Asthma and rhinoconjunctivitis comorbidity: United airway disease or inherited target organs?
Garcia-Marcos L, Ruiz TR, Garcia-Hernandez G, Suarez-Varela MM, Valverde-Molina J, Sanchez-Solis M. Asthma and rhinoconjunctivitis comorbidity: United airway disease or inherited target organs? Pediatr Allergy Immunol 2010: 21: e142–e148. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard The idea of a united airway disease for asthma and rhinoconjunctivitis is supported by clinical and epidemiological data. However, many asthmatics do not have rhinoconjunctivitis and vice versa. The aim of this study was to investigate if the family history of a specific organ involvement is associated with the implication of the same organ in the allergic child. According to the organ invo…
Seasons and Other Factors Affecting the Quality of Life of Asthmatic Children
Amparo.Escribano@uv.es Objective: To study the effect of seasons on the health-related quality of life (HRQL) of asthmatic children. Methods: Four groups of asthmatic children 7 to 14 years old were recruited by pediatricians during each season of the year. Their HRQL was assessed by means of the Paediatric Asthma Quality of Life Questionnaire (PAQLQ). Other factors surveyed were asthma severity, atopy, medical treatment, immunotherapy, obesity, parental smoking, and anti-allergic measures. Results: The mean (SD) overall PAQLQ score was highest in summer at 6.2 (1.0) and lowest in autumn at 5.5 (1.2). The same trend was found for domains in summer and autumn, respectively: symptoms, 6.2 (1.…
Tendencia temporal y variaciones geográficas de la prevalencia de síntomas de rinitