Prevalence and severity of asthma, allergic rhinoconjunctivitis and atopic eczema in "Grand Tunis" schoolchildren: ISAAC

The aim of this study was to assess the prevalence and severity of asthma, allergic rhinoconjunctivitis and atopic eczema in 13-14 year old children living in "Grand Tunis". Using the international study of asthma and allergies in childhood (ISAAC) questionnaire, 3350 schoolchildren aged 13-14 years, from the Grand Tunis (Ariana, Ben Arous, Manouba, Tunis) were studied. Our results showed that in the past year 13.2% of children had wheezed, 1.4% had more than 12 attacks and 4.3% had experienced a speech limiting attack. 29.7% had symptoms of allergic rhinoconjunctivitis and 8.3% atopic eczema. The classic preponderance of asthma in boys has not been retrieved in our study. The highest level of wheeze was found in an agricultural area. According the published data, asthma prevalence in Tunisian schoolchildren is intermediate and allergic diseases are perhaps a common childhood diseases in Tunisia.     

Prevalence of asthma and asthma symptoms among 13 and 14-year-old schoolchildren, Brazil

OBJECTIVE: Before the use of the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire in epidemiologic surveys, little could be told about the comparative occurrence of asthma in the world due to differences in employed methods. In Brazil, the ISAAC questionnaire has been used in some urban regions. In this study it was applied in both, urban and rural areas, in order to estimate the prevalence of asthma among schoolchildren living in Montes Claros, Brazil. METHODS: A cross-sectional study was carried out using the ISAAC written questionnaire with four questions added on exposures of interest. The questionnaire was self-applied in 3,770 randomly selected schoolchildren aged 13 and 14 years. RESULTS: The prevalence of "wheezing in the last year" was 15.8%, and "asthma or bronchitis ever" was 23.8% with no statistically significant difference between boys and girls. There were significant differences between girls and boys regarding "wheezing ever" (37.8% and 33.6%), "sleeping disturbed by wheezing" (13.7% and 9.5%), and "nocturnal dry coughing without respiratory infection" (36.6% and 28.7%), respectively. "Wheezing in the last year" was found to be positively associated with "pet contact" (OR=1.27; 95% CI: 1.03-1.56), and "family history of asthma" (OR=1.79; 95% CI: 1.50-2.14), and negatively associated with "rural school" (OR=0.63; 95% CI: 0.44-0.91). But no association was found with sex, age, private/public school, and passive smoking. CONCLUSIONS: The prevalence of asthma in Montes Claros was high and some symptoms were seen mainly among girls. The occurrence of "wheezing in the last year" showed to be associated with family history, contact with pets and urban schools.     

Prevalence of childhood asthma in Baranya County, Hungary, between 2003 and 2006

INTRODUCTION: The prevalence of bronchial asthma, allergic rhinitis and atopic dermatitis (AD) in children has constantly and significantly increased worldwide in the past decades. Recent publications, however, reported a moderate decrease or levelling off in this parameter. The authors estimated the prevalence of bronchial asthma and asthmatic complaints among schoolchildren in Baranya county in the years 2003 and 2006 in order to register the possible changes. MATERIALS AND METHODS: Both surveys were carried out by means of identical questionnaires which were consistent with the ISAAC Phase III. protocol. The data were collected in 16 primary schools (6 in a city, 10 in small settlements and villages) in February 2006. Finally 2404 questionnaires (1124 boys, 1280 girls) in two age groups, among 6-7 and 13-14-year-old children were processed and compared to the data derived from the survey done in 2003. RESULTS: The prevalence of the "wheezing-ever" and "physician diagnosed asthma" did not change during the observation period (2006: 20.2% and 6.7%; 2003: 19.8% and 8.2%) but there was a significant increase in the frequency of "wheezing in the last 12 months" (2006: 9.6%; 2003: 6.8%). As expected, significantly higher prevalence rates were detected among boys and in the 6-7-year-old age group than among girls and in the 13-14-year-old age group in both surveys. There was no significant difference in the two surveys in the prevalence of bronchial asthma and asthmatic signs between children from a city and from small settlements. CONCLUSION: During the observation period of three years there was a significant increase "wheezing in the last 12 months", but the prevalence of "wheezing-ever" as well as the "physician-diagnosed asthma" remained unchanged.     

The ecological relationship of tobacco smoking to the prevalence of symptoms of asthma and other atopic diseases in children: the International Study of Asthma and Allergies in Childhood (ISAAC)

This study examined the relationship between parental smoking and asthma and other atopic diseases at the ecological level. The prevalence of atopic symptoms in 6–7- and 13–14-year old children was assessed in 91 centres (from 38 countries) and 155 centres (from 56 countries) respectively in the International Study of Asthma and Allergy in Childhood (ISAAC). These symptoms were related to prevalence of tobacco smoking for each country by gender as reported by the World Health Organisation. There was a significant negative association between the prevalence of smoking by men and the prevalence of symptoms of asthma and rhinitis, but not eczema in the 13–14-year age group. There was a significant positive relationship between prevalence of smoking by women and prevalence of wheeze in the last 12 months, but not for any other symptoms in the 13–14-year age group. In the 6–7-year age group, there was a significant negative correlation between prevalence of smoking by men and the prevalence of wheeze causing sleep disturbance and a close to significant negative association at the 5% level with the prevalence of wheeze in the last 12 months and rhinitis. Thus, for the countries that are included in this analysis, countries that have high adult male smoking rates have a lower risk of asthma and rhinitis symptoms in children. It should be stressed that this analysis does not involve information on individual exposures and therefore does not contradict the well-established association of active and passive smoking in individuals with the occurrence of asthma symptoms in the same individuals. Rather, it indicates that this well-established individual-level association does not account for the international differences in asthma prevalence, and that other risk factors for asthma must be responsible for the observed international patterns.     

Asthma in 13-14-year-old schoolchildren in the city of Nova Iguaçu, Rio de Janeiro State, Brazil: prevalence, severity, and gender differences

This study aimed to assess the prevalence and severity of asthma and related symptoms and the associations with gender in 13-14-year-old schoolchildren in the city of Nova Igua?u, Rio de Janeiro State, Brazil. The cross-sectional study used the self-applied International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The sample included 3,033 students randomly selected from 37 public and private schools. Prevalence of "any history of wheezing" was 26%, as compared to 11.7% within the last 12 months ("current asthma"), and was higher among girls (PR = 1.46; 95%CI: 1.31-1.62 and PR = 1.72; 95%CI: 1.35-2.21). Symptoms associated with severity, like "sleep disorders" and "speech limited by wheezing" were associated with female gender (PR = 2.57; 95%CI: 1.77-3.73 and PR = 2.07; 95%CI: 1.25-3.43). Although asthma prevalence was lower than in other Brazilian cities, it was still high among schoolchildren in Nova Igua?u, and was more frequent and severe among girls. Further research is needed to explain the observed differences.     

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.     

The prevalence and management of asthma in primary-aged schoolchildren in the south of England

A postal questionnaire survey of headteachers in 149 Infant, Junior and Primary schools (response rate: 63.8%) indicated poor asthma record keeping and a need for regular staff training in asthma. Dealing with an emergency was a major concern of headteachers. In 25 of the schools surveyed, an International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was distributed to parents of children in Years 3 and 4 (7-9 years). Headteacher-reported asthma prevalence was 11.9% in these schools, while ISAAC parental reports indicated a current or previous diagnosis of asthma in 24.3% children, with 17.8% receiving asthma treatment and 18.9% reporting wheeze in the previous 12 months. Of six wheezing children per Year 3/4 class, one was receiving no treatment for asthma, three had experienced four or more attacks of wheeze in the previous year with one wheezing child per two Year 3/4 classes experiencing more than 12 such attacks. Four in six children experienced exercise-related wheeze, while only one in five schools allowed asthma medication at Physical Education lessons. A whole school policy on asthma together with some regularly updated staff education and training by an asthma-trained nurse would address many of the issues raised in this study.     

