International Study Of Asthma And Allergies In Childhood Phase Research Articles

Decreased prevalence and severity of asthma symptoms among adolescents in Ibadan, Nigeria, 1995-2018.

BACKGROUND: Phases I and III of the International Study of Asthma and Allergies in Childhood (ISAAC) documented increased asthma symptoms among Nigerian 13-14-year old adolescents. We investigated the trend further using the Global Asthma Network (GAN) surveillance.METHODS: Using ISAAC methodology, GAN Phase I data on symptoms and risk factors for asthma and asthma management were obtained from February to July 2018.RESULTS: There were 2,897 adolescents from 23 secondary schools. For current wheeze, there was an absolute prevalence fall per decade of -1.4 with -1 standard error (SE) in 16 years from 2002 (ISAAC Phase III) to 2018 (GAN Phase I). This pattern was evident for prevalence of reported asthma ever, severe asthma symptoms and night cough with ≥1 SE. During the 23-year interval between ISAAC Phase I and GAN Phase I, there was a fall (≥1 SE) in the absolute prevalence of reported asthma ever, severe asthma symptoms and night cough, except for severe asthma symptoms (-0.2 SE). Respectively 36% and 43% of symptomatic adolescents purchased and used salbutamol and prednisolone.CONCLUSION: The prevalence and severity of asthma symptoms remain high among adolescents in Ibadan. This could be mitigated by improved access to affordable and effective asthma treatments.

Have the prevalence of eczema symptoms increased in the Mexican pediatric population? Prevalence and associated factors according to Global Asthma Network Phase I

BackgroundIn children, atopic dermatitis or eczema is the most common inflammatory disease of the skin. According to the International Study of Asthma and Allergies in Childhood (ISAAC) Phase IIIB in Mexico, 5.8% of children and 4.9% of adolescents had eczema symptoms. In 2012, Global Asthma Network (GAN) was established to update the prevalence of eczema and estimate potential factors contributing to its development. ObjectiveTo estimate the prevalence and associated factors for atopic eczema symptoms and diagnosis in children and adolescents according to GAN Phase I and compare the results with ISAAC Phase IIIB in Mexico. MethodsA cross-sectional, multicenter survey was conducted in 15 Mexican centers during the period of 2015–2017 using the GAN Phase I questionnaires in children (6–7-year-olds) and adolescents (13–14-year-olds). The prevalences obtained from the GAN Phase I study, were compared with ISAAC Phase IIIB results; a Spearman's correlation analysis was conducted between temperature, relative humidity, and altitude and eczema symptoms, and a logistic regression was performed to predict current eczema symptoms by age group. ResultsA total of 35 777 children and 41 399 adolescents were included. Since ISAAC Phase IIIB, the prevalence of itchy rash in the past 12 months significantly increased in the children's group [6.6% (95% CI 5.7–7.4) vs 7.8 (95% CI 7.5–8.1), p = 0.000] and adolescents' group [5.8% (95% CI 5.0–6.7) vs 6.7% (95% CI 6.5–7.0), p = 0.000].In the adolescents' group, the prevalence of nocturnal awakenings caused by rash symptoms on more than one night per week had a negative correlation between altitude (Spearman's Rho = −0.558, p value = 0.031), and a positive correlation with the average annual temperature (Spearman's Rho = 0.604, p value = 0.017) and annual relative humidity (Spearman's Rho = 0.742, p value = 0.002). The most significant associations in children were the presence of sneezing or runny or blocked nose in the past 12 months [(OR 3.13, 95% CI 2.60–3.77), p = 0.000], the use of paracetamol in the first year of life ([OR 1.52, 95% CI 1.15–2.01), p = 0.003] and the use of antibiotics in the first year of life [(OR 1.30, 95% CI 1.08–1.55) p = 0.004]. Moreover, altitude at 100–1000 m above sea level was associated with current eczema symptoms in adolescents (p = 0.001). ConclusionsThere has been a significant increase in eczema symptoms in both age groups since ISAAC Phase IIIB study. Additionally, eczema symptoms were associated with temperature, relative humidity, asthma, hay fever symptoms, the use of paracetamol and antibiotics.

Atopic Dermatitis in Latin America: A Roadmap to Address Data Collection, Knowledge Gaps, and Challenges.

