International Study Of Asthma And Allergies In Childhood Study Research Articles

Childhood Wheeze, Allergic Rhinitis, and Eczema in Hong Kong ISAAC Study from 1995 to 2015.

The prevalence of allergic diseases has been increasing in developing areas but has reached a plateau in many developed areas. Regular surveys are imperative to assess the disease burden for the prioritization of resource allocation. We examined the change in the prevalence of wheezing, allergic rhinitis (AR), and eczema in school-aged children with possible associative factors and possible health effects of school air quality. This was the third repeated cross-sectional study conducted in 2015-2016 using the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. Our first and second surveys were conducted in 1994-1995 and 2000-2001, respectively. Regarding the third survey, we recruited 3698 children aged 6-7 from 33 local schools in 18 districts. Air quality, temperature, and humidity were also measured. The changes in prevalence, multiple regression, and GLIMMIX procedure were analyzed. From our first survey to our third survey, the increased prevalences for lifetime wheeze, current wheeze, lifetime rhinitis, current rhinitis, current rhinoconjunctivitis, lifetime chronic rash, and current chronic rash were 4.2%, 2.1%, 12.5%, 12.6%, 14.2%, 3.9%, and 4.1%, respectively. Increased prevalence of parental atopy had the strongest association with an increased prevalence of each of these seven health outcomes. There was no significant association between school air pollutant levels and the prevalence of health outcomes. There was an increase in the prevalence of wheezing, allergic rhinitis, and eczema across the surveys. The most important associated risk factor identified was the increased prevalence of a parental history of atopy.

Asthma in children and adolescents in Brazil: contribution of the International Study of Asthma and Allergies in Childhood (ISAAC)

Objective: To assess asthma among Brazilian pediatric population applying the International Study of Asthma and Allergies in Childhood (ISAAC), an internationally standardized and validated protocol. Data sources: ISAAC was conceived to maximize the value of epidemiologic studies on asthma and allergic diseases, establishing a standardized method (self-applicable written questionnaire and/or video questionnaire) capable to facilitate the international collaboration. Designed to be carried out in three successive and dependent phases, the ISAAC gathered a casuistic hitherto unimaginable in the world and in Brazil. This review included data gathered from ISAAC official Brazilian centers and others who used this method. Data synthesis: At the end of the first phase, it has been documented that the prevalence of asthma among Brazilian schoolchildren was the eighth among all centers participating all over the world. Few centers participated in the second phase and investigated possible etiological factors, especially those suggested by the first phase, and brought forth many conjectures. The third phase, repeated seven years later, assessed the evolutionary trend of asthma and allergic diseases prevalence in centers that participated simultaneously in phases I and III and in other centers not involved in phase I. Conclusions: In Brazil, the ISAAC study showed that asthma is a disease of high prevalence and impact in children and adolescents and should be seen as a Public Health problem. Important regional variations, not well understood yet, and several risk factors were found, which makes us wonder: is there only one or many asthmas in Brazil?

Analysis of the Prevalence of and Risk Factors for Atopic Dermatitis Using an ISAAC Questionnaire in 8,750 Korean Children

Background: Since 1995, epidemiologic studies of atopic disorders using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire have been performed in many countries, including the Republic of Korea. The prevalence, burden and risk factors of atopic dermatitis were surveyed in these studies, which helped to enhance their comparability among different areas and age groups, as well as to clarify the nature of atopic dermatitis and other atopic disorders. Methods: From 21 facilities, 8,750 children were enrolled in this cross-sectional study. The data were collected via the Internet using a questionnaire based on the Korean-language version of the ISAAC study format. Results: The prevalence of atopic dermatitis over the previous 12 months was 14.4%. The prevalence in preschool children was significantly higher than in elementary school children. Family history of atopic diseases, diagnosis of allergic conjunctivitis and diagnosis of food allergy were positively associated with atopic dermatitis in both preschool and elementary school children. In addition, raising pets was positively associated with atopic dermatitis in preschool children. In elementary school children, female gender, secondhand smoking, breastfeeding, changing the parents' house to a newly built one during the first year of life, diagnosis of asthma and diagnosis of allergic rhinitis were positively associated with atopic dermatitis. Conclusion: The prevalence of atopic dermatitis in preschool and elementary school children in Korea is similar to that of children in other developing countries. The risk factors for atopic dermatitis are different in preschool and elementary school children. More detailed strategies will be necessary to reduce atopic dermatitis in both age groups.

Cooking fuels and prevalence of asthma: a global analysis of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC)

Indoor air pollution from a range of household cooking fuels has been implicated in the development and exacerbation of respiratory diseases. In both rich and poor countries, the effects of cooking fuels on asthma and allergies in childhood are unclear. We investigated the association between asthma and the use of a range of cooking fuels around the world. For phase three of the International Study of Asthma and Allergies in Childhood (ISAAC), written questionnaires were self-completed at school by secondary school students aged 13-14 years, 244,734 (78%) of whom were then shown a video questionnaire on wheezing symptoms. Parents of children aged 6-7 years completed the written questionnaire at home. We investigated the association between types of cooking fuels and symptoms of asthma using logistic regression. Adjustments were made for sex, region of the world, language, gross national income, maternal education, parental smoking, and six other subject-specific covariates. The ISAAC study is now closed, but researchers can continue to use the instruments for further research. Data were collected between 1999 and 2004. 512,707 primary and secondary school children from 108 centres in 47 countries were included in the analysis. The use of an open fire for cooking was associated with an increased risk of symptoms of asthma and reported asthma in both children aged 6-7 years (odds ratio [OR] for wheeze in the past year, 1·78, 95% CI 1·51-2·10) and those aged 13-14 years (OR 1·20, 95% CI 1·06-1·37). In the final multivariate analyses, ORs for wheeze in the past year and the use of solely an open fire for cooking were 2·17 (95% CI 1·64-2·87) for children aged 6-7 years and 1·35 (1·11-1·64) for children aged 13-14 years. Odds ratios for wheeze in the past year and the use of open fire in combination with other fuels for cooking were 1·51 (1·25-1·81 for children aged 6-7 years and 1·35 (1·15-1·58) for those aged 13-14 years. In both age groups, we detected no evidence of an association between the use of gas as a cooking fuel and either asthma symptoms or asthma diagnosis. The use of open fires for cooking is associated with an increased risk of symptoms of asthma and of asthma diagnosis in children. Because a large percentage of the world population uses open fires for cooking, this method of cooking might be an important modifiable risk factor if the association is proven to be causal. BUPA Foundation, the Auckland Medical Research Foundation, the Health Research Council of New Zealand, the Asthma and Respiratory Foundation of New Zealand, the Child Health Research Foundation, the Hawke's Bay Medical Research Foundation, the Waikato Medical Research Foundation, Glaxo Wellcome New Zealand, the NZ Lottery Board, Astra Zeneca New Zealand, Hong Kong Research Grant Council, Glaxo Wellcome International Medical Affairs.

Paracetamol use for non-respiratory indications and subsequent asthma: a valuable way to eliminate confounding by respiratory infections

