Increasing prevalence of asthma, allergic rhinitis but not eczema in 5- to 8-yr-old Maltese children (ISAAC)

The International Study of Asthma and Allergies in Childhood (ISAAC) was the first worldwide study carried out with standardized questionnaires in order to create a reliable global map of childhood allergy. Phase 1 of the study was carried out in the Maltese Islands in 1994/95 while a similar study (phase 3) was repeated 7 yr later (2001/02). In this paper, the data obtained from 3816 5‐ to 8‐yr‐olds (80% response rate) in phase 3 were compared to that obtained from 3509 5‐ to 8‐yr‐olds (78.5% response rate) in phase 1 of the study in order to evaluate whether the problem of allergic conditions in Maltese schoolchildren was indeed changing. About 30.2% (phase 3) vs. 19.1% (phase 1) (p < 0.0001) of the participants were wheezers ‘ever’ while 14.8% vs. 8.8% (p < 0.0001) were current wheezers and 14.8% vs. 7.5% (p < 0.0001) were labelled as asthmatics. Of these wheezing children, 13.3% vs. 6.2% (p = 0.0002) had a wheezing episode severe enough to limit speech. Nasal problems were present in 28.8% of Maltese children in 2001 and in 23.4% in 1994 (p < 0.0001) and 24.4% vs. 20.7% (p < 0.0001) of all respondents persisted with these symptoms up to the year of answering the questionnaire. Hayfever had been diagnosed in 22.2% vs. 14.7% (p < 0.0001) of all the children. About 6.7% vs. 7.0% (p = 0.61) of respondents had an recurring itchy rash suggestive of eczema for at least 6 months of their lives and 5.4.% vs. 5.5% had it currently. In 1994, the prevalence of wheezing and eczema were slightly lower than the global mean, unlike the case of rhinitis, which in Malta was commoner than the world average, while in 2001 wheezing together with rhinitis surpassed the global mean as well. These results indicate a rising prevalence of wheezing and rhinitis but not eczema in Maltese children. Asthma seemed to be better controlled and all three allergic conditions more likely to be diagnosed.     

Prevalence of asthma and other allergic disorders among schoolchildren in Diyarbakir, Turkey.

This study was performed to describe the prevalence rates of allergic diseases among children in southeast Anatolia. A questionnaire survey of children six to 15 years old was conducted using a modified version of the Turkish translated ISAAC protocol, with additional questions concerning sociodemographic and environmental characteristics of children that could be potential risk factors for allergic disorders. Questionnaires were distributed to parents of all children aged below 11 years and to children themselves aged over 11 for completion. A total of 3,040 children returned the questionnaires. The lifetime prevalence rates of asthma, wheezing, allergic rhinitis and atopic dermatitis were 14.1%, 22.4%, 12.9%, and 7.8%, respectively. The prevalence of wheezing, rhinitis and chronic rash in the last 12 months were 14.7%, 39.9%, and 11.8%, respectively. The prevalence rates of symptoms and diagnoses of allergic disorders were similar in boys and girls. Passive smoking, pet ownership, number of household and socioeconomic status were not significant risk factors for allergic diseases. Family history of atopy was the most prominent risk factor for all types of allergic diseases, high prevalence rates of asthma, rhinitis and eczema exist among schoolchildren in southeast Anatolia.     

The effect of cigarette smoking on allergic conditions in Maltese children (ISAAC)

Maltese children are frequently exposed to tobacco smoke through passive and personal smoking. In the phase 3 ISAAC study questionnaire, we enquired about passive smoking to the parents of 3816 (80% response rate) 5- to 8-yr-old children and about passive and personal smoking to 4139 (90% response rate) 13- to 15-yr-old participating children. Thirty-one percent of 5- to 8-yr olds were passive smokers with their father more likely to be the smoker (p?相似文献   

Prevalence of asthma,rhinitis and eczema among schoolchildren in Kelantan,Malaysia