Atopic dermatitis (AD) is a systemic, multifactorial disease that causes significant morbidity and health care burden in Latin America (LA). Data on AD are scarce in LA. Lack of disease registries and non-standardized study methodologies, coupled with region-specific genetic, immunological, and environmental factors, hamper data collection. A panel of LA experts in AD was given a series of relevant questions to address before a conference. Each narrative was discussed and edited through numerous rounds of deliberation until achieving consensus. Identified knowledge gaps in AD research were updated prevalence, adult-disease epidemiology, local phenotypes and endotypes, severe-disease prevalence, specialist distribution, and AD public health policy. Underlying reasons for these gaps include limited funding for AD research, from epidemiology and public policy to clinical and translational studies. Regional heterogeneity requires that complex interactions between race, ethnicity, and environmental factors be further studied. Informed awareness, education, and decision making should be encouraged.

Worldwide trends in the burden of asthma symptoms in school-aged children: Global Asthma Network Phase I cross-sectional study

SummaryBackgroundAsthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of asthma symptoms is changing.MethodsThis updated cross-sectional study used the same methods as the International study of Asthma and Allergies in Childhood (ISAAC) Phase III. Asthma symptoms were assessed from centres that completed GAN Phase I and ISAAC Phase I (1993–95), ISAAC Phase III (2001–03), or both. We included individuals from two age groups (children aged 6–7 years and adolescents aged 13–14 years) who self-completed written questionnaires at school. We estimated the 10-year rate of change in prevalence of current wheeze, severe asthma symptoms, ever having asthma, exercise wheeze, and night cough (defined by core questions in the questionnaire) for each centre, and we estimated trends across world regions and income levels using mixed-effects linear regression models with region and country income level as confounders.FindingsOverall, 119 795 participants from 27 centres in 14 countries were included: 74 361 adolescents (response rate 90%) and 45 434 children (response rate 79%). About one in ten individuals of both age groups had wheeze in the preceding year, of whom almost half had severe symptoms. Most centres showed a change in prevalence of 2 SE or more between ISAAC Phase III to GAN Phase I. Over the 27-year period (1993–2020), adolescents showed a significant decrease in percentage point prevalence per decade in severe asthma symptoms (–0·37, 95% CI –0·69 to –0·04) and an increase in ever having asthma (1·25, 0·67 to 1·83) and night cough (4·25, 3·06 to 5·44), which was also found in children (3·21, 1·80 to 4·62). The prevalence of current wheeze decreased in low-income countries (–1·37, –2·47 to –0·27], in children and –1·67, –2·70 to –0·64, in adolescents) and increased in lower-middle-income countries (1·99, 0·33 to 3·66, in children and 1·69, 0·13 to 3·25, in adolescents), but it was stable in upper-middle-income and high-income countries.InterpretationTrends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma.FundingInternational Union Against Tuberculosis and Lung Disease, Boehringer Ingelheim New Zealand, AstraZeneca Educational Grant, National Institute for Health Research, UK Medical Research Council, European Research Council, and Instituto de Salud Carlos III.

Rising and falling prevalence of asthma symptoms

Asthma is the leading chronic disease in children, affecting 5·1 million children in the USA. 1 Asthma and Allergy Foundation of AmericaAsthma facts and figures. https://www.aafa.org/asthma-factsDate: 2021 Date accessed: July 13, 2021 Google Scholar However, worldwide important variations have been reported in asthma prevalence. In The Lancet, Innes Asher and colleagues report findings from the Global Asthma Network (GAN), assessing global changes in asthma prevalence over the past three decades, with use of similar, standardised methods as the International Study of Asthma and Allergies in Childhood (ISAAC). 2 Asher MI Rutter CE Bissell K et al. Worldwide trends in the burden of asthma symptoms in school-aged children: Global Asthma Network Phase I cross-sectional study. Lancet. 2021; 398: 1569-1580 Google Scholar Using centres that completed GAN Phase I and ISAAC Phase I (1993–95), ISAAC Phase III (2001–03), or both, the authors assessed the global prevalence and the 10-yearly change in prevalence of current wheeze, severe asthma symptoms, asthma ever, exercise wheeze, and night cough (defined by four core questions in a questionnaire). The study included data from questionnaires filled by almost 120 000 adolescents (aged 13–14 years) and school-aged children (aged 6–7 years) from 27 centres in 14 countries. Worldwide trends in the burden of asthma symptoms in school-aged children: Global Asthma Network Phase I cross-sectional studyTrends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma. Full-Text PDF Open Access

Worldwide time trends in prevalence of symptoms of rhinoconjunctivitis in children: Global Asthma Network Phase I.

