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Weber A, Herr C, Hendrowarsito L, Meyer N, Nennstiel-Ratzel U, von Mutius E, Bolte G, Colon D, Kolb S. No further increase in the parent reported prevalence of allergies in Bavarian preschool children: Results from three cross-sectional studies. Int J Hyg Environ Health 2016; 219:343-8. [PMID: 26944211 DOI: 10.1016/j.ijheh.2016.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 02/11/2016] [Accepted: 02/11/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND After three decades of an increase in the prevalence of asthma and allergies, new findings show a plateau in the prevalence of industrialized nations. The objective of this study was to determine whether there was a change in the parent reported prevalence of asthma and allergies among Bavarian preschool children since 2004. METHODS A parent questionnaire was administered as part of the Bavarian school entrance examination in three cross-sectional studies from 2004/2005, 2006/2007 and 2012/2013. The questionnaire included items on allergy testing history, identified allergens, symptoms (e.g. wheezing, itchy eyes, rash), medically diagnosed asthma, hay fever and atopic dermatitis. Logistic regression was performed to observe time patterns and adjust for risk factors. RESULTS Data were available for 6350 (2004/2005), 6483 (2006/2007) and 5052 (2012/2013) individuals. Symptoms and diseases were more frequent in boys, except for allergies which affect the skin. From 2004 to 2012 the parent reported prevalence of asthma (2.6% to 2.8%), hay fever (4.7% to 4.0%) and atopic dermatitis (12.4% to 11.1%) either remained quite stable or decreased not significantly. CONCLUSIONS Results from these three cross-sectional surveys of parent reports suggest that the parent reported prevalences of asthma and allergies are quite stable with small fluctuations since 2004 for Bavarian preschool children. Future research is needed to determine if this trend will continue.
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Affiliation(s)
- Alisa Weber
- Department of Occupational and Environmental Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538, Munich, Germany.
| | - Caroline Herr
- Department of Occupational and Environmental Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538, Munich, Germany
| | - Lana Hendrowarsito
- Department of Occupational and Environmental Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538, Munich, Germany
| | - Nicole Meyer
- Department of Occupational and Environmental Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538, Munich, Germany
| | - Uta Nennstiel-Ratzel
- Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764, Oberschleißheim, Germany
| | - Erika von Mutius
- Dr von Hauner Children's Hospital, Ludwig Maximilian University, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Lindwurmstrasse 4, 80337, Munich, Germany
| | - Gabriele Bolte
- Department of Occupational and Environmental Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538, Munich, Germany; Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Diana Colon
- Department of Occupational and Environmental Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538, Munich, Germany
| | - Stefanie Kolb
- Department of Occupational and Environmental Epidemiology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, 80538, Munich, Germany
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Schuh C, Fritscher LG, Chapman KR, Fritscher CC. The prevalence of asthma and atopy in schoolchildren from Porto Alegre, Brazil, has plateaued. Respir Med 2015; 109:308-11. [PMID: 25683031 DOI: 10.1016/j.rmed.2015.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 01/05/2015] [Accepted: 01/24/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE A significant increase in the prevalence of asthma and atopy was observed in epidemiological studies conducted in 1980, 1989 and 1998, with schoolchildren of Porto Alegre. The present study aims to determine changes in the prevalence of symptoms of current and lifetime asthma and also to document the prevalence of atopy in schoolchildren from a region of Porto Alegre. METHODS This was a cross-sectional study in which schoolchildren from 5th to 8th grade (10-18 years), from four schools located in the same geographic area were interviewed. The questionnaire covered symptoms suggestive of lifetime or current asthma (at some point in life or in the last twelve months, respectively). In addition, skin tests were performed in a subset of 241 schoolchildren. RESULTS 964 students were interviewed from a total of 1195 registered. The prevalence of lifetime asthma symptoms was found to be 41.7%, symptoms of current asthma 14.9% and atopy 52.7%. Compared to previous studies, the prevalence of lifetime asthma and atopy has stabilized while the prevalence of current asthma fell from 22% to 14.9% (P < 0.001). CONCLUSIONS In the last decade the prevalence of atopy and lifetime asthma has plateaued, while the prevalence of current asthma fell.
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Affiliation(s)
- Camila Schuh
- Faculty of Medicine, Pontific Catholic University (PUCRS), Ipiranga Av. 6690, Porto Alegre, RS, Brazil
| | - Leandro Genehr Fritscher
- Faculty of Medicine, Pontific Catholic University (PUCRS), Ipiranga Av. 6690, Porto Alegre, RS, Brazil
| | - Kenneth R Chapman
- Asthma and Airway Centre, University Health Network, University of Toronto, Toronto Western Hospital, 399 Bathurst St., Toronto, ON M5T 2S8, Canada
| | - Carlos Cezar Fritscher
- Faculty of Medicine, Pontific Catholic University (PUCRS), Ipiranga Av. 6690, Porto Alegre, RS, Brazil.
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Song N, Shamssain M, Mohammed S, Zhang J, Wu J, Fu C, Hao S, Guan J, Yan X. Prevalence, severity and risk factors of asthma, rhinitis and eczema in a large group of Chinese schoolchildren. J Asthma 2013; 51:232-42. [PMID: 24303994 DOI: 10.3109/02770903.2013.867973] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is a lack of information on the prevalence, severity and risk factors of asthma, rhinitis and eczema in Chinese children. OBJECTIVE To establish baseline data for a major longitudinal study of factors affecting asthma, rhinitis and eczema in a large group of children from the industrialized city of Shijiazhuang, China. METHODS We used the International Study of Asthma and Allergies in Childhood questionnaire and studied 10 338 children, ages 6-18, from Shijiazhuang. RESULTS The prevalence of childhood asthma, rhinitis and eczema is 1.2%, 13.5% and 11.8%, respectively. Boys had higher prevalence of these conditions than girls and younger children had higher prevalence of asthma and eczema but lower prevalence of rhinitis than older children. Breastfed children had lower prevalence of asthma and rhinitis, but not eczema, than non-breastfed children. Overweight children had higher prevalence of asthma and rhinitis than those who were not overweight. Children exposed to paternal smoking had higher prevalence of rhinitis and eczema than those not exposed; children exposed to pets had higher prevalence of asthma and rhinitis than those not exposed. CONCLUSIONS The prevalence of asthma in this study group is low, but the prevalence of rhinitis is high, and could be considered a major public health problem. The prevalence of asthma, rhinitis and eczema is generally higher in boys and younger children generally have higher prevalence of asthma and eczema but lower prevalence of rhinitis. Exposure to pets is a risk factor for rhinitis, being overweight is a risk factor for asthma and rhinitis, and exposure to parental smoking is a risk factor for asthma, rhinitis and eczema in these children.
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Affiliation(s)
- Ning Song
- Department of Respiratory Medicine, the Second Hospital of Hebei Medical University , Shijiazhuang, Hebei , P.R. China
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Delmas MC, Marguet C, Raherison C, Nicolau J, Fuhrman C. [Admissions for pediatric asthma in France]. Arch Pediatr 2013; 20:739-47. [PMID: 23731604 DOI: 10.1016/j.arcped.2013.04.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 04/08/2013] [Accepted: 04/20/2013] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Most hospital admissions for asthma exacerbation are avoidable with adequate disease management. The objective of this study was to describe admissions for asthma in children in France using data from the French nationwide hospital database. METHODS We selected admissions having either a main diagnosis of asthma or a main diagnosis of acute respiratory failure (ARF) with asthma as an associated diagnosis, occurring in children (age<15years) between 2002 and 2010 in France (excluding French Guyana). RESULTS In 2010, 35,004 asthma admissions and 1381 cases of asthma-related ARF were recorded (crude admission rate, 30.1/10,000 children); the mean length of stay was 2days. The in-hospital lethality rate ranged from 0.01% to 0.03% depending on the year. The annual age-standardized admission rate increased between 2002 and 2010 (+2.5% per year on average in metropolitan France). In 2010, 11.8% of children admitted for asthma or asthma-related ARF were readmitted for asthma or asthma-related ARF at least once within the same calendar year, and 1.3% were readmitted within the week following admission. The proportion of children aged less than 5 years who were readmitted within the same calendar year increased between 2002 and 2010. CONCLUSION The increase in admission and readmission rates indicates non-optimal management of asthma in children in France.
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Affiliation(s)
- M-C Delmas
- Département des maladies chroniques, institut de veille sanitaire, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France.
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Aubas C, Bourdin A, Aubas P, Gamez AS, Halimi L, Vachier I, Malafaye N, Chanez P, Molinari N. Role of comorbid conditions in asthma hospitalizations in the south of France. Allergy 2013; 68:637-43. [PMID: 23573840 DOI: 10.1111/all.12137] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2013] [Indexed: 01/25/2023]
Abstract
BACKGROUND Reasons for asthma hospitalizations are dynamic and complex. Comorbid conditions are important contributors to most chronic diseases today. We aim to characterize and describe risk factors associated with hospitalizations due to asthma in the Languedoc-Roussillon region (France) in 2009. METHODS Programme de Médicalisation des Systèmes d'Information (PMSI) data records from 2009 were sorted using selected International Classification of Diseases (ICD10) codes eliciting three groups of asthma hospitalizations according to acute severity. All available data including demographics, comorbid conditions, past hospitalizations either related or unrelated to asthma, seasonality and distance to medical facilities were used to compare the subjects within the three groups. RESULTS One thousand two hundred and eighty-nine hospitalizations due to asthma exacerbation were found, concerning 1122 patients. We observed significant differences within the groups, using univariate analysis, concerning duration of hospitalizations (mean ± SD, 4.9 ± 5.9 days vs 6.4 ± 6.8 vs 15.8 ± 16.8, P < 0.001), deaths (percentage, 0.03% vs 1.50% vs 9.20%, P < 0.001) and numbers of comorbid conditions (0.80 ± 0.95 vs 0.75 ± 0.97 vs 1.74 ± 1.36, P < 0.001). Recurrent admissions for asthma during the period 2006-2008 were significantly more frequent in the more severe group (1.93 ± 3.91 vs 2.56 ± 4.47 vs 2.81 ± 3.97, P = 0.006). In the multivariate model, age and number of comorbid conditions were independently associated with severe hospitalizations and deaths. CONCLUSIONS Asthma hospitalizations can be appropriately assessed using PMSI coding databases. In this study, age and the presence of comorbid conditions are the major risk factors for asthma hospitalizations and deaths.
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Affiliation(s)
| | | | - P. Aubas
- Department of Medical Information; CHU Montpellier; Montpellier; France
| | - A. S. Gamez
- Department of Pneumology; CHU Montpellier; Montpellier; France
| | - L. Halimi
- Department of Pneumology; CHU Montpellier; Montpellier; France
| | - I. Vachier
- Department of Pneumology; CHU Montpellier; Montpellier; France
| | - N. Malafaye
- Department of Medical Information; CHU Montpellier; Montpellier; France
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Goodwin RD, Seeley JR, Lewinsohn PM. Childhood respiratory symptoms and mental health problems: the role of intergenerational smoking. Pediatr Pulmonol 2013; 48:195-201. [PMID: 22588945 PMCID: PMC3422397 DOI: 10.1002/ppul.22579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 03/13/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the potential role of youth smoking, parental cigarette smoking and parental anxiety/depressive disorders in the relationship between respiratory symptoms and mental health problems among youth. WORKING HYPOTHESIS Adjusting for both parental smoking and parental anxiety/depressive disorders in the association between respiratory symptoms and mental health problems among young persons will significantly reduce the strength of the observed relationship. STUDY DESIGN Prospective cohort study. PATIENT-SUBJECT SELECTION: Data were drawn from a school-based sample of 1709 young persons in Oregon. METHODOLOGY Physical and mental health data were collected on youth. RESULTS Respiratory symptoms were associated with significantly increased odds of mental health problems among youth. After adjusting for youth smoking, the relationship between respiratory symptoms and depressive disorders was no longer statistically significant. The relationships between respiratory symptoms and anxiety and depressive disorders were no longer significant after adjusting for parental smoking. Parental anxiety/depressive disorders did not appear to influence these relationships. CONCLUSIONS These results provide initial evidence that exposure to parental smoking may play a role in the observed co-occurrence of respiratory and mental health problems in youth, and youths' own smoking appears to influence the link with depressive disorders, but not anxiety disorders.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
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A medication assessment tool to evaluate adherence to medication guideline in asthmatic children. Int J Clin Pharm 2013; 35:289-95. [PMID: 23359031 DOI: 10.1007/s11096-012-9702-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 09/17/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Asthma is one of the commonest causes of morbidity and mortality in childhood. The goals of the present study were to design a valid medication assessment tool for evaluating the quality of medication use according to recommendations of updated asthma guidelines for children aged from 5 to 12 years, and to quantify adherence to guideline recommendations. SETTING Two primary care settings in Scotland, UK. METHODS Recommendations related to the long-term management of asthmatic children in the British Thoracic Society/Scottish Intercollegiate Guidelines Network and Global Initiative for Asthma guidelines were identified and corresponding criteria were created. These criteria were incorporated to generate an assessment tool named MAT ASTHMA-PAED. Two phases of field-testing were undertaken and the tool was also subject to examination by a focus group of specialist practitioners. Thereafter, MAT ASTHMA-PAED was modified accordingly. MAIN OUTCOME MEASURE Applicability and adherence to each criterion and overall adherence to the MAT ASTHMA-PAED. RESULTS The MAT ASTHMA-PAED field-testing was undertaken in two primary care practices in Scotland, United Kingdom and 77 asthmatic children were recruited. Results of the pilot study field-testing showed a high overall adherence of 70.0 % (95 % CI: 58.7-81.3 %) to the guidelines. Low adherence (<50 %) was seen for 4 criteria, whereas 8 criteria were considered high-adherence criteria (>70 %). The final MAT ASTHMA-PAED comprised of 25 criteria was produced based on the results of field testing and the opinions from the focus group. CONCLUSION Although high utility of MAT ASTHMA-PAED criteria was found, there were gaps in the implementation of certain recommendations, particularly in relation to demonstrated satisfactory technique of inhaler. Moreover, further studies assessing the use of oral steroids and exercise-induced asthma, and wider implementation of MAT ASTHMA-PAED are required.