The prevalence and severity of asthma, rhinitis and eczema in Kelantanese schoolchildren were determined as part of an international study of the epidemiology of asthma and allergic diseases. The international study of asthma and allergies in childhood (ISAAC) written questionnaire was administered to 7055 schoolchildren from February 1995 to August 1995. The respondents were parents or guardians of 5- to 7-year-old children (n = 3939), and schoolchildren aged 12–14 years (n = 3116). The ISAAC video questionnaire (AVQ3.0) was shown to children aged 12–14 years after the written questionnaire. The overall prevalences of ‘ever wheezed’ and ‘wheezing in last 12 months' were 9.4 and 6.0% respectively. The prevalence of ‘ever diagnosed with asthma’ was 9.4%. Both ‘ever wheezed’ and ‘wheezing in the last 12 months’ were significantly higher in 12- to 14-year-old children than in 5- to 7-year-old children, with P values of 0.0006 and 0.014 respectively. No gender differences in the prevalences were observed. For the complete study group, 4.7% of children had sleep disturbed by wheezing but only 1.1% had a severe attack limiting speech in the preceding 12 months. Sleep disturbance was more common in the 12- to 14-year-old children than in 5- to 7-year-old children (P = 0.006). There was no difference between the age groups for severe attacks limiting speech. The overall prevalence of rhinitis and eczema symptoms were 27 and 12%, respectively. The prevalence of rhinitis in the 12–14 year age group (38.2%) was significantly higher (P < 0.0001) than in the 5–7 year age group (18.2%). The prevalence of eczema in the 5–7 year age group (13.7%) was significantly higher (P = < 0.0001) than in the 12–14 year age group (9.9%). These prevalence data are comparable with previous reports in Malaysian children, but are considerably lower than those reported for most developed countries     

Increased rate and greater severity of allergic reactions to insect sting among schoolchildren with atopic diseases

The question of whether atopic diseases are a risk factor for allergic reactions to insect sting is still unresolved. The aim of this study was to evaluate the association between atopic diseases (asthma, allergic rhinitis, atopic eczema) and allergic reactions to insect stings among schoolchildren in Israel. A self‐report questionnaire of the International Study of Asthma and Allergies in Childhood was administered to a national sample of 13–14‐yr‐old schoolchildren. Questions regarding reactions to insect stings were added. A total of 10,021 questionnaires were available for analysis. Among the children who reported insect stings (56.3%), the prevalence of current asthma was 6.0%, of allergic rhinitis, 10.5%, and of atopic eczema, 8.7%, with no significant differences from the whole study population. Among children with any of the atopic diseases, 36.9% reported an allergic reaction to insect sting compared to 24.8% of the non‐atopic children (p < 0.0001). On multivariate analysis, asthma, allergic rhinitis, and atopic eczema were found to be significant risk factors for allergic reactions of any severity. Children in the atopic group had a significantly higher rate of severe allergic reactions than the non‐atopic children, and relatively higher rates of milder ones (p < 0.0001). Asthmatic patients with severe allergic reactions had more parameters of severe asthma than asthmatic patients with mild or no reactions. In conclusions, allergic diseases are associated with a higher rate and greater severity of allergic reactions to insect sting in children. The severity of the allergic reaction is related to the severity of the asthma symptoms.     

Prevalence and risk factors of asthma and allergic diseases among schoolchildren in Bolu, Turkey

AIM: In this study we aimed to detect the prevalence and risk factors of asthma and allergic diseases in children aged between 7 and 14 years old at rural and urban areas of Bolu, Turkey. METHODS: Questionnaire of International Study of Asthma and Allergies in Childhood (ISAAC) phase one and questionnaire including questions about family, demographic, socio-economic characteristics of children were applied to 931 schoolchildren who were selected by randomized sampling. RESULTS: In children, the prevalence of diseases and symptoms were as follows: wheeze ever: 15.5%, asthma: 5.6%, nasal symptoms ever: 41.4%, allergic rhinitis: 23.2%, itchy rash ever: 5.9% and eczema: 5.0%. In multivariate regression analysis, presence of allergic disease in the family was risk factor for wheezing (OR=1.74, 95% CI=1.19-2.76), asthma (OR=2.19, CI=1.06-4.52), allergic rhinitis (OR=2.68, CI=1.80-3.98) and eczema (OR=2.33, CI=1.17-4.65); living in shanties was risk factor for allergic rhinitis (OR=5.26, CI=2.1-13.16); a monthly income below $300 was risk factor for asthma (OR=2.54, CI=1.06-6.08). CONCLUSION: It was detected that the prevalence of allergic rhinitis and its symptoms was more common in schoolchildren living in Bolu. Presence of allergic disease in fathers or mothers and low socio-economic level increase the risk of asthma and other allergic diseases in children.     