Rusconi et al. report an interesting analysis of the data arising out of SIDRIA-2 (Italian Studies of Respiratory Disorders in Childhood and the Environment phase 2), the Italian arm of phase two of the International Study of Asthma and Allergies in Childhood (ISAAC). Using directed acyclic graph (DAG) and logistic regression analysis, the authors conclude that the association between paracetamol consumption in early life and childhood asthma ‘might fully or in part, be due to confounding’. The use of age of onset of symptoms is innovative and useful, and we appreciate the more comprehensive analysis of ISAAC data relating to this question than has been previously reported. Whereas we agree with the authors’ overall conclusion, we feel that one of the issues raised within this paper needs further discussion to put the results in the context of all the available evidence. The authors state that ‘It is well known that wheeze, especially in the first years of life, is chiefly triggered in susceptible individuals by viral infections for which paracetamol (owing to accompanying fever) and antibiotics (owing to a difficult differential diagnosis with bacterial infections) are often prescribed’. Although paracetamol is commonly used for the management of fever, it is also often used as an analgesic in young children. In the Melbourne Atopy Cohort Study (MACS), a birth cohort of 620 children with a family history of allergic disease, we found that 94% of children had received paracetamol for various forms of physical injury, or for the management of immunization-related pain, by 2 years of age. Examining the impact of paracetamol treatment for non-respiratory causes on subsequent asthma is not confounded by respiratory infections, and allows us to see the direct effect of paracetamol exposure on risk of allergic disease. Such an approach is valuable in disentangling the effect of paracetamol and respiratory tract infections on subsequent risk of asthma. Unfortunately, the indication for use of paracetamol was not collected within the ISAAC study. In the MACS, we found that, although total use of paracetamol was associated with increased risk of childhood asthma (at 6–7 years of age), paracetamol for non-respiratory tract indications was not associated with any allergic disease outcome, including asthma. This provides further evidence that the association between paracetamol intake in early life and childhood asthma is more likely to be due to confounding, rather than a causal relationship. Conflict of interest: Unrelated to the current research, S.C.D. has received a research grant from GlaxoSmithKline, and M.J.A. has acted in advisory roles for GlaxoSmithKline. In addition, M.J.A. has received a research grant from Reckitt Benckiser; these companies might have an interest in this issue. The other author has declared no conflicts of interest. A.J.L. and S.C.D. received personal funding from the National Health and Medical Research Council to support this work.

The prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in Korean children: Nationwide cross-sectional survey using complex sampling design

To investigate the prevalence of asthma, allergic rhinitis, and eczema, we did a cross-sectional survey of 4,003 children aged 6-7 years (students in the 1st year of elementary school) and 4,112 students aged 13-14 years (students in the 1st year of middle school), chosen from a random sample of 45 primary and 40 middle schools across the nation. The Korean-translated modified version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used in this survey. The weighted 12-month prevalence of asthma symptoms from the questionnaires was 10.3% (95% confidence interval [CI], 9.2 to 11.4) for children aged 6-7 years and 8.3% (95% CI, 7.4 to 9.2) for children aged 13-14 years. The weighted 12-month prevalence of allergic rhinoconjuctivitis symptoms was 18.9% (95% CI, 17.5 to 20.4) for children aged 6-7 years and 19.2% (95% CI, 17.9 to 20.6) for children aged 13-14 years. The weighted 12-month prevalence of eczema symptoms was 17.9% (95% CI, 16.6 to 19.3) for children aged 6-7 years and 11.2% (95% CI, 10.1 to 12.3) for children aged 13-14 years. Compared with results from a 2000 ISAAC study, the 12-month prevalence of asthma increased from 5.8% to 10.3% in children aged 6-7 years, but there was little change (from 8.7% to 8.3%) in children aged 13-14 years. The prevalence of allergic rhinoconjunctivitis and eczema has increased considerably in both age groups.

Aims and methods of the ISAAC study (International Study of Asthma and Allergy in Childhood)

The International Study of Asthma and Allergies in Childhood (ISAAC) is a multicentric, transversal, epidemiological study for investigating the epidemiology of asthma using a standardised methodology. In the case of Spain, centres in Almeria, Barcelona, Bilbao, Cadiz, Cartagena, Castellon, Valladolid and Valencia are collaborating in the study. The aim of the study is to obtain knowledge of the prevalence and seriousness of asthma amongst children living in different cities so as to compare the results between different Spanish cities and with other countries. This will make it possible to elaborate hypotheses on the aetiology of asthma. The ISAAC protocol studies two groups: children of 6 to 7 years of age, and adolescents of 13 to 14 years. The parents of the children of 6 to 7 years were sent questionnaires on asthma, atopic dermatitis, rhinitis and conjunctivitis, while the children in the 13 to 14 year old age group received the same written questionnaire together with a video questionnaire. A minimum of 3,000 children have been studied in each centre and age group. The information obtained from the ISAAC study, besides facilitating the study of the aetiology of asthma, will provide a baseline measure for studying the world evolution of the illness.

