis and Its Impact on Asthma (ARIA) classification.

METHODS

A cross-sectional study was performed by using data from 11,154 individuals, 19 years old or older in the Korean National Health and Nutrition Examination Survey 2011-2012. Univariate analysis was conducted in the healthy AR groups with weighted prevalence of demographic characteristics, socioeconomic status, and comorbid diseases. Subanalysis that classified AR severity according to the ARIA classification was carried out to evaluate the relationship of AR severity with mental health. The odds ratios (ORs) for each component representing mental health status were estimated by multiple logistic regression analysis with confounder adjustment.

RESULTS

Univariate analysis with the chi-square test after adjustment for age, sex, body mass index, smoking status, alcohol use status, and exercise status, components representing mental health status showed a linear relationship with the severity of AR according to the ARIA classification. Stress, depressive mood, suicidal thoughts, and psychological consultation factors were correlated with AR after adjustment for demographic characteristics and socioeconomic status. Even after adjustment for comorbid allergic diseases, the correlation remained significant with stress, depressive mood, and psychological consultation factors (OR [95% CI]; 1.227 [1.042, 1.445], 1.368 [1.095, 1.71], 1.804 [1.096, 2.969], respectively).

CONCLUSIONS

Patients with AR appear to be at higher risk of mental disorders in the general Korean adult population. Moreover, persistent or severe AR was correlated with poor mental health. Therefore, better control of AR may be conducive to better mental health, and more attention should be paid to the psychological status of AR patients.

Allergic rhinitis in adolescence increases the risk of depression in later life: a nationwide population-based prospective cohort study

BACKGROUND

Many cross-sectional studies have suggested an association between allergic rhinitis (AR) and depression, but the timing relationship was not determined. Using a nationwide population-based prospective cohort study (1:4, age-/gender-matched), we hypothesized that AR in adolescence would increase the risk of depression in later life.

METHODS

In all, 1673 adolescents aged 12-15 that had AR between 1996 and 2000 were recruited for our study. Cases of major depressive disorder and any depressive disorder that occurred to the end of follow-up (December 31, 2010) were identified.

RESULT

Adolescents with AR had a higher prevalence of major depression (2.5% vs. 1.2%, p<0.001) and any depressive disorder (4.9% vs. 2.8%, p<0.001) and an earlier onset of major depression (19.31 ± 2.91 vs. 20.43 ± 2.71 years, p=0.038) and any depressive disorder (19.35 ± 2.63 vs. 20.43 ± 2.62 years, p=0.002) compared with the controls. The Cox regression model showed that adolescents with AR had increased HRs of major depression (HR: 1.59, 95% CI: 1.02-2.50) and any depressive disorder (HR: 1.42, 95% CI: 1.04-1.93) after controlling residence location and comorbid allergic diseases.

LIMITATIONS

The prevalence of depressive disorder may be underestimated because only those who had medicine-seeking behaviors were enrolled.

CONCLUSIONS

This first cohort case-control study showed an association between AR in early adolescence and depression in late adolescence and early adulthood. Our results suggested that allergic responses played important roles in the development of depression.

[Prevalence of asthma and rhinitis symptoms in A Coruña (Spain)]

INTRODUCTION

The prevalence of asthma and rhinitis is high in childhood and has been increasing in the last few years. In both diseases underdiagnosis is frequent.

OBJECTIVE

To asses the prevalence of asthma and rhinitis symptoms in childhood.

MATERIAL AND METHODS

We performed a cross-sectional study using a written questionnaire, following the methodology of the International Study of Asthma and Allergies in Childhood (ISAAC), on the prevalence of symptoms of asthma and rhinitis in La Coruña.

RESULTS

A total of 3017 boys and girls aged 6-7 years old (response rate 73.9 %) and 2981 boys and girls aged 13-14 years old (response rate 93.6 %) were included. The prevalence of "wheezing at some time" was 25.3 % in adolescents aged 13-14 years old and was 37.2 % in children aged 6-7 years. The prevalence of "asthma at some time" was 18.5 % in adolescents and 13.7 % in children. The prevalence of "rhinitis at some time" was 30.4 % in the group aged 6-7 years and 47.3 % in the group of adolescents. The prevalence of rhinitis was highest in autumn.

CONCLUSIONS

The prevalence of asthma and rhinitis is high in our population and is higher than that observed in most Spanish populations studied.

[Incidence of allergic rhinitis in a cohort of schoolchildren between 1994 and 2002 in Castellón (Spain), following the ISAAC study]

OBJECTIVE

To estimate the incidence of allergic rhinitis in schoolchildren in Castellón by comparing phases I and III of the International Study of Asthma and Allergies in Childhood (ISAAC), carried out in 1994 and 2002, respectively.

MATERIAL AND METHODS

A cohort study was performed with 3607 schoolchildren aged 6-7 years old who participated in phase I of the ISAAC study. Of these, 1805 participated in phase III (8 years later) at the age of 14-15 years, with 1627 schoolchildren without allergic rhinitis in phase I. The cumulative incidence of allergic rhinitis was estimated. Two definitions of new cases of allergic rhinitis were used: the first was based on medical diagnosis or treatment of the disease, and the second also included symptoms of allergic rhinitis in the previous 12 months. Relative risks were calculated using Poisson regression.

RESULTS

Participation was 50.0 %, and 151 new cases of allergic rhinitis according to the first definition (cumulative incidence of 9.3 % and 1.2 % per year) and 339 new cases according to the second definition (cumulative incidence of 20.8 % and 2.6 % per year) were found. No differences in incidence by gender were observed with the first definition (RR = 1.00 95 % CI 0.73-1.38) but with the second definition, the incidence was greater in girls (RR = 1.46 95 % CI 1.18-1.82).

CONCLUSIONS

The cumulative incidence of allergic rhinitis according to the first definition was in the range of incidence from cohort studies of adolescents.