Effect of outdoor and indoor nitrogen dioxide on respiratory symptoms in schoolchildren

BACKGROUND: Nitrogen dioxide (NO(2)), an oxidant gas that contaminates both outdoor and indoor air, is considered to be a potential risk factor for asthma. We investigated concurrently the effects of outdoor and indoor NO(2) on the prevalence and incidence of respiratory symptoms among children. METHODS: A cohort study was carried out over 3 years on 842 schoolchildren living in seven different communities in Japan. Indoor NO(2) concentrations over 24 hours were measured in both winter and summer in the homes of the subjects, and a 3-year average of the outdoor NO(2) concentration was determined for each community. Respiratory symptoms were evaluated every year from responses to questionnaires. RESULTS: The prevalence of bronchitis, wheeze, and asthma significantly increased with increases of indoor NO(2) concentrations among girls, but not among boys. In neither boys nor girls were there significant differences in the prevalence of respiratory symptoms among urban, suburban, and rural districts. The incidence of asthma increased among children living in areas with high concentrations of outdoor NO(2). Multiple logistic regression analysis showed that a 10 parts per billion (ppb) increase of outdoor NO(2) concentration was associated with an increased incidence of wheeze and asthma (odds ratios [OR] = 1.76, 95% CI : 1.04-3.23 and OR = 2.10, 95% CI : 1.10-4.75, respectively), but that no such associations were found with indoor NO(2) concentration (OR = 0.73, 95% CI : 0.45-1.14 and OR = 0.87, 95% CI : 0.51-1.43, respectively). CONCLUSIONS: These findings suggest that outdoor NO(2) air pollution may be particularly important for the development of wheeze and asthma among children. Indoor NO(2) concentrations were associated with the prevalence of respiratory symptoms only among girls. Girls may be more susceptible to indoor air pollution than boys.     

Smoking habits, exposure to environmental tobacco smoke, and respiratory symptoms in schoolchildren aged 14-15 years in Terrassa (Barcelona)

OBJECTIVES: Assessment of the prevalence of smoking habits, environmental tobacco exposure, and asthma-related symptoms in a cross-sectional study in schoolchildren aged 14-15 years in Terrassa (Barcelona). METHODS: A sample of 793 students from 21 schools answered a self-administered questionnaire including information on smoking habits, environmental tobacco exposure and asthma-related symptoms. RESULTS: The prevalence of smoking daily was 16.3% (CI 13. 7-18.9); no difference between sexes were observed, while the proportion of occasional smokers was higher among girls. Age, maternal habit, friend's smoking habit and having older siblings were independently associated to the schoolchildren's smoking habits. Overall, 13% reported a positive history of wheezing and 20.3% of nocturnal cough during the previous year. Smoking daily and passive smoking were positively associated with the prevalence of asthma-related symptoms, but not with previous diagnosis of asthma. CONCLUSIONS: The prevalence of smoking among adolescents seems to have levelled off. There is some trend toward a higher prevalence among girls than among boys. The presence of smoking in the social environment is a strong predictor of the smoking habits among schoolchildren. Both active smoking and environmental exposure to tobacco smoke are associated to increased asthma-related symptoms.     

Evaluation of folate status by serum and erythrocyte folate levels and dietary folate intake in Taiwanese schoolchildren

The folate status and dietary folate intake of Taiwanese schoolchildren was investigated by analysis of both serum and red blood cell (RBC) folate levels and dietary folate intake in 1105 boys and 958 girls aged 6-13 years sampled from the Nutrition and Health Survey in Taiwan Elementary School Children 2001-2002 (NAHSIT Children 2001-2002). Mean serum folate levels were 18.3+/-8.8 nmol/L (8.1+/-3.9 ng/mL) in boys and 20.3+/-9.7 nmol/L (9.0+/-4.3 ng/mL) in girls. Mean RBC folate levels were 700+/-320 nmol/L (308+/-141 ng/mL) in boys and 751+/-347 nmol/L (331+/-153 ng/mL) in girls. The prevalence of serum folate deficiency was 1.4% in boys and girls, and the prevalence of marginal serum folate deficiency (7-14 nmol/L) was 31.1% in boys and 25.8% in girls. In addition, 8.5% of boys and 7.4% girls had RBC folate deficiency (RBC folate < 318 nmol/L), and 17% of children had marginal RBC folate deficiency (RBC folate of 318-454 nmol/L). Our results suggesting that Taiwanese schoolchildren have poor folate status especially during periods of rapid growth and development such as the transition from childhood to early adolescence (boys at age 12-12.9, girls at age 11-12.9). The average estimated folate intakes were 269+/-9 microg/d in boys and 259+/-9 microg/d in girls, and 42% of Taiwanese schoolchildren had a dietary folate intake below 2/3 of the RDA, indicating a poor dietary folate intake in this population. This study shows that the folate status of Taiwanese schoolchildren is currently inadequate and strategies are needed for improvement.     

Exposure to Cats and Dogs, and Symptoms of Asthma, Rhinoconjunctivitis, and Eczema

BACKGROUND:: Associations between exposure to cats and dogs and respiratory and allergic outcomes in children have been reported in affluent countries, but little is known about such associations in less-affluent countries. METHODS:: The International Study of Asthma and Allergies in Childhood, phase 3 was carried out in children aged 6-7 years and adolescents aged 13-14 years across the world. Questions about cats and dogs in the home were included in an additional questionnaire. Using logistic regression, we investigated the association between such exposures and symptoms of asthma, rhinoconjunctivitis, and eczema. Adjustments were made for sex, region of the world, language, gross national income per capita, and 10 other covariates. RESULTS:: Among children (6-7 years of age), cat exposure in the first year of life was associated with current symptoms of asthma, wheeze, rhinoconjunctivitis, and eczema, especially in less-affluent countries. Among adolescents (13-14 years of age), we found a positive association between exposure to cats or dogs and symptom prevalence in more-affluent and less-affluent countries. The global multivariate odds ratios for children with complete covariate data were 1.17 (95% confidence interval = 1.08-1.29) for current symptoms of asthma, 1.13 (1.05-1.23) for rhinoconjunctivitis, and 1.38 (1.26-1.52) for eczema. Smaller odds ratios were found for exposure to only dogs. Exposure to only cats was associated with eczema. CONCLUSION:: Early-life exposure to cats is a risk factor for symptoms of asthma, rhinoconjunctivitis, and eczema in 6- to 7-year-old children, especially in less-affluent countries. Current exposure to cats and dogs combined, and only to dogs, is a risk factor for symptom reporting by 13- to 14-year-old adolescents worldwide.     

The relationship of per capita gross national product to the prevalence of symptoms of asthma and other atopic diseases in children (ISAAC)

BACKGROUND: Increasing prevalence and worldwide variation in asthma and other atopic diseases suggest the influence of environmental factors, at least one possibly related to socioeconomic wellbeing. This paper examines the relationship of symptoms of asthma, rhinitis and eczema with gross national product per capita (GNP per capita). METHODS: The prevalences of atopic symptoms in 6-7- and 13-14-year-old children were assessed in 91 centres (from 38 countries) and 155 centres (from 56 countries), respectively, in the International Study of Asthma and Allergy in Childhood (ISAAC). These symptoms were related to 1993 GNP per capita for each country as reported by the World Bank. The relationships between symptoms of atopic diseases and infant mortality, the human development index and 1982 GNP per capita were also considered. RESULTS: The countries in the lowest quartile of GNP per capita have the lowest median positive responses to all the questions on symptoms of asthma, rhinitis and eczema. There was a statistically significant positive association between wheeze in the last 12 months and GNP per capita in the 13-14-year age group, but not in the 6-7-year age group. There was also a positive association between GNP per capita and eczema in both age groups. CONCLUSIONS: The positive associations between GNP per capita and atopic symptoms being of only moderate strength suggests that the environmental factors are not just related to the wealth of the country.     

Self-reported asthma symptoms in children and adults of Bangladesh: findings of the National Asthma Prevalence Study

BACKGROUND: No population-based studies to determine the magnitude of the asthma problem have been carried out in Bangladesh. This study aimed to define the prevalence of asthma as well as to identify the risk factors of asthma in the general population of Bangladesh. METHODS: A cross-sectional study was conducted from January 1999 to August 1999 on 5642 Bangladeshi people. Data were collected from randomly selected primary sampling units of 8 municipality blocks of 4 large metropolitan cities, 12 municipality blocks of 6 district towns and 12 villages of 6 districts chosen randomly from all 64 districts of the country. Face-to-face interviews were performed with the housewives or other guardians at the household level using a structured questionnaire. RESULTS: The prevalence of asthma (wheeze in the last 12 months) was 6.9% (95% CI : 6.2-7.6). The prevalence of other asthma definitions were: ever wheeze (lifetime wheeze) 8.0% (95% CI : 7.3-8.7); perceived asthma (perception of having asthma) 7.6% (95% CI : 6.9-8.3); doctor diagnosed asthma (diagnosis of asthma by any category of doctor either qualified or unqualified) 4.4% (95% CI : 3.9-4.9). The prevalence of asthma in children (5-14 years) was higher than in adults (15-44 years) (7.3% versus 5.3%; odds ratio [OR] = 1.41, 95% CI : 1.09-1.82). Asthma in children was found to be significantly higher in households with 相似文献   