Prevalência da asma e da rinite em adolescentes de 13 anos do Porto, Portugal

Background: The prevalence of asthma and rhinitis has been increasing over the past few decades, but the last few years have seen these rates stabilise or even decrease.Aim: The aim of our study was to describe the prevalence of rhinitis, asthma or asthma-like symptoms in 13 year-old urban adolescents.Methods: Eligible participants were all students at state and private schools in Porto born in 1990. 2161 (77.5%) agreed to participate. Information was obtained using self-administered questionnaires inquiring into social, demographic, behavioural and clinical history including asthma and allergic diseases in the adolescent and the family. We used the Portuguese version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and we also performed spirometry tests.Results: In this sample of 13 year old urban adolescents the prevalence of asthma ever was 12.9%, 84.4% with physician diagnosis. Lifetime wheezing was reported by 18.3% and current wheezing by 9.3% of the adolescents. Rhinitis was referred to by 10.1%, but the prevalence of adolescents with sneezing ever, or a runny/blocked nose, was 32.0% and the prevalence in the last 12 months was 27.4%.Conclusion: We concluded that there was stabilisation or even decrease in the prevalence of asthma and rhinitis symptoms and diagnosis in adolescents reported in Porto, compared with the 2002 ISAAC study, as observed in other surveys in Europe. Asthma and rhinitis is frequently present in the same patient and nocturnal cough is an important symptom concomitant with nasal symptoms. Measures of lung function permitted the discrimination of adolescents with respiratory complaints.Rev Port Pneumol 2008; XIV (6): 747-768

Prevalence of asthma and rhinitis in 13 year old adolescents in Porto, Portugal

BackgroundThe prevalence of asthma and rhinitis has been increasing over the past few decades, but the last few years have seen these rates stabilise or even decrease. AimThe aim of our study was to describe the prevalence of rhinitis, asthma or asthma-like symptoms in 13 year-old urban adolescents. MethodsEligible participants were all students at state and private schools in Porto born in 1990. 2161 (77.5%) agreed to participate. Information was obtained using self-administered questionnaires inquiring into social, demographic, behavioural and clinical history including asthma and allergic diseases in the adolescent and the family. We used the Portuguese version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and we also performed spirometry tests. ResultsIn this sample of 13 year old urban adolescents the prevalence of asthma ever was 12.9%, 84.4% with physician diagnosis. Lifetime wheezing was reported by 18.3% and current wheezing by 9.3% of the adolescents. Rhinitis was referred to by 10.1%, but the prevalence of adolescents with sneezing ever, or a runny/blocked nose, was 32.0% and the prevalence in the last 12 months was 27.4%. ConclusionWe concluded that there was stabilisation or even decrease in the prevalence of asthma and rhinitis symptoms and diagnosis in adolescents reported in Porto, compared with the 2002 ISAAC study, as observed in other surveys in Europe. Asthma and rhinitis is frequently present in the same patient and nocturnal cough is an important symptom concomitant with nasal symptoms. Measures of lung function permitted the discrimination of adolescents with respiratory complaints.

Prevalencia de dermatitis atópica en escolares de Granada

IntroductionAtopic dermatitis is a common and increasingly prevalent disorder. The International Study of Asthma and Allergies in Childhood (ISAAC) made a major contribution to the understanding of its epidemiology. ObjectivesThe aim of this study was to estimate the prevalence and severity of atopic dermatitis in a representative sample of 6 to 7-year-old and 13 to 14-year-old children from the province of Granada, Spain, using validated questionnaires and to analyze potential differences between coastal and inland regions. Material and methodsThis was a descriptive cross-sectional observational study of schoolchildren from Granada, Spain, aged between 6 and 7 years and 13 and 14 years. The main instrument was the core questionnaire module for dermatitis used in phase I of the ISAAC study. ResultsStatistically significant differences were found in Granada schoolchildren aged 6 to 7 years in terms of prevalence of dermatitis at some time, typical site, resolution in the last 12 months, and diagnosis of atopic dermatis. No significant differences were observed on comparison of the prevalence of atopic dermatitis between coastal and inland populations. Finally, in the comparison of schoolchildren aged 6 to 7 years, we observed almost significant differences for dermatitis at some time, resolution in the last 12 months, and diagnosis of atopic dermatitis on considering age and geographic location of the study population. ConclusionsThe prevalence of atopic dermatitis is similar in the coastal population and the provincial capital. In terms of clinical symptoms and disease course, atopic dermatitis tends to stabilize with age.