The association of allergic symptoms with sensitization to inhalant allergens in childhood

Although it is generally agreed that sensitization is an important risk factor for allergic diseases, the extent to which sensitization accounts for allergic symptoms in children is controversial. As part of the Aalst Allergy Study, this cross‐sectional study investigated the prevalence of allergic symptoms and their association with sensitization in an unselected population of Flemish children aged 3.4–14.8 yr. Skin prick testing with the most common aeroallergens was performed and allergic symptoms were documented by a parental questionnaire. In the children older than 6 yr, a significant association of current wheezing, current dyspnea, airway hyperreactivity, rhinoconjunctivitis, and current eczema with sensitization was found, while in the pre‐school children these associations were less pronounced. The association with sensitization was strongest for rhinoconjunctivitis and current respiratory symptoms – the association was less striking for children with current eczema. The impact of a positive family history of allergy on the association with sensitization was more important for eczema than for the other analyzed allergic symptoms. Persistent and late‐onset wheezers were significantly more likely than non‐wheezers and transient early wheezers to be associated with sensitization and a personal history of rhinoconjunctivitis. Late‐onset wheezing was associated with a positive family history of allergy, while transient early wheezing was associated with day‐care attendance. An association with eczema was found for all three childhood wheezing phenotypes. The association of allergic symptoms with sensitization is significant in the older but less pronounced in pre‐school children and is more pronounced for current allergic symptoms. Diagnosis and disease definition of allergy symptoms remains difficult at pre‐school age. The influence of a positive family history of allergy on the association of the respective allergic symptoms with sensitization was most important for eczema. Our data confirm the atopic characteristics of the different wheeze phenotypes.     

乌鲁木齐地区喘息患儿发生支气管哮喘的危险因素

目的 探讨乌鲁木齐地区喘息患儿发生支气管哮喘(哮喘)的危险因素.方法 对2008年1 -12月在新疆医科大学第五附属医院门诊及住院的300例喘息患儿的临床资料进行统计.用统一的调查表调查其年龄、性别、湿疹、变应性鼻炎、食物过敏、家族过敏史/哮喘史、运动相关性喘息等.出院后通过门诊或电话进行随访.采用 Logistic回归分析方法对各因素与哮喘发生的关系及相关程度进行分析.结果 随访2a,275例获得随访;25例失访.275例喘息患儿在随访期内86例(31.2％)发生哮喘.Logistic回归分析发现湿疹、变应性鼻炎、家族过敏史/哮喘史、运动相关性喘息、反复下呼吸道感染( LRTI)、外周血嗜酸性粒细胞(EOS)增高与喘息患儿发生哮喘有关(湿疹:OR=2.376,95％ CI0.098～0.935,P=0.039;变应性鼻炎:OR=1.052,95％ CI2.267 ～14.283,P =0.024;家族过敏史/哮喘史:OR=1.886,95％CI1.004～3.542,P =0.048;运动相关性喘息:OR=1.881,95％ CI2.267 ～18.983,P =0.001;LRTI:OR=5.341,95％ CI1.676～ 10.983,P =0.016;外周血EOS增高:OR=3.915,95％ CI1.459～ 10.501,P=0.002).结论 个人过敏史(湿疹和变应性鼻炎)、家族过敏史/哮喘史、运动相关性喘息、LRTI、外周血EOS增高是乌鲁木齐地区喘息患儿发生哮喘的危险因素.     

