Abstract
BackgroundThe Global Asthma Network (GAN), by using the International Study of Asthma and Allergies in Childhood (ISAAC) methodology, has updated trends in prevalence of symptoms of childhood allergic diseases, including non‐infective rhinitis and conjunctivitis (‘rhinoconjunctivitis’), which is reported here.MethodsPrevalence and severity of rhinoconjunctivitis were assessed by questionnaire among schoolchildren in GAN Phase I and ISAAC Phase I and III surveys 15–23 years apart. Absolute rates of change in prevalence were estimated for each centre and modelled by multi‐level linear regression to compare trends by age group, time period and per capita national income.ResultsTwenty‐seven GAN centres in 14 countries surveyed 74,361 13‐ to 14‐year‐olds (‘adolescents’) and 45,434 6‐ to 7‐year‐olds (‘children’), with average response proportions of 90% and 79%, respectively. Many centres showed highly significant (p < .001) changes in prevalence of rhinoconjunctivitis in the past year (‘current rhinoconjunctivitis’) compared with ISAAC. The direction and magnitude of centre‐level trends varied significantly (p < .001) both within and between countries. Overall, current rhinoconjunctivitis prevalence decreased slightly from ISAAC Phase III to GAN: −1.32% per 10 years, 95% CI [−2.93%, +0.30%] among adolescents; and −0.44% [−1.29%, +0.42%] among children. Together, these differed significantly (p < .001) from the upward trend within ISAAC. Among adolescents, centre‐level trends in current rhinoconjunctivitis were highly correlated with those for eczema symptoms (rho = 0.72, p < .0001) but not with centre‐level trends in asthma symptoms (rho = 0.15, p = .48). Among children, these correlations were positive but not significant.ConclusionSymptoms of non‐infective rhinoconjunctivitis among schoolchildren may no longer be on the increase globally, although trends vary substantially within and between countries.
Highlights
Non-infective rhinitis and conjunctivitis (‘rhinoconjunctivitis’) are common manifestations of allergic disease among children, and their prevalence varied substantially around the world during the 1990s, as documented by the International Study of Asthma and Allergies in Childhood (ISAAC) Phase I.1 Approximately seven years later, a comparison of ISAAC Phase III with ISAAC Phase I assessed time trends in annual period prevalence of rhinoconjunctivitis symptoms among almost half a million children from 106 centres in 56 countries.[2]
Greater increases were evident in centres from low- and middle-income countries, but prevalence decreased in many centres with the highest rates in ISAAC Phase I, suggesting that rhinoconjunctivitis symptoms may have peaked in those generally more affluent countries.[2]
We extend those earlier ISAAC time trend comparisons to include more recent surveys using identical methodology, which were conducted by the Global Asthma Network[3] in 27 centres that had previously participated in ISAAC
Summary
Non-infective rhinitis and conjunctivitis (‘rhinoconjunctivitis’) are common manifestations of allergic disease among children, and their prevalence varied substantially around the world during the 1990s, as documented by the International Study of Asthma and Allergies in Childhood (ISAAC) Phase I.1 Approximately seven years later, a comparison of ISAAC Phase III with ISAAC Phase I assessed time trends in annual period prevalence of rhinoconjunctivitis symptoms among almost half a million children from 106 centres in 56 countries.[2]. We extend those earlier ISAAC time trend comparisons to include more recent surveys using identical methodology, which were conducted by the Global Asthma Network[3] in 27 centres that had previously participated in ISAAC. This offers the opportunity to assess time trends over a longer period in both higher and lower income countries. The Global Asthma Network (GAN), by using the International Study of Asthma and Allergies in Childhood (ISAAC) methodology, has updated trends in prevalence of symptoms of childhood allergic diseases, including non-infective rhinitis and conjunctivitis (‘rhinoconjunctivitis’), which is reported here. Absolute rates of change in prevalence were estimated for each centre and modelled by multi-level linear regression to compare trends by age group, time period and per capita national income.
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