Household Conditions, Eczema Symptoms and Rhinitis Symptoms: Relationship with Wheeze and Severe Wheeze in Children Living in the Polokwane Area, South Africa

This is the fifth study that applied the International Study of Asthma and Allergies in Childhood (ISAAC) methodology in the Southern African Development Community (SADC region). However, it is the first ISAAC study that focused on 6- to 7-year-old children living in South Africa and that also investigated the association between potential risk factors and asthma symptoms. Objective To assess the 12-month prevalence of wheeze and severe wheeze along with their potential risk factors. Setting Within a 60-km radius from the Polokwane city centre, Limpopo Province. The survey was conducted during August 2004 and February 2005. Parents/guardians of 6- to 7-year-old children completed the questionnaires in English, Afrikaans or North-Sotho. However, the statistical analyses were restricted to the North-Sotho group (n = 2,437). The 12-month prevalence rates of wheeze and severe wheeze were 11.2% and 5.7%, respectively. The 12-month prevalence rates of eczema symptoms and rhinoconjunctivitis symptoms were 8.0% and 7.3%, respectively. Living in a rural area significantly decreased the likelihood of wheeze by 31%. Exposure to environmental tobacco smoke at home and the presence of eczema symptoms and rhinoconjunctivitis symptoms increased the likelihood of wheeze by 77%, 104% and 226%, respectively. Only the presence of rhinoconjunctivitis symptoms increased the likelihood of severe wheeze by 107%. Wheeze appears to be an emerging public health problem in the Polokwane area. Hopefully, detailed analytical intervention studies will further explicate these results in the near future.

Prevalence of Asthma Symptoms in 7th- and 8th-Grade School Children in a Rural Region in India

We estimated the prevalence of asthma related symptoms in grade 7 and 8 students in a rural region in India. Method. An International Study of Asthma and Allergies in Childhood (ISAAC), questionnaire with added questions related to environmental and familial exposures, was administered to 3668 students from 48 rural schools near Malegaon, India. Results. A history of asthma was present in 10.7% students and 7.3% wheezed in the past 12 months, with about one-third having at least four attacks. Boys had the higher prevalence of all asthma-related symptoms than girls did, and symptom frequency was generally above the median reported for urban Indian ISAAC centers. Asthma and wheeze were associated with a family history of asthma, smoking, and frequent chest colds. Significant environmental factors included parental occupation and smoking and poor water sources. Increased odds of asthma occurred in students working for wages, exposed to animals, or eating in the kitchen. Relationships were similar for wheezing. Both asthma and wheeze were higher in the Scheduled Tribe (ST) group. Most markers of socioeconomic status and environmental exposure were not significant in multivariate analysis. Conclusion. The prevalence of asthma and wheeze in a rural region in India was similar to that found in the urban ISAAC study; it was higher in students from lower socioeconomic groups with poorer environmental conditions.