The prevalence, severity and seasonal variations of asthma, rhinitis and eczema in Taiwanese schoolchildren

The prevalence of asthma is increasing in Taiwan but data remain limited. The aim of this study was to determine the prevalence, severity, demographic and seasonal variations of asthma, rhinitis, and eczema in Taiwan. Using a one-stage stratified cluster random sampling, first grade (aged 6-8) and eighth grade (aged 13-15) students from Taoyuan, northern Taiwan, were invited to participate in this survey. The results showed a total of 6190 students, 3079 aged 6-8 and 3111 aged 13-15, completed this survey. In general, children aged 6-8 had significantly higher prevalence rates of diagnosed asthma, rhinitis, and eczema than children aged 13-15 (12.2%, 29.8%, and 10.2% vs. 9.6%, 18.3%, and 4.7%, respectively). Similarly, children aged 6-8 had significantly higher proportions of allergic symptoms, except for exercise-induced wheezing (5.8% vs. 17.8%, p < 0.0001). Among those with allergic disorders, children aged 6-8 presented a greater severity of wheezing attacks in the last 12 months. As regards gender, boys aged 6-8 had a significantly higher proportion of asthma or rhinitis symptoms than girls aged 6-8 but not in children aged 13-15. In children aged 6-8, asthma and rhinitis peaked in winter, especially in December. However, children aged 13-15 had two peaks (winter and summer) for asthma or rhinitis.     

Prevalence of asthma and allergic diseases in primary school children in Ankara, Turkey: Two cross‐sectional studies, five years apart

The prevalence of allergic diseases is reported to have increased worldwide. Two questionnaire surveys, five years apart, were conducted to evaluate the trend of prevalence rates and possible risk factors among primary school children in Ankara, Turkey. A previous survey in 1992 revealed the lifetime prevalences of asthma, wheezing, allergic rhinitis and atopic dermatitis were 17.4%, 23.3%, 28% and 6.1%, and the prevalences for the preceding 12 months were 8.3%, 11.9%, 15.4% and 4%, respectively. The survey was repeated with the same questionnaire in the same age group (6–13 years) of the same school in May 1997. The parents of 358 boys and 380 girls completed the questionnaire. The lifetime and last 12 months' prevalences of asthma, wheezing, rhinitis and atopic dermatitis were 16.8%, 22.5%, 18.7%, 6.5%, and 9.8%, 13.3%, 14.1%, 4.3%, respectively. There was a significant change only for the lifetime prevalence of rhinitis (p < 0.001). The rate of indoor smoking had declined from 73.9% to 64%, and pet ownership had risen from 7.9% to 22.9% (p < 0.001 for both). Atopic family history was the most prominent risk factor for all types of allergic disorders. Male gender was a significant risk factor for current asthma and wheezing [odds ratio (OR) = 1.80 and 1.59; 95% confidence intervals (CI) = 1.09–2.98 and 1.01–2.48, respectively], and passive smoking affected the occurrence of allergic rhinitis (OR = 1.84; CI = 1.13–3.00). The prevalence rates of allergic diseases among primary school children in Ankara stabilized during a 5‐year period for all diseases other than allergic rhinitis. However, there are changing behavior patterns, i.e. indoor smoking and keeping pet animals, which that may have affected these rates.     

Ten-year prognosis for generalized infantile eczema

Forty children treated in our hospital for generalized infantile eczema were re-examined at 11-13 years of age. In 7 (18%) children the eczema had disappeared and in 26 (65%) it had become less severe. Unrelated to dermatological status or gender, allergic rhinitis was diagnosed in 31 (78%) and asthma in 21 (53%) children. Only 8 children continued without either of these two conditions. All 32 children with allergic rhinitis and/or asthma showed at least one positive skin test reaction in a test panel of 11 common inhalant and food allergens compared with only 4 of 8 children without either allergic rhinitis or asthma (p < 0.001). Our results showed an improvement of dermatological status in most children with generalized infantile eczema but there was a high risk of a concomitant respiratory allergy and development of allergic rhinitis or asthma.     

