The epidemiologic characteristics of healthcare provider-diagnosed eczema, asthma, allergic rhinitis, and food allergy in children: a retrospective cohort study.

David A Hill,Robert W Grundmeier,Jonathan M Spergel,Gita Ram

doi:10.1186/s12887-016-0673-z

David A Hill, Robert W Grundmeier + Show 2 more

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https://doi.org/10.1186/s12887-016-0673-z

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Abstract

BackgroundThe rates of childhood allergic conditions are changing, prompting the need for continued surveillance. Examination of healthcare provider-based diagnosis data is an important and lacking methodology needed to complement existing studies that rely on participant reporting.MethodsUtilizing our care network of 1,050,061 urban and sub-urban children, we defined two retrospective cohorts: (1) a closed birth cohort of 29,662 children and (2) a cross-sectional cohort of 333,200 children. These cohorts were utilized to determine the epidemiologic characteristics of the conditions studied. Logistic regression was utilized to determine the extent to which food allergy was associated with respiratory allergy.ResultsIn our birth cohort, the peak age at diagnosis of eczema, asthma, rhinitis, and food allergy was between 0 and 5 months (7.3 %), 12 and 17 months (8.7 %), 24 and 29 months (2.5 %), and 12 and 17 months (1.9 %), respectively. In our cross-sectional cohort, eczema and rhinitis prevalence rates were 6.7 % and 19.9 %, respectively. Asthma prevalence was 21.8 %, a rate higher than previously reported. Food allergy prevalence was 6.7 %, with the most common allergenic foods being peanut (2.6 %), milk (2.2 %), egg (1.8 %), shellfish (1.5 %), and soy (0.7 %). Food allergy was associated with development of asthma (OR 2.16, 95 % CI 1.94-2.40), and rhinitis (OR 2.72, 95 % CI 2.45-3.03).ConclusionsCompared with previous reports, we measure lower rates of eczema and higher rates of asthma. The distribution of the major allergenic foods diverged from prior figures, and food allergy was associated with the development of respiratory allergy. The utilization of provider-based diagnosis data contributes an important and lacking methodology that complements existing studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0673-z) contains supplementary material, which is available to authorized users.

Highlights

The rates of childhood allergic conditions are changing, prompting the need for continued surveillance
We examine healthcare provider-based diagnosis data to determine the age at diagnosis, incidence, and prevalence of eczema, asthma, rhinitis, and food allergy
We report the largest study to date to examine the epidemiologic characteristics of healthcare provider-diagnosed eczema, asthma, allergic rhinitis, and food allergy in a pediatric primary care population

Summary

Introduction

The rates of childhood allergic conditions are changing, prompting the need for continued surveillance. Examination of healthcare provider-based diagnosis data is an important and lacking methodology needed to complement existing studies that rely on participant reporting. Asthma, and allergic rhinitis (rhinitis) are among the most common childhood medical conditions in the United States [1]. Hill et al BMC Pediatrics (2016) 16:133 utilize participant reporting or provider-based diagnosis data provide different estimates of disease patterns [10, 11]. Provider-based diagnosis data is needed to complement existing studies and to provide for the most accurate estimates of disease rates. Recent estimates have reported food allergy prevalence figures between 4 and 8 %, these studies are limited in size and scope or rely on participant reporting rather than healthcare providerbased diagnosis [18, 20, 21]. An examination of the epidemiologic landscape of food allergy, through the utilization of healthcare provider-based diagnosis data, is needed

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