Prevalence and Risk Factors of Asthma and Allergy-Related Diseases among Adolescents (PERFORMANCE) study: rationale and methods

Allergic rhinitis in India

India is the home of nearly 20% of the global population with 1.35 billion people. Of all non-communicable diseases, allergic diseases such as allergic rhinitis (AR) and asthma appear to have increased in India over the past decades. Approximately 22% of adolescents currently suffer from AR in India. However, owing to the lack of adequate epidemiological studies in India, particularly in rural and suburban areas, this number may misrepresent the true burden of this disease. While the risk factors for AR are mainly environmental exposures or genetic factors, several new environmental, social, and behavioural risk factors such as the presence of dumpsters near residences, movement of vehicles near homes, and exposure to artificial light at night have been found to be associated with AR. However, despite international guidelines, the diagnosis and management of AR in India are often suboptimal, for multiple reasons such as the lack of specialized training in allergy and immunology among Indian clinicians, the lack of diagnostic facilities, and the high cost of medications. This review aims at highlighting the current scenario of AR in India and how it differs from the rest of the world. It also highlights the need for developing a strategic approach to enhance the quality of care for allergic diseases by upgrading education and training for healthcare professionals, creating awareness among clinicians and patients, and involving stakeholders and policymakers in making treatments accessible and affordable to patients.

Relationship between Body Mass Index and Gender with Asthma

Background: Asthma is ranked 16th among the leading causes of years lived with disability (YLD) and ranks 28th among the causes of global burden of disease (GBD). Various potential factors can cause asthma, which include body mass index (BMI) and gender. Purpose: This research aimed to determine the relationship between BMI and gender in people living with asthma in Indonesia. Methods: This research employed secondary data obtained from the Indonesian family life support (IFLS) 5th edition. This research used an observational analysis technique with a cross-sectional approach. The number of respondents in this research were 30,713. In this study, the BMI category was based on WHO’s classification for Asians. Data was analyzed using logistic regression tests and chi square. Statistical significance was set at a value of p<0.05. Results: As many as 17,175 respondents had a normal BMI range (56.92%), out of which the majority were women—16,001 respondents (52.10%). After controlling the other variables, statistical test results with logistic regression indicated that male respondents had 1.23 times the odds of experiencing asthma compared to females (adjusted odds ratio (AOR)=1.23; 95% confidence interval (CI), 1.04–1.44; p=0.02). Again, after controlling the other variables, underweight respondents had 1.31 times the odds of experiencing asthma compared to respondents who had a normal BMI (AOR=1.31; 95%CI=1.07–1.59; p=0.01). Conclusion: A relationship between gender and the category of people who were underweight after determining their BMI could be established. Health counseling can be provided to help improve the respiratory conditions of these individuals.

Relationship between pediatric asthma and psychosocial status of caregivers

OBJECTIVE

To determine the relationship between psychosocial caregiver disorders and childhood asthma.

STUDY DESIGN

We performed a matched case-control study with asthmatic children (6-14 years of age) from two different clinics in Zaragoza, Spain, between 2010 - 2016. Clinical data were collected from medical records and psychosocial disorders were assessed by interviewing the caregiver using validated questionnaires (Goldberg, CES-D, SF-12, PSS and SPIN). General analysis of cases and controls was performed using McNemar, Chi² and Wilcoxon nonparametric tests. A logistic regression model to predict more severe asthma, adjusted by caregiver psychosocial disorders was performed.

RESULTS

208 children were evaluated (104 cases). Mean age was 9.7 ± 2.4 years, with a male predominance (62.5%). Anxiety, social phobia, depression, acute and chronic psychological disorders, and poor quality of life related to mental health were significantly more prevalent in caregivers of asthmatic children (p<0.05). On multivariate analysis, all of the above disorders significantly increased the risk of uncontrolled asthma, where anxiety, acute psychological disorders, and chronic psychological disorders were the most significant (OR 8.54, 95%CI 3.46-21.05, p<0.001; OR 6.05, 95%CI 2.39-15.28, p<0.001; and OR 4.86, 95%CI 1.97-12.02, p=0.001, respectively).

CONCLUSION

The prevalence of psychosocial disorders in caregivers of asthmatic children is high, when compared to caregivers of healthy children. The presence of anxiety, social phobia, depression, and poor quality of life is associated with an increased risk of worse controlled asthma. Perhaps, early detection and treatment of these disorders could positively impact childhood asthma control.

Individual circadian preference (chronotype) is associated with asthma and allergic symptoms among adolescents

Circadian rhythm is an endogenously driven cyclical process that regulates most of our bodily functions, such as sleep–wakefulness cycle, metabolism, and a wide range of cellular, molecular and behavioural processes. Chronotype, or an individual's preferred time of sleep and activity, is one of the major internal cues that helps to harmonise one's biological events according to its circadian timing [1]. Three major variations of chronotype exist among humans, those who prefer to wake up early and sleep early at night (known as morning types or “larks”), those who prefer late sleep at night and late waking up in the morning (referred to as evening type or “owls”) and those who remain in between (intermediate type) [1].

Individual preference of sleep and activity (chronotype) might play an important role on asthma and allergic diseases in adolescents: this link underscores a potential plausible behavioural intervention for asthma and allergic diseases in young populationhttps://bit.ly/2THta9I

Allergic Disease, Short Sleep Duration, and Suicidal Ideation and Plans Among Korean Adolescents

The purpose of the study is to identify the relationships between allergic disease, suicidal ideation, and plans among Korean adolescents. Additionally, we examined the mediating role of short sleep duration. We analyzed nationally representative cross-sectional data from the 12th to 14th Korea Youth Risk Behavior Web-Based Survey; the final sample included 164,725 middle school-aged and high school-aged adolescents (mean age = 15.17 years, standard deviation = .13; 51.1% male). Allergic disease was a statistically significant risk factor for suicidal ideation (crude odds ratio [COR] = 1.284, 95% confidence interval [CI] = [1.246, 1.323]) and suicide plans (COR = 1.165, 95% CI = [1.108, 1.224]). Short sleep duration was a statistically significant mediator (p < .001). We advised school nurses to assess warning signs of poor sleep-including irritability, depression, sleep problems, poor concentration, and poor academic achievement-and that programs be created to improve sleep and mental health in adolescents with allergic disease.