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Sachedina N, Donaldson LJ. Paediatric mortality related to pandemic influenza A H1N1 infection in England: an observational population-based study. Lancet 2010; 376:1846-52. [PMID: 21030071 DOI: 10.1016/s0140-6736(10)61195-6] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Young people (aged 0-18 years) have been disproportionately affected by pandemic influenza A H1N1 infection. We aimed to analyse paediatric mortality to inform clinical and public health policies for future influenza seasons and pandemics. METHODS All paediatric deaths related to pandemic influenza A H1N1 infection from June 26, 2009, to March 22, 2010 in England were identified through daily reporting systems and cross-checking of records and were validated by confirmation of influenza infection by laboratory results or death certificates. Clinicians responsible for each individual child provided detailed information about past medical history, presentation, and clinical course of the acute illness. Case estimates of influenza A H1N1 were obtained from the Health Protection Agency. The primary outcome measures were population mortality rates and case-fatality rates. FINDINGS 70 paediatric deaths related to pandemic influenza A H1N1 were reported. Childhood mortality rate was 6 per million population. The rate was highest for children aged less than 1 year. Mortality rates were higher for Bangladeshi children (47 deaths per million population [95% CI 17-103]) and Pakistani children (36 deaths per million population [18-64]) than for white British children (4 deaths per million [3-6]). 15 (21%) children who died were previously healthy; 45 (64%) had severe pre-existing disorders. The highest age-standardised mortality rate for a pre-existing disorder was for chronic neurological disease (1536 per million population). 19 (27%) deaths occurred before inpatient admission. Children in this subgroup were significantly more likely to have been healthy or had only mild pre-existing disorders than those who died after admission (p=0·0109). Overall, 45 (64%) children had received oseltamivir: seven within 48 h of symptom onset. INTERPRETATION Vaccination priority should be for children at increased risk of severe illness or death from influenza. This group might include those with specified pre-existing disorders and those in some ethnic minority groups. Early pre-hospital supportive and therapeutic care is also important. FUNDING Department of Health, UK.
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Gonzalez Barcala F, Aboal Viñas J, Valdes Cuadrado L, Bourdin A, Alvarez Dobaño J, Takkouche B. Trends in hospital admissions due to asthma in north-west Spain from 1995 to 2007. Allergol Immunopathol (Madr) 2010; 38:254-8. [PMID: 20452117 DOI: 10.1016/j.aller.2009.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 10/31/2009] [Accepted: 11/07/2009] [Indexed: 10/19/2022]
Abstract
PURPOSE Asthma is the most common chronic disease in childhood. Hospital admissions in the child population appear to be reducing in different populations. METHODS We have retrospectively analysed admissions into hospitals in our region due to asthma in a 0 to 14 years population, between the years 1995 and 2007. The age, sex, date of admission, and length of hospital stay of each patient was recorded and analysed. RESULTS A total of 9106 admissions (64% males) have been included. A gradual trend towards a reduction in admissions is observed during the period analysed. There were more admissions in 1996, with 2.91 per thousand inhabitants, gradually reducing to 1.33 per thousand in 2007. There were more admissions in May and between September and December, being less frequent in July and August. The mean stay in this period was 4.18 days, which was stable during the whole period of the study. Older children tended to have a longer hospital stay. CONCLUSIONS Our study shows that admissions due to childhood asthma tend to be decreasing, particularly due to younger males, with no change in the length of hospital stay. Asthma exacerbations seemed to be associated with infections and exposure to allergens.