Prevalence of Atopic Dermatitis in Schoolchildren in Granada, Spain

Introduction Atopic dermatitis is a common and increasingly prevalent disorder. The International Study of Asthma and Allergies in Childhood (ISAAC) made a major contribution to the understanding of its epidemiology. Objectives The aim of this study was to estimate the prevalence and severity of atopic dermatitis in a representative sample of 6 to 7-year-old and 13 to 14-year-old children from the province of Granada, Spain, using validated questionnaires and to analyze potential differences between coastal and inland regions. Material and methods This was a descriptive cross-sectional observational study of schoolchildren from Granada, Spain, aged between 6 and 7 years and 13 and 14 years. The main instrument was the core questionnaire module for dermatitis used in phase I of the ISAAC study. Results Statistically significant differences were found in Granada schoolchildren aged 6 to 7 years in terms of prevalence of dermatitis at some time, typical site, resolution in the last 12 months, and diagnosis of atopic dermatis. No significant differences were observed on comparison of the prevalence of atopic dermatitis between coastal and inland populations. Finally, in the comparison of schoolchildren aged 6 to 7 years, we observed almost significant differences for dermatitis at some time, resolution in the last 12 months, and diagnosis of atopic dermatitis on considering age and geographic location of the study population. Conclusions The prevalence of atopic dermatitis is similar in the coastal population and the provincial capital. In terms of clinical symptoms and disease course, atopic dermatitis tends to stabilize with age.

Asthma and other allergic diseases in 13-14-year-old schoolchildren in Urmia: an ISAAC study

We determined the prevalence and risk factors of asthma, allergic rhinitis and atopic eczema in 3000 13-14-year-old schoolchildren in Urmia, Islamic Republic of Iran. We used the International Study of Asthma and Allergies in Childhood (ISAAC) written and video questionnaires. With the written questionnaire, the prevalence of current symptoms (within the past 12 months) was: wheeze 14.5%, allergic rhinitis 23.6% and eczema 10.1%. Self-reported asthma ever was only 2.1%. With the video questionnaire, the prevalence of wheeze was lower; 7.4% for wheeze at rest ever and 4.6% during the past 12 months. Boys had a significantly higher prevalence for most items examined except for eczema.

Incidencia de rinitis alérgica en escolares entre 1994 y 2002 en Castellón según el estudio ISAAC

To estimate the incidence of allergic rhinitis in schoolchildren in Castellón by comparing phases I and III of the International Study of Asthma and Allergies in Childhood (ISAAC), carried out in 1994 and 2002, respectively. A cohort study was performed with 3607 schoolchildren aged 6-7 years old who participated in phase I of the ISAAC study. Of these, 1805 participated in phase III (8 years later) at the age of 14-15 years, with 1627 schoolchildren without allergic rhinitis in phase I. The cumulative incidence of allergic rhinitis was estimated. Two definitions of new cases of allergic rhinitis were used: the first was based on medical diagnosis or treatment of the disease, and the second also included symptoms of allergic rhinitis in the previous 12 months. Relative risks were calculated using Poisson regression. Participation was 50.0 %, and 151 new cases of allergic rhinitis according to the first definition (cumulative incidence of 9.3 % and 1.2 % per year) and 339 new cases according to the second definition (cumulative incidence of 20.8 % and 2.6 % per year) were found. No differences in incidence by gender were observed with the first definition (RR = 1.00 95 % CI 0.73-1.38) but with the second definition, the incidence was greater in girls (RR = 1.46 95 % CI 1.18-1.82). The cumulative incidence of allergic rhinitis according to the first definition was in the range of incidence from cohort studies of adolescents.

A comparative study of bronchodilator reversibility with albuterol, between asthma symptomatic and asymptomatic children according to ISAAC questionnaire in Mexico city