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.

Вплив екологічних факторів на маніфестацію респіраторних захворювань

Вперше в Україні в Харківському регіоні в 2015–2017 роках виконано IV фазу Міжнародної програми ISAAC. Було роздано 6330 анкет; у програмі взяли участь 6146 (97 %) школярів. Респіраторні скарги виявлені у 12,8 %: серед дітей 6–7 років — 13,2 %, 13–14 років — 12,4 %. Для виявлення динаміки поширення респіраторних симптомів проведено порівняння з даними І фази ISAAC (Огнєв В.А., 1998) — за останні 19 років поширеність респіраторних симптомів знизилася у 1,6 раза серед дітей молодшого шкільного віку, у 2 рази — в підлітковому віці. Дослідження проведено в 8 районах Харківської області (Лозівському, Куп’янському, Вовчанському, Богодухівському, Сахновщанському, Барвінківському, Дергачівському, Нововодолазькому), що відрізняються екологічними характеристиками середовища. В екологічно забруднених районах вище поширеність wheezing у 1,4 раза, симптомів астми фізичного напруження — у 1,9 раза та у 3,4 раза частіше відзначаються тяжкі напади задишки, що порушують нічний сон. Дослідження спрямовано на удосконалення профілактики бронхіальної астми в дитячій популяції Харківської області.

Prevalence of symptoms, severity and diagnosis of asthma in adolescents in the Province of Salamanca, Spain: Global Asthma Network (GAN) Phase I.

Asthma is the most prevalent chronic disease in childhood. However, the latest data on its prevalence in Spain are from Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC), 2004. The objective of our study was to assess the prevalence of asthma symptoms, severity and diagnosis in the paediatric population aged between 13 and 14 years in the province of Salamanca. Cross-sectional multicentre study carried out in 2017-2018 in 13-and 14-year-old school children in the province of Salamanca as a centre participating in of the Global Asthma Network (GAN) Phase I. The standardised validated written questionnaire and that directed by a video was administered; it was self-completed by the pupils. A total of 3485 questionnaires were completed, and the pupils' participation rate was 95.01%. Among the total, 25.7% indicated having had wheeze ever (20.7% in the video questionnaire); 14.7% indicated having had wheeze in the past 12 months (11.3% in the video questionnaire). The prevalence of current wheeze that limited speech was 3.9% (7.5% in the video questionnaire) and the current prevalence of severe wheeze was 6.5%. Regarding asthma diagnosis, 19.7% of the sample answered that they had had asthma ever, whilst 14.0% referred to having physician-diagnosed asthma. The agreement between the written questionnaire and that directed by video was acceptable for the questions of wheeze ever (Cohen Kappa index [k] = 0.53) and current wheeze (k = 0.42). The prevalence of current asthma (wheeze in the past 12 months) in the population aged 13 and 14 years in the province of Salamanca is higher compared with that presented in 2004 in Spain, but similar to that described at the world level (low-moderate level), according to the ISAAC Phase III studies.

Have asthma symptoms in Mexico changed in the past 15 years? Time trends from the International Study of Asthma and Allergies in Childhood to the Global Asthma Network.

The Global Asthma Network (GAN) builds on the International Study of Asthma and Allergies in Childhood (ISAAC). To compare asthma prevalence time trends in primary and secondary school children in four Mexican centers participating in ISAAC and GAN. GAN is a cross-sectional, multicenter, epidemiological methodology carried out in groups of primary school children aged 6-7 and adolescents aged 13-14 following the ISAAC Phase Three protocol, with additional questions on risk factors and asthma management. Overall, the prevalence of asthma symptoms and diagnosis in primary school children was higher in males than in females both in ISAAC (p < 0.05) and in GAN (p < 0.01), while adolescent females had a higher prevalence, also both in ISAAC (p < 0.001) and in GAN (p < 0.001). The prevalence of asthma and its symptoms has increased from ISAAC Phase Three since 2003 to GAN Phase I in Mexico in 2019. These findings are in line with the increases observed in the centers with low asthma baseline prevalence in ISAAC Phase One in comparison with ISAAC Phase Three.