合肥市儿童哮喘的危险因素分析

目的：调查合肥市儿童哮喘的危险因素,提出该地区下一步哮喘的防治策略。方法：抽取400名确诊为哮喘的患儿,同时选取400名年龄、性别、生活环境、家庭背景等与之相匹配的非呼吸系统疾病患儿作为对照进行病例对照研究,填写问卷调查表,采用logistic单因素及多因素分析哮喘危险因素。结果：Logistic单因素及多因素分析均显示过敏性家族史、过敏性鼻炎、婴儿湿疹、非母乳喂养、空调通风、被动吸烟是儿童哮喘发病的危险因素,其OR值依次为9.63、7.56、4.58、2.16、1.71、1.55。结论：为了减少哮喘的发生,应该倡导母乳喂养,坚持户外活动,保持室内通风,杜绝被动吸烟,积极治疗过敏性鼻炎。     

Prevalence of self-perceived allergic diseases and risk factors in Italian adolescents

The aim of the study was to assess the symptoms prevalence of allergic diseases in a population of 11–15 yr old schoolchildren, to evaluate the associations between asthma and other symptoms and identify risk factors for asthma, rhinitis and eczema syndromes. A sample of 481 students was studied using an International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Prevalence of different kind of self-reported symptoms was calculated. Using a logistic regression approach, we tried to identify risk factors for three syndromes – rhinitis, eczema and asthma. The highest and the lowest prevalence rates of self-reported symptoms were recorded for rhinitis (43.6%) and for eczema (8.1%), respectively. The prevalence of asthma was 15.7%. Univariate analysis showed a mutual association between wheeze and rhinitis symptoms. Multivariate logistic regression model for eczema syndrome revealed female gender as a significant risk factor. The polytomic logistic multivariate regression revealed female gender and family history of allergy as significant risk factors for rhinitis syndrome only, and maternal smoking and familial allergy for rhinitis and asthma together. In particular, familial allergy yields a 400% higher chance of developing asthma and rhinitis together. The synergistic effect of familial allergy on rhinitis and asthma syndromes suggests the implementation of preventive measures in children with family history of these diseases.     

吸人糖皮质激素与口服孟鲁司特治疗咳嗽变异型哮喘的疗效比较及随访研究

目的 比较吸入糖皮质激素(ICS)和口服白三烯调节剂(LTM)对儿童咳嗽变异型哮喘(CVA)的疗效,探讨儿童CVA的最佳治疗方案,并探讨CVA发展为典型哮喘的相关危险因素.方法 将84例年龄(3.9±1.2)岁(2～6岁)的CVA患儿随机分为ICS组(42例)和LTM组(42例).ICS组患儿通过定量气雾剂+储雾罐规律吸人二丙酸倍氯米松200 μg/d维持治疗,LTM组患儿每晚口服孟鲁司特5 mg维持治疗,治疗时间6个月,停用试验药物治疗后继续随访18个月.结果 ICS组平均止咳天数为(14±9)d,LTM组平均止咳天数为(13±9)d,两组问比较差异无统计学意义(Z=1.12,P=0.25).在24个月的研究观察期间,ICS组出现喘息的比率(7.1%)明显低于LTM组(33.3%)(x2=8.92,P=0.003).喘息组患儿湿疹和变应性鼻炎的患病率分别为47.1%和58.8%,明显高于无喘息组(分别为19.4%和31.3%)(x2分别为4.16和4.40,P均＜0.05).多因素逐步回归分析结果显示,湿疹和变应性鼻炎是CVA发展为典型哮喘的危险因素,OR值分别为7.668和3.855(P分别为0.002和0.049),而规律吸入ICS是有效的保护因素,其OR值为0.128(P=0.008).结论 CVA患者可转化为典型哮喘,接受ICS治疗的患儿出现喘息的比率低于接受LTM治疗的患儿,湿疹和过敏性鼻炎是CVA发展为典型哮喘的危险因素.     