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Anandan C, Nurmatov U, van Schayck OCP, Sheikh A. Is the prevalence of asthma declining? Systematic review of epidemiological studies. Allergy 2010; 65:152-67. [PMID: 19912154 DOI: 10.1111/j.1398-9995.2009.02244.x] [Citation(s) in RCA: 353] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Asthma prevalence has increased very considerably in recent decades such that it is now one of the commonest chronic disorders in the world. Recent evidence from epidemiological studies, however, suggests that the prevalence of asthma may now be declining in many parts of the world, which, if true is important for health service planning and also because this offers the possibility of generating and testing new aetiological hypotheses. Our objective was to determine whether the prevalence of asthma is declining worldwide. We undertook a systematic search of EMBASE, Medline, Web of Science and Google Scholar, for high quality reports of cohort studies, repeat cross-sectional studies and analyses of routine healthcare datasets to examine international trends in asthma prevalence in children and adults for the period 1990-2008. There were 48 full reports of studies that satisfied our inclusion criteria. The large volume of data identified clearly indicate that there are, at present, no overall signs of a declining trend in asthma prevalence; on the contrary, asthma prevalence is in many parts of the world still increasing. The reductions in emergency healthcare utilization being reported in some economically developed countries most probably reflect improvements in quality of care. There remain major gaps in the literature on asthma trends in relation to Africa and parts of Asia. There is no overall global downward trend in the prevalence of asthma. Healthcare planners will for the foreseeable future, therefore, need to continue with high levels of anticipated expenditure in relation to provision of asthma care.
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Affiliation(s)
- C Anandan
- Centre for Population Health Sciences, University of Edinburgh, UK
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McNeill G, Tagiyeva N, Aucott L, Russell G, Helms PJ. Changes in the prevalence of asthma, eczema and hay fever in pre-pubertal children: a 40-year perspective. Paediatr Perinat Epidemiol 2009; 23:506-12. [PMID: 19840286 DOI: 10.1111/j.1365-3016.2009.01057.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Surveys of primary schools children in Aberdeen carried out in 1964, 1989, 1994 and 1999 suggested a slowing of the increase in parent-reported wheeze between 1994 and 1999. To assess whether this pattern had continued, questionnaires were distributed to 5712 children aged 7-12 years in the same schools in 2004. A total of 3271 (57.3%) completed questionnaires were returned. As in earlier surveys the results were divided into those for younger children (school years 3-4; age 7-9 years) and older children (school years 5-7; age 9-12 years). Compared with 1999, the 2004 results showed a decrease in the proportion of children with wheeze in the last 3 years from 30.1% to 23.3% (P < 0.001) in the younger group and from 27.6% to 25.1% (P = 0.052) in the older group. There was no significant change in the lifetime prevalence of asthma in either the younger or the older group, but the lifetime prevalence of eczema and hay fever increased by around 10% in both the younger and older groups (all P < 0.001). The differences in the time trends for the different conditions suggest that the causal factors for wheeze and asthma differ from those for other allergic diseases of childhood.
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Affiliation(s)
- G McNeill
- Departments of Child Health, University of Aberdeen, Aberdeen, UK.
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Tai A, Volkmer R, Burton A. Prevalence of asthma symptoms and atopic disorders in preschool children and the trend over a decade. J Asthma 2009; 46:343-6. [PMID: 19484666 DOI: 10.1080/02770900802660998] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Over the last few decades, there have been substantial publications on the prevalence and trends of asthma in school-age children and adolescents. There has been a scarcity of reports on asthma prevalence and trends in preschool children. This study was performed to measure the prevalence of symptoms of asthma, allergic rhinitis, and eczema in preschool (4- and 5-year-old) children and the trend over a decade. STUDY DESIGN A cross-sectional questionnaire based survey using the International Study of Asthma and Allergy in Childhood (ISAAC) was performed on South Australian preschool children in 2006. The results were compared to a previous survey conducted in 1993. RESULTS The 12-month period prevalence of reported wheeze, allergic rhinitis, and eczema was 23.7%, 20.8%, and 18.8%, respectively. The prevalence of wheeze symptoms was higher in males than females. There was a decline in the prevalence of "wheeze in the last 12 months" (25.2% to 23.7%) and in "asthma ever" (22.5% to 19.0%, p < 0.05) from 1993 to 2006. CONCLUSION There is a burden in the symptoms of asthma, allergic rhinitis, and eczema in preschool children. There is a declining trend in the prevalence of "current wheeze" and "asthma ever" in South Australian preschool children over a decade.