Antibiotic sales and the prevalence of symptoms of asthma, rhinitis, and eczema: The International Study of Asthma and Allergies in Childhood (ISAAC)

BACKGROUND: It has been hypothesized that antibiotic use early in life may increase the subsequent risk of asthma. We have conducted an ecologic analysis of the relationship between antibiotics sales and the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema in 99 centres from 28 countries. METHODS: Data for antibiotics sales for 28 countries were obtained from the Institute for Medical Statistics (IMS), Health Global Services, UK and converted to defined daily doses (DDD). Data on the prevalence of symptoms of asthma, rhinitis, and eczema in 13-14 year olds were based on the responses to the written and video questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC). The analysis was adjusted for gross national product (GNP) as an estimate of the level of affluence. RESULTS: In general, there was a positive association between per capita antibiotics sales and the prevalence of symptoms for asthma, rhinitis, and eczema, but the associations generally became negative once the analyses had been adjusted for GNP. In particular, there were non-significant negative associations between total antibiotics sales and the prevalence of wheeze ever, wheeze in the last 12 months, nose problems with itchy-watery eyes, itchy rash in the last 12 months, and eczema ever. On the other hand there were weak non-significant positive associations for asthma ever, nose problems ever, nose problems in the last 12 months, and itchy rash ever. There was a statistically significant positive association with wheeze at rest as measured by the asthma video questionnaire; however, even this association was weak and would not account for more than a 1% difference in asthma prevalence between countries. CONCLUSIONS: These findings are generally not consistent with the hypothesis that antibiotic use increases the risk of asthma, rhinitis, or eczema. If there is a causal association of antibiotic use with asthma risk, it does not appear to explain the international differences in asthma prevalence.     

Asthma and associated factors in students 13 and 14 years of age in São Luís, Maranhão State, Brazil

The aim of this study was to estimate the prevalence of asthma and associated factors among students 13 and 14 years of age in S?o Luís, Maranh?o State, Brazil. A cross-sectional study was conducted using the questionnaire developed by ISAAC (International Study of Asthma and Allergies in Childhood) and an additional questionnaire from July 2008 to May 2009, including 3,069 adolescents. Asthma prevalence (wheezing in the previous 12 months) was 12.7%, lifetime prevalence was 32.4%, 3.9% reported difficulty speaking due to wheezing, and 9.8% reported wheezing after exercise. In the multivariate analysis, factors associated with increased asthma prevalence were family history of asthma, respiratory infection and wheezing in early life, eczema, allergic rhinitis, and passive smoking. Asthma prevalence was lower than for Brazil as a whole. Factors most strongly associated with asthma prevalence in these adolescents were family history of asthma (PR = 3.86), wheezing in early childhood (PR = 4.58), and allergic rhinitis (PR = 3.21).     

Prevalence of asthma and wheeze in relation to passive smoking in Japanese children

PURPOSE: Evidence remains inconclusive as to whether environmental tobacco smoke is a risk factor for allergic disorders in childhood. The present large-scale cross-sectional study examined the relationship between passive smoking at home and the prevalence of allergic disorders in Japanese schoolchildren. METHODS: Study subjects were 23,044 children aged 6 to 15 years in Okinawa. Outcomes were based on diagnostic criteria from the International Study of Asthma and Allergies in Childhood. Adjustment was made for sex, age, region of residence, number of siblings, paternal and maternal history of asthma, atopic eczema, or allergic rhinitis, as well as paternal and maternal educational level. RESULTS: The prevalence of wheeze, asthma, atopic eczema, and allergic rhinoconjunctivitis in the previous 12 months was 10.7%, 7.6%, 6.8%, and 7.7%, respectively. Current heavy passive smoking and 7.0 or more pack-years of smoking in the household were independently related to an increased prevalence of wheeze and asthma, especially in children 6 to 10 years of age and children with a positive parental allergic history. There was no dose-response relationship between pack-years of smoking in the household and atopic eczema or allergic rhinoconjunctivitis. CONCLUSIONS: Our findings suggested that environmental tobacco smoke might be associated with an increased prevalence of wheeze and asthma in Japanese children.     