Allergic conjunctivitis in children with asthma, rhinitis and eczema in a secondary outpatient clinic

Little evidence is available on the prevalence of allergic conjunctivitis in pediatric populations. The objective of this study was to assess the cumulative prevalence of allergic conjunctivitis in children with rhinitis, asthma and eczema in a secondary pediatric outpatient clinic. Children aged 5-15 yr referred during the period of 2002-2004 in whom allergic conjunctivitis, asthma, allergic rhinitis or eczema was diagnosed were included in a retrospective survey. At referral patient characteristics, history, symptoms, signs and results of type 1 allergy tests were entered into an electronic form. Four hundred and fifty-eight children with a mean age of 9.4 yr were studied. Of 316, 324 and 149 children with rhinitis, asthma or eczema, respectively, 133 (42%), 78 (24%) and 45 (30%) had concomitant allergic conjunctivitis. One hundred and thirty-seven (30%) had allergic conjunctivitis, of whom 133 (97%) also had allergic rhinitis, 77 (56%) asthma and 45 (33%) eczema. One hundred and twenty-five (91%) of the children with allergic conjunctivitis had positive allergy tests to one or more allergens, sensitization to house dust mites being more frequent in chronic allergic conjunctivitis than in acute allergic conjunctivitis (95% vs. 53%; p < 0.01). Sensitization to grass was more frequent in children with acute allergic conjunctivitis (78% vs. 57%; p = 0.03). In a secondary pediatric outpatient clinic allergic conjunctivitis is a frequent co-morbidity to allergic rhinitis and to asthma and eczema. Allergic conjunctivitis need to be included as an important co-morbidity in future guidelines on asthma, rhinitis and eczema management.     

Prevalence and severity of asthma,rhinitis, and eczema in Singapore schoolchildren.

This study was part of an international effort to evaluate the epidemiology of asthma and allergic diseases around the world. The aim was to assess the prevalence and severity of these disorders in Singapore schoolchildren. The international study of asthma and allergies in childhood (ISAAC) written questionnaire was administered to 6238 schoolchildren. The respondents were parents of a 6-7 year cohort (n = 2030), and schoolchildren aged 12-15 years (n = 4208). The overall cumulative and 12 month prevalence of wheezing were 22% and 12%, respectively. The prevalence of doctor diagnosed asthma was 20%. Rhinitis was reported by 44% and chronic rashes by 12%. Multiple logistic regression analysis showed that a higher prevalence of wheezing and rhinitis was associated with males, and subjects of higher socioeconomic status (based on type of housing and total family income). More severe asthma related symptoms were present in Malays and Indians than in the Chinese. Allergic disorders are common in Singapore and prevalence is comparable to some populations in the West. Demographic and socioeconomic factors appear to influence the prevalence and severity of these disorders.     

Prevalence and severity of asthma, rhinitis, and eczema in Singapore schoolchildren

This study was part of an international effort to evaluate the epidemiology of asthma and allergic diseases around the world. The aim was to assess the prevalence and severity of these disorders in Singapore schoolchildren. The international study of asthma and allergies in childhood (ISAAC) written questionnaire was administered to 6238 schoolchildren. The respondents were parents of a 6-7 year cohort (n = 2030), and schoolchildren aged 12-15 years (n = 4208). The overall cumulative and 12 month prevalence of wheezing were 22% and 12%, respectively. The prevalence of doctor diagnosed asthma was 20%. Rhinitis was reported by 44% and chronic rashes by 12%. Multiple logistic regression analysis showed that a higher prevalence of wheezing and rhinitis was associated with males, and subjects of higher socioeconomic status (based on type of housing and total family income). More severe asthma related symptoms were present in Malays and Indians than in the Chinese. Allergic disorders are common in Singapore and prevalence is comparable to some populations in the West. Demographic and socioeconomic factors appear to influence the prevalence and severity of these disorders.     