BackgroundAsthma is an important childhood disease. Recent surveys of the International Study of Asthma and Allergies in Childhood (ISAAC) suggest that the prevalence of asthma is increasing but these surveys do not include any pulmonary tests to confirm the possible diagnosis of asthma ObjectiveTo compare bronchodilator reversibility with the albuterol test in symptomatic and asymptomatic 6-7-year-old children with asthma participating in the ISAAC survey and living in Mexico City Patients and methodsWe performed an observational, descriptive, comparative, cross sectional study in children participating in phase 3b of the ISAAC study. According to the ISAAC questionnaire children were classified as asthma symptomatic or asymptomatic. Both groups had bronchodilator reversibility with the albuterol test, using the guidelines of the American Thoracic Society to confirm or rule out the diagnosis of asthma ResultsThe asymptomatic group had a baseline FEV1 of 1.70 ± 0.34 l/sec (mean ± SD) and an endpoint FEV1 of 1.76 ± 0.42 l/sec; in the symptomatic group the respective values were 1.51 ± 0.41 l/sec and 1.57 ± 0.44 l/sec (p < 0.05). A positive reversibility test was found in 13/136 (9.6 %) children in the asymptomatic group and in 22/112 (19.6 %) children in the symptomatic group (p < 0.05) ConclusionBecause of its low sensitivity, bronchodilator reversibility cannot be considered a diagnostic tool to confirm diagnosis of asthma

Chronic bronchial asthma from challenge to treatment: epidemiology and social impact

Asthma is an important cause of chronic morbidity and a crucial health problem among children and adults worldwide, with high prevalence rates particularly in many developed countries.1 2 Increasing morbidity,...

Application of geographical information systems in epidemiological studies exemplified by the ISAAC study in Munich

Geographical Information Systems (GIS) are increasingly applied as modern tools for analysis and visualization of health-related spatial data, especially in epidemiological research. GIS are used by medical researchers and executives in the public health service. A community-based survey was conducted according to the phase II protocol of the International Study of Asthma and Allergies in Childhood (ISAAC) in Munich. The spatial patterns of disease incidence were analysed and related to exposure data by GIS. The prevalence study on fourth-grade pupils (n = 3354) and school beginners (n = 2890) was conducted during the school term 1995/96 in Munich. Parental questionnaires and measurements of lung function and immunological parameters were used. The questionnaire data were integrated in a GIS database. In this paper we discuss methodological aspects of GIS-based spatial analysis related to epidemiological data. In addition, we investigate whether there were spatial clusters of children with wheeze in the last 12 months of a magnitude unlikely to occur by chance and which could indicate local health risks. The study was based on permutation tests where global and local methods were applied. No spatial clusters of children with asthma symptoms were identified in the city of Munich.

Prevalence of asthma, allergic rhinitis, and eczema in 13- to 14-year-old children in Kuwait: an ISAAC study

To determine the prevalence of asthma and allergic diseases in 13 to 14 years old children in Kuwait. Supervised self-administered written and video questionnaires of the international study of asthma and allergies in childhood (ISAAC). Students at third and fourth years from 40 intermediate level schools chosen randomly from across Kuwait. 3,110 students were surveyed. The prevalence rates (95% CI) in the written questionnaire for wheeze ever, current wheeze (within the last 12 months), and physician diagnosis of asthma are 25.9% (24.5 to 27.4), 16.1% (15.8 to 17.4), and 16.8% (15.5 to 18.1) respectively. The prevalence rates (95% CI) for symptoms of allergic rhinitis (AR) ever, current symptoms of allergic rhinitis (AR), and diagnosis of AR are 43.9% (42.2 to 45.6), 30.7% (29.1 to 32.4) and 17.1% (14.8 to 18.4) respectively. The prevalence rates (95% CI) for itchy rash ever, current itchy rash, and diagnosis of eczema are 17.5% (16.2 to 18.8), 12.6% (11.4 to 13.8), and 11.3% (10.2 to 12.4) respectively. The prevalence of wheeze ever, wheeze during the last year, and physician diagnosis of asthma are higher in males compared with females, P < .01. In multiple logistic regression: male gender (OR 1.6, 95% CI, 1.3 to 2.0) and diagnosis of AR (OR 1.7, 95% CI, 1.4 to 2.2) were associated with the physician diagnosis of asthma even after controlling for symptoms of asthma. This is the first study on the prevalence of allergic diseases in Kuwait and it shows that children in Kuwait have a moderate prevalence of asthma, AR, and eczema compared with other countries where the ISAAC study is done. The prevalence of asthma is higher in boys compared with girls.

Descriptive epidemiology of asthma

Descriptive epidemiology of asthma