Satellite-based Estimates of Ambient Air Pollution and Global Variations in Childhood Asthma Prevalence

Background: The effect of ambient air pollution on global variations and trends in asthma prevalence is unclear.Objectives: Our goal was to investigate community-level associations between asthma prevalence data from the International Study of Asthma and Allergies in Childhood (ISAAC) and satellite-based estimates of particulate matter with aerodynamic diameter < 2.5 μm (PM2.5) and nitrogen dioxide (NO2), and modelled estimates of ozone.Methods: We assigned satellite-based estimates of PM2.5 and NO2 at a spatial resolution of 0.1° × 0.1° and modeled estimates of ozone at a resolution of 1° × 1° to 183 ISAAC centers. We used center-level prevalence of severe asthma as the outcome and multilevel models to adjust for gross national income (GNI) and center- and country-level sex, climate, and population density. We examined associations (adjusting for GNI) between air pollution and asthma prevalence over time in centers with data from ISAAC Phase One (mid-1900s) and Phase Three (2001-2003).Results: For the 13- to 14-year age group (128 centers in 28 countries), the estimated average within-country change in center-level asthma prevalence per 100 children per 10% increase in center-level PM2.5 and NO2 was -0.043 [95% confidence interval (CI): -0.139, 0.053] and 0.017 (95% CI: -0.030, 0.064) respectively. For ozone the estimated change in prevalence per parts per billion by volume was -0.116 (95% CI: -0.234, 0.001). Equivalent results for the 6- to 7-year age group (83 centers in 20 countries), though slightly different, were not significantly positive. For the 13- to 14-year age group, change in center-level asthma prevalence over time per 100 children per 10% increase in PM2.5 from Phase One to Phase Three was -0.139 (95% CI: -0.347, 0.068). The corresponding association with ozone (per ppbV) was -0.171 (95% CI: -0.275, -0.067).Conclusion: In contrast to reports from within-community studies of individuals exposed to traffic pollution, we did not find evidence of a positive association between ambient air pollution and asthma prevalence as measured at the community level.     

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

Background 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. Methods 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). Results 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%. Conclusion 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.

Obesity in schoolchildren

In 1971 triceps skinfold thickness was measured in a sample of 6-14-year-old children attending school in Aylesbury, Buckinghamshire. The sample consisted of 1,243 boys and 1,183 girls. In both boys and girls triceps skinfolds tended to increase with age, this being most marked in the girls. If a 25 mm triceps skinfold is taken as indicating obesity, then 32·4% of the 14-year old girls and 3·6% of the 14-year-old boys would be classified as obese. Comparison with the findings of the 1959 study of London schoolchildren suggests that obesity in 14-year-old girls has become more prevalent.     

Prevalence of symptoms of severe asthma and allergies in Irish school children: an ISAAC protocol study, 1995-2007

Childhood asthma is a recurring health burden and symptoms of severe asthma in children are also emerging as a health and economic issue. This study examined changing patterns in symptoms of severe asthma and allergies (ever eczema and hay fever), using the Irish International Study of Asthma and Allergies in Childhood (ISAAC) protocol. ISAAC is a cross-sectional self-administered questionnaire survey of randomly selected representative post-primary schools. Children aged 13-14 years were studied: 2,670 (in 1995), 2,273 (in 1998), 2,892 (in 2002-2003), and 2,805 (in 2007). Generalized linear modelling using Poisson distribution was employed to compute adjusted prevalence ratios (PR). A 39% significant increase in symptoms of severe asthma was estimated in 2007 relative to the baseline year 1995 (adjusted PR: 1.39 [95% CI: 1.14-1.69]) increasing from 12% in 1995 to 15.3% in 2007. Opposite trends were observed for allergies, showing a decline in 2007, with an initial rise. The potential explanations for such a complex disease pattern whose aetiological hypothesis is still evolving are speculative. Changing environmental factors may be a factor, for instance, an improvement in both outdoor and indoor air quality further reinforcing the hygiene hypothesis but obesity as a disease modifier must also be considered.