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Affiliation(s)
- Andrew Tai
- Department of Respiratory Medicine, Royal Children's Hospital Melbourne, Victoria, Australia.
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Living with childhood asthma: parental perceptions of risk in the household environment and strategies for coping. Prim Health Care Res Dev 2009. [DOI: 10.1017/s1463423608001011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Day-care attendance, position in sibship, and early childhood wheezing: a population-based birth cohort study. J Allergy Clin Immunol 2008; 122:500-6.e5. [PMID: 18774386 DOI: 10.1016/j.jaci.2008.06.033] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Revised: 06/26/2008] [Accepted: 06/27/2008] [Indexed: 01/21/2023]
Abstract
BACKGROUND There are conflicting data on the effect of day-care attendance and position in sibship on the development of wheezing. OBJECTIVE To investigate the relationship between day-care attendance and position in sibship with early childhood wheeze. METHODS Prospective population-based birth cohort. At age 5 years, we collected information on parentally reported symptoms (n = 922); lung function was ascertained using plethysmography (n = 745) and allergic sensitization by skin testing (n = 815). Participants were assigned into categories according to the age of entry to day-care (0-6, 6-12, >12 mo) and number of older siblings (0, 1, 2, >2). RESULTS Current wheeze was reported by 203 participants (22%); 224 (28%) were sensitized. In the multivariate model, sensitization (odds ratio, 2.47; 95% CI, 1.66-3.67), male sex (1.49, 1.01-2.20), maternal asthma (1.72, 1.10-2.68), and maternal smoking during pregnancy (2.15, 1.26-3.66) significantly increased the risk of wheezing. Entering day-care between 6 and 12 or after 12 months of age was significantly and inversely associated with current wheeze (0.25, 0.11-0.60; and 0.65, 0.44-0.98, respectively). Entry into nursery between 6 and 12 months reduced the risk of persistent wheezing (P = .04). We found no association between day-care attendance and lung function. Entering nursery in the first 6 months of life was associated with increased risk of atopy (2.47, 1.23-4.95). Having older siblings was associated only with rhinoconjunctivitis (0.72, 0.54-0.97). CONCLUSION Day-care attendance was associated with a reduced risk of current wheezing in 5-year-old children. The protective effect appeared strongest for children who entered day-care between the ages of 6 and 12 months.
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Al-Rawas OA, Al-Riyami BM, Al-Kindy H, Al-Maniri AA, Al-Riyami AA. Regional Variation in the Prevalence of Asthma Symptoms among Omani School Children: Comparisons from Two Nationwide Cross-sectional Surveys Six Years Apart. Sultan Qaboos Univ Med J 2008; 8:157-164. [PMID: 21748053 PMCID: PMC3074827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Accepted: 02/02/2008] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVES The International Study of Asthma and Allergies in Children (ISAAC) highlighted the presence of wide variations in asthma prevalence between and within countries. The aim of this study was to determine the changes in the prevalence of asthma and its symptoms across the different regions of Oman. METHODS Two cross-sectional surveys were conducted as part of ISAAC phases I (1995) and III (2001) in two age groups (6-7 and 13-14 years) from nation-wide samples of Omani school children, with 7,067 participants in 1995 (3,893 young and 3,174 older group) and 7,879 participants in 2001 (4,126 young and 3,753 older group). RESULTS Over the period of six years, the Sharqiya (Eastern) region continued to have the highest prevalence of self-reported asthma diagnosis and all asthma symptoms in both age groups, with a significant increase in the prevalence of wheeze in the past 12 months (from 8.7% to 13.8%; p=0.002) and asthma diagnosis (from 13.8% to 17.8 %; p=0.046) in the young group, and a significant increase in night cough (from 21.6% to 27.8%; p=0.039) in the older group. All other regions had lower prevalence rates in 1995 in both age groups, and showed either no significant change or a decline in one or two of the self-reported asthma symptoms. The prevalence of asthma diagnosis among wheezy children remained unchanged across all regions. In addition, asthma under-diagnosis remains a problem with only 60% of children with severe wheeze reporting asthma diagnosis in both surveys. CONCLUSION The geographic variation in the prevalence of self-reported of asthma symptoms among Omani school children persists with further increase in the Sharqiya region. The findings also suggest under-diagnosis and/or poor recognition of asthma which had not improved over time.