Combined impact of healthy lifestyle factors on risk of asthma, rhinoconjunctivitis and eczema in school children: ISAAC phase III

BackgroundAsthma is not the key focus of prevention strategies. A Healthy Lifestyle Index (HLI) was developed to examine the combined effect of modifiable lifestyle factors on asthma, rhinoconjunctivitis and eczema...

Effect of industrialization on allergic diseases in school children

Aim: The lifestyle and environmental changes associated with industrialization and urbanization are crucial factors in determining the prevalence of allergic diseases. Material and Methods: The aim of this study was to determine the prevalence of asthma and other allergic disorders in an industrial town.Study Design: Prospective, Cross-sectional study. This cross-sectional population-based study was conducted in Kemalpasa, Ýzmir, Turkey, which is an industrial town. Using the International Study of Asthma and Allergies in Childhood (ISAAC), the questionnaire was carried out on 1511 school-children aged between 13-14 years living in the district center. Results: The ISAAC Phase One questionnaire was answered by 1373 (90.87%) students. Six hundred ninety two (50.5%) of the children were girls and 681 (49.5%) were boys. The frequency of ever wheezing was 34%,that of current wheezing was 31.1% and that of physician-diagnosed asthma was 4.1%. The frequency of ever rhinitis was 36.6%, current rhinitis was 31.3%, current allergic rhino-conjunctivitis was 22.1% and physician-diagnosed allergic rhinitis was 11.1%. The frequency of ever eczema was 11.3% and that of physician-diagnosed eczema was 3.6%. Conclusion: The prevalence of asthma was found to be significantly higher, although there was no significant difference in allergic rhinitis and eczema compared with non-industrial neighboring states. The incidence of asthma was higher than other provinces which may be explained by the risk factors associated with this industrialized area. The fact that only children of the same age group and residence were evaluated contributed to the epidemiological value of our study.

Allergic Diseases and Atopy Among Schoolchildren in Eastern Croatia.

SUMMARY – A cross-sectional study was carried out in Brod-Posavina County, Croatia, to assess the prevalence of allergic diseases and atopy, as well as to investigate the possible etiologic factors for asthma, allergic rhinitis and eczema in childhood. The study included 1687 schoolchildren aged 10-11 years. Data were collected using standardized International Study of Asthma and Allergies in Childhood (ISAAC) Phase II written questionnaire. Skin prick tests were performed to provide an objective measure of atopy, defined as skin reactivity to one or more allergens. Lifetime prevalence of wheezing was 22.7%, rhinitis symptoms 22.5%, and eczema symptoms 17.9%. Period prevalence in the past 12 months was 7.9% for attacks of wheezing, 9.9% for rhinoconjunctivitis symptoms, and 10.1% for eczema symptoms. Of the children in which skin prick test was performed, 20.2% were positive for at least one of the allergens used, with house dust mite sensitization being the most frequent one. Risk factors for allergic disease include allergic disease in family, atopy, sensitization to indoor and outdoor allergens, and environmental tobacco smoke exposure at home. International comparison with the results of other ISAAC Phase II studies showed the Brod-Posavina County to be an area with moderate prevalence of atopy and current asthma symptoms.

Diet and Respiratory Health in Children from 11 Latin American Countries: Evidence from ISAAC Phase III

Background and AimThe burden of childhood asthma and its risk factors is an important but neglected public health challenge in Latin America. We investigated the association between allergic symptoms and dietary intake in children from this region.MethodsAs part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase III, questionnaire collected dietary intake was investigated in relation to risk of parental/child reported current wheeze (primary outcome) and rhino-conjunctivitis and eczema. Per-country adjusted logistic regressions were performed, and combined effect sizes were calculated with meta-analyses.Results143,967 children from 11 countries had complete data. In children aged 6–7 years, current wheeze was negatively associated with higher fruit intake (adjusted odds ratio [aOR] 0.65; 95% CI 0.74, 0.97). Current rhino-conjunctivitis and eczema were statistically negatively associated with fruit intake (aOR 0.72; 95% CI 0.64, 0.82; and OR 0.64, 95% CI 0.56, 0.74, respectively). Vegetable intake was negatively associated with risk of symptoms in younger children, but these associations were attenuated in the 13–14 years old group. Fastfood/burger intake was positively associated with all three outcomes in the older children.ConclusionA higher intake of fruits and vegetables was associated with a lower prevalence of allergic symptoms in Latin American children. Conversely, intake of fastfood was positively associated with a higher prevalence of wheeze in adolescents. Improved dietary habits in children might help reduce the epidemic of allergic symptoms in Latin America. Food interventions in asthmatic children are needed to evaluate the possible public health impact of a better diet on respiratory health.