Childhood allergic disorders in Samsun, Turkey: discrepancy between reported and diagnosed

Schoolchildren (n = 1310) randomly selected from 32 schools in Samsun, Northern Turkey, were screened using the International Study of Asthma and Allergies in Childhood questionnaire. The prevalence of wheezing and current (last 12 months) wheezing were 21% and 14%, respectively: 2.3% of this group had received the diagnosis of asthma by a physician. Allergic skin rash was described in 17.3% and rhinitis in 44.7%, while 2.6% had been diagnosed with eczema and 10.5%, with allergic rhinitis. Respiratory symptoms were more common among 6-7-yr-old children compared with those aged 13-14 yr, and tended to be more prevalent in urban and coastal regions. The discrepancy between the rate of allergic symptoms and diagnosed allergic disorders may indicate a need for increased public and professional awareness and screening for allergic disorders in this area.     

The relationship among markers of allergy, asthma, allergic rhinitis, and eczemain Costa Rica

The association between allergy markers and asthma and allergic rhinitis is stronger in countries with a Western lifestyle than in rural areas of Africa and Asia. We examined the relationship among allergy markers, asthma, rhinitis, and eczema in a case-control study of 198 schoolchildren, 10–13 years of age, living in Costa Rica, a Latin American country. The geometric mean total serum immunoglobulin E (IgE) level in subjects with and without asthma was 465.0 and 143.0 IU/ml, respectively (difference = 322 IU/ml, 95% CI = 141.8–616.1 IU/ml, p < 0.001), and that in subjects with and without allergic rhinitis was 442.5 and 144.3 IU/ml, respectively (difference = 298.2 IU/ml, 95% CI = 125.7–581.0 IU/ml, p < 0.001). After adjusting for age, gender, and skin test reactivity to allergens, we found a linear relationship between serum total IgE level and the log odds ratio (OR) of having asthma. In a multivariate analysis, there was a linear relationship between skin test reactivity to allergens and the log OR of having allergic rhinitis. The OR of having allergic rhinitis was almost three times higher in children who had four positive skin tests than in non-reactors. Skin test reactivity to greater than five aeroallergens was an independent predictor of eczema in a multivariate analysis (OR = 3.1, 95% CI = 1.1–8.4). Although the geometric mean total serum IgE levels of Costa Rican children with either asthma or allergic rhinitis are higher than those of children with asthma or allergic rhinitis in most industrialized countries, the relationship among markers of allergy, asthma, rhinitis, and eczema in Costa Rica is similar to that found in countries with a Western lifestyle and different from that found in rural areas of Asia and Africa.     

Prevalence and risk factors of allergies in Turkey: Results of a multicentric cross-sectional study in children

The Prevalence And Risk Factors of Allergies in Turkey (PARFAIT) study was planned to evaluate prevalence and risk factors of asthma and allergic diseases and also to find out which geographical variables and/or climatic conditions play a role determining the prevalence of allergic diseases in Turkish school children. Study was planned as cross-sectional questionnaire-based. About 25,843 questionnaires from 14 centers were appropriate for analysis. Parental history of allergy, having an atopic sibling and other atopic disease in index case was significant risk factors for all allergic diseases. Breast feeding decreased the risk of current asthma (OR: 0.92, CI: 0.86-0.99) and wheezing (OR: 0.93, CI: 0.87-0.99) but not allergic rhinitis and eczema. Respiratory infection in the past was an important risk factor for the occurrence of allergic diseases especially for asthma which was increased 4.53-fold. Children exposed to household smoke were significantly at higher risk of asthma, wheezing, and allergic rhinitis (OR: 1.20, CI: 1.08-1.33; OR: 1.21, CI: 1.09-1.34; and OR: 1.32, CI: 1.21-1.43, respectively). All allergic diseases were increased in those children living in areas which have altitude of below 1000 m and mean yearly atmospheric pressure above 1000 mb. The study has suggested that household and country-specific environmental factors are associated with asthma, wheezing, allergic rhinitis, and eczema risk during childhood in Turkey.