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Affiliation(s)
| | | | | | - Abdullah A Al-Maniri
- Family Medicine and Public Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Asya A Al-Riyami
- Department of Resarch Studies, Ministry of Health, Muscat, Sultanate of Oman
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Kälvesten L, Bråbäck L. Time trend for the prevalence of asthma among school children in a Swedish district in 1985-2005. Acta Paediatr 2008; 97:454-8. [PMID: 18363954 DOI: 10.1111/j.1651-2227.2008.00698.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To assess the temporal trend for asthma and asthma-like symptoms over a period of 20 years. METHOD Repeated cross-sectional surveys with identical study design were carried out among all school children (7-16 years) in a well-defined area in Sweden in 1985, 1995 and 2005. RESULTS In 2005, the parents of 1110 out of 7825 children (14.2%) answered yes to a screening question on asthmatic symptoms. Of these, 783 out of 1110 (70.5%) replied to a postal questionnaire with detailed questions concerning symptoms and asthma management. The rate of affirmative response to the screening question was unchanged between 1995 and 2005. However, the percentage of children with wheezing or three or more asthma-like symptoms decreased, whereas the percentage of children with physician-diagnosed asthma increased steadily since 1985. The number of reported symptoms was closely associated with the number of days with physical restriction. The annual sale of inhaled steroids from local pharmacies was stable between 1995 and 2005. CONCLUSION The increase in asthmatic symptoms in school children has peaked. Reduced severity of symptoms and divergent trends for wheezing and physician-diagnosed asthma suggest an increased awareness of asthma with improved management of the symptoms. However, differences in trends between allergic and nonallergic asthma could not be excluded.
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Affiliation(s)
- Lena Kälvesten
- Department of Public Health and Research, Sundsvall Hospital, Sundsvall, Sweden.
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Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, van Weel C, Agache I, Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet LP, Bousquet PJ, Camargos P, Carlsen KH, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, van Wijk RG, Kalayci O, Kaliner MA, Kim YY, Kowalski ML, Kuna P, Le LTT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FER, Toskala E, Valovirta E, van Cauwenberge P, Wang DY, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Ben Kheder A, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek JM, Larenas-Linnemann D, Lipworth B, Malo JL, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 Suppl 86:8-160. [PMID: 18331513 DOI: 10.1111/j.1398-9995.2007.01620.x] [Citation(s) in RCA: 3008] [Impact Index Per Article: 188.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/etiology
- Asthma/therapy
- Child
- Global Health
- Humans
- Prevalence
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/complications
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/therapy
- Risk Factors
- World Health Organization
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Affiliation(s)
- J Bousquet
- University Hospital and INSERM, Hôpital Arnaud de Villeneuve, Montpellier, France
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Pawankar R, Baena-Cagnani CE, Bousquet J, Walter Canonica G, Cruz AA, Kaliner MA, Lanier BQ, Henley K. State of World Allergy Report 2008: Allergy and Chronic Respiratory Diseases. World Allergy Organ J 2008. [DOI: 10.1186/1939-4551-1-s1-s4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Gale CR, Robinson SM, Harvey NC, Javaid MK, Jiang B, Martyn CN, Godfrey KM, Cooper C. Maternal vitamin D status during pregnancy and child outcomes. Eur J Clin Nutr 2008; 62:68-77. [PMID: 17311057 PMCID: PMC2629513 DOI: 10.1038/sj.ejcn.1602680] [Citation(s) in RCA: 459] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Revised: 12/18/2006] [Accepted: 01/09/2007] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate whether exposure to high maternal concentrations of 25(OH)-vitamin D in pregnancy poses any risk to the child. DESIGN Prospective study. SETTING Princess Anne Maternity Hospital, Southampton, UK. SUBJECTS A group of 596 pregnant women were recruited. A total of 466 (78%) children were examined at birth, 440 (74%) at age 9 months and 178 (30%) at age 9 years. METHODS Maternal 25 (OH)-vitamin D concentrations were measured in late pregnancy. Anthropometry of the child was recorded at birth, 9 months and 9 years. At 9 months, atopic eczema was assessed. At 9 years, children had an echocardiogram and a dual energy x-ray absorptiometry scan, blood pressure, arterial compliance and carotid intima-media thickness were measured and intelligence and psychological function assessed. RESULTS There were no associations between maternal 25(OH)-vitamin D concentrations and the child's body size or measures of the child's intelligence, psychological health or cardiovascular system. Children whose mothers had a 25(OH)-vitamin D concentration in pregnancy >75 nmol/l had an increased risk of eczema on examination at 9 months (OR 3.26, 95% CI 1.15-9.29, P=0.025) and asthma at age 9 years (OR 5.40, 95% CI, 1.09-26.65, P=0.038) compared to children whose mothers had a concentration of <30 nmol/l. CONCLUSION Exposure to maternal concentrations of 25(OH)-vitamin D in pregnancy in excess of 75 nmol/l does not appear to influence the child's intelligence, psychological health or cardiovascular system; there could be an increased risk of atopic disorders, but this needs confirmation in other studies.