Does urban extent from satellite images relate to symptoms of asthma, rhinoconjunctivitis and eczema in children? A cross-sectional study from ISAAC Phase Three

Objective: The relationship between urbanisation and the symptom prevalence of asthma, rhinoconjunctivitis and eczema is not clear, and varying definitions of urban extent have been used. Furthermore, a global analysis has not been undertaken. This study aimed to determine whether the symptom prevalence of asthma, rhinoconjunctivitis and eczema in centres involved in the International Study of Asthma and Allergies in Childhood (ISAAC) were higher in urban than rural centres, using a definition of urban extent as land cover from satellite data. Methods: A global map of urban extent from satellite images (MOD500 map) was used to define the urban extent criterion. Maps from the ISAAC centres were digitised and merged with the MOD500 map to describe the urban percentage of each centre. We investigated the association between the symptom prevalence of asthma, rhinoconjunctivitis and eczema and the percentage of urban extent by centre. Results: A weak negative relationship was found between the percentage of urban extent of each ISAAC centre and current wheeze in the 13–14-year age group. This association was not statistically significant after adjusting for region of the world and gross national income. No other relationship was found between urban extent and symptoms of asthma, rhinoconjunctivitis and eczema. Conclusions: In this study, the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema in children were not associated with urbanisation, according to the land cover definition of urban extent from satellite data. Comparable standardised definitions of urbanisation need to be developed so that global comparisons can be made.

Prevalence and factors associated with asthma in students from Montes Claros, Minas Gerais, Brazil.

We investigated the prevalence of asthma and factors related to asthma development in schoolchildren aged 6 to 14, living in central and peripheral areas of the city of Montes Claros, Minas Gerais and who were registered with the Family Health Strategy program. Initially, a standard written questionnaire, based on ISAAC (International Study of Asthma and Allergies in Childhood), was administered to collect personal data, information regarding income, asthma prevalence, allergic rhinitis and eczema (N = 1,131). Secondly, a case-control study was performed by grouping the patients as either asthmatic (A; N = 172) or non-asthmatic (NA; N = 379). Potential factors associated with the occurrence of asthma were evaluated using the complementary questionnaire from ISAAC phase II. Skin tests for immediate hypersensitivity (STIH) and parasitological tests were also performed. The odds ratio, estimated by multivariate analysis, indicated that asthma cases were related to kindergarten attendance, household smoking, family history of asthma, rhinitis and positive STIH. It was concluded that, in the studied population, the prevalence of asthma was related to genetic predisposition, in addition to individual history, social demographics, exposure to pollutants such as tobacco smoke and a positive response to allergy testing.

The Prevalence of Atopic Dermatitis in Korean Children.

The Prevalence of Atopic Dermatitis in Korean Children.

Effects Of Air Pollution On Asthma And Rhinitis In Children

Introduction Little is known about the effect of air pollution from ports on children's health. This study is set in one of the most important ports of Brazil, carrying 41.9 million tons of freight in 2013. The study area has 140 469 inhabitants. This study aims to investigate the association between air pollution from ports and the prevalence of asthma and rhinitis in children. This research is part of a larger study on the influence of a port on health and the environment. Method This research is a cross-sectional study of 13 to 14 year old students attending 16 local schools. Respiratory health was assessed using the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire. The work on exposure assessment it's underway, and will be based on total particulate material and heavy metal contamination using tree bark as biomonitor. The exploratory statistical analysis will be based on principal component analysis. Results A total of 680 questionnaires was sent out and we achieved an 81% response rate. The results showed that 12% of the students had asthma during their lifetime, and 42.6% had rhinitis at least once in their lives. Conclusion The prevalence of asthma is comparable to the average level in Brazil (To et al. 2012). However, the prevalence of rhinitis is higher than in other Brazilian cities (Sole et al. 2007), therefore air pollution from ports may be a risk factor. The statistical analyses will provide further insight into this potential association. References Solé D, Camelo-Nunes SIC, Freitas LS, Brito M, Rosario NA, Jones M, et al. Changes in the prevalence of asthma and allergic diseases among Brazilian school children (13-14 year-old): comparison between ISAAC's Phases One and Three. J Trop Pediatr 2007; 53:13-21. To T, Stanojevic S, Moores G, Gershon AS, Bateman ED, Cruz AA, et al. Global asthma prevalence in adults: findings from the cross-sectional world health survey. BMC public health. 2012;12(1):204.

Prevalence of asthma and allergic diseases in adolescents: nine‐year follow‐up study (2003‐2012)

ObjectiveTo determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema in adolescents (AD; 13‐14 years) living in seven Brazilian cities, by applying the standardized written questionnaire (WQ) of the International Study of Asthma and Allergies in Childhood (ISAAC), and to evaluate the time trend nine years after the last assessment of ISAAC phase 3 (ISP3). MethodsThe ISAAC‐WQ was answered by 20,099 AD from the Northern, Northeastern, Southeastern, and Southern Brazilian regions. Values obtained were compared to those observed in ISP3 using nonparametric (chi‐squared or Fisher) tests, and the ratio of annual increment/decrement was established for each of the centers, according to the symptom assessed. ResultsConsidering the national data and comparing to values of ISP3, there was a decrease in the mean prevalence of active asthma (18.5% vs. 17.5%) and an increase in the frequency of severe asthma (4.5% vs. 4.7%) and physician‐diagnosed asthma (14.3% vs. 17.6%). An increase in prevalence of rhinitis, rhinoconjunctivitis, and atopic eczema was also observed. ConclusionsThe prevalence of asthma, rhinitis, and atopic eczema in Brazil was variable; higher prevalence values, especially of asthma and eczema, were observed in regions located closer to the Equator.

Overweight/obesity and respiratory and allergic disease in children: international study of asthma and allergies in childhood (ISAAC) phase two.

BackgroundChildhood obesity and asthma are increasing worldwide. A possible link between the two conditions has been postulated. MethodsCross-sectional studies of stratified random samples of 8–12-year-old children (n = 10 652) (16 centres in affluent and 8 centres in non-affluent countries) used the standardized methodology of ISAAC Phase Two. Respiratory and allergic symptoms were ascertained by parental questionnaires. Tests for allergic disease were performed. Height and weight were measured, and overweight and obesity were defined according to international definitions. Prevalence rates and prevalence odds ratios were calculated.ResultsOverweight (odds ratio = 1.14, 95%-confidence interval: 0.98; 1.33) and obesity (odds ratio = 1.67, 95%-confidence interval: 1.25; 2.21) were related to wheeze. The relationship was stronger in affluent than in non-affluent centres. Similar results were found for cough and phlegm, rhinitis and eczema but the associations were mostly driven by children with wheeze. There was a clear association of overweight and obesity with airways obstruction (change in FEV1/FVC, −0.90, 95%-confidence interval: −1.33%; −0.47%, for overweight and −2.46%, 95%-confidence interval: −3.84%; −1.07%, for obesity) whereas the results for the other objective markers, including atopy, were null.ConclusionsOur data from a large international child population confirm that there is a strong relation of body mass index with wheeze especially in affluent countries. Moreover, body mass index is associated with an objective marker of airways obstruction (FEV1/FVC) but no other objective markers of respiratory and allergic disorders.

Respiratory effects in children from passive smoking of cigarettes and narghile: ISAAC Phase Three in Syria.

The association between environmental tobacco smoke (ETS) and asthma symptoms is well documented, but a causal relationship is inconclusive. International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three was the first to report a dose-response relationship between current wheezing and exposure to parental cigarette smoke. As exposure of children to water pipe (narghile) smoke is of concern in Syria, in the ISAAC Phase Three Tartous Centre we also examined the role of parental smoking of the narghile. Parents of children aged 6-7 years completed core written questionnaires about the prevalence of symptoms, and an environmental questionnaire for other risk factors, including parental cigarette smoking. We added questions about narghile to the questionnaire. Among 2 734 pupils (49% females) surveyed, we found an association between exposure to ETS of the mother smoking cigarette or narghile and ever wheezing, nocturnal cough and severe wheeze; however, the strongest association was found when the mother smoked narghile. Mother smoking narghile was also associated with exercise wheeze. Father smoking narghile, but not cigarettes, was associated with nocturnal cough, severe wheeze and exercise wheeze. The association with current wheeze became significant when mother smoked both cigarettes and narghile; however, the effect was addititive and not synergic. We recommend that international studies investigating ETS include questions on narghile smoking.