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Affiliation(s)
- C R Gale
- MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton, UK.
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Bibliography. Current world literature. Outcome measures. Curr Opin Allergy Clin Immunol 2007; 7:288-90. [PMID: 17489050 DOI: 10.1097/aci.0b013e3281fbd52a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Dishing the dirt on asthma: What we can learn from poor hygiene. Biologics 2007; 1:139-50. [PMID: 19707324 PMCID: PMC2721305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Allergic asthma continues to represent a huge health burden worldwide and is largely treated by non-selective immunosuppressive drugs, which often prove ineffective. The hygiene hypothesis proposes that the increased incidence of allergy and asthma in Western countries observed in the last 50 years is due to environmental changes that include improved hygiene and a lack of infections. The immunological mechanisms that must underpin such an environmental impact on immune regulation remain to be defined, making it difficult to identify specific ways of preventing development of allergy and asthma in early life. In this article we will seek to review some of the pathways that might underlie the hygiene hypothesis in an attempt to provide targets for future asthma prevention.
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Anderson HR, Gupta R, Strachan DP, Limb ES. 50 years of asthma: UK trends from 1955 to 2004. Thorax 2007; 62:85-90. [PMID: 17189533 PMCID: PMC2111282 DOI: 10.1136/thx.2006.066407] [Citation(s) in RCA: 179] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2006] [Accepted: 09/14/2006] [Indexed: 11/04/2022]
Abstract
Trends in asthma indicators from population surveys (prevalence) and routine statistics (primary care, prescriptions, hospital admissions and mortality) in the UK were reviewed from 1955 to 2004. The prevalence of asthma increased in children by 2 to 3-fold, but may have flattened or even fallen recently. Current trends in adult prevalence are flat. The prevalence of a life-time diagnosis of asthma increased in all age groups. The incidence of new asthma episodes presenting to general practitioners increased in all ages to a plateau in the mid 1990s and has declined since. During the 1990s, the annual prevalence of new cases of asthma and of treated asthma in general practice showed no major change. Hospital admissions increased from the early 1960s, more so in children, until the late 1980s and have fallen since. Asthma mortality showed two waves, a shorter and more intense one in the mid 1960s and a longer and less intense one in the late 1970s and early 1980s. The relative roles of diagnostic transfer, coding changes, medical care and epidemiological factors are discussed.
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Affiliation(s)
- H Ross Anderson
- Division of Community Health Sciences, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK.
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Sim ATR, Ludowyke RI, Verrills NM. Mast cell function: regulation of degranulation by serine/threonine phosphatases. Pharmacol Ther 2006; 112:425-39. [PMID: 16790278 DOI: 10.1016/j.pharmthera.2006.04.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2006] [Accepted: 04/26/2006] [Indexed: 01/28/2023]
Abstract
Mast cells play both effector and modulatory roles in a range of allergic and immune responses. The principal function of these cells is the release of inflammatory mediators from mast cells by degranulation, which involves a complex interplay of signalling molecules. Understanding the molecular architecture underlying mast cell signalling has attracted renewed interest as the capacity for therapeutic intervention through controlling mast cell degranulation is now accepted as a viable proposition. The dynamic regulation of signalling by protein phosphorylation is a well-established phenomenon and many of the early events involved in mast cell activation are well understood. Less well understood however are the events further downstream of receptor activation that allow movement of granules through the cytoskeletal barrier and docking and fusion of granules with the plasma membrane. Whilst a potential role for the protein phosphatase family of signalling enzymes in mast cell function has been accepted for some time, the evidence has largely been derived from the use of broad specificity pharmacological inhibitors and results often depend upon the experimental conditions, leading to conflicting views. In this review, we present and discuss the pharmacological and recent molecular evidence that protein phosphatases, and in particular the protein phosphatase serine/threonine phosphatase type 2A (PP2A), have major regulatory roles to play and may be potential targets for the design of new therapeutic agents.
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Affiliation(s)
- Alistair T R Sim
- School of Biomedical Sciences and Hunter Medical Research Institute, Faculty of Health, The University of Newcastle, Callaghan, NSW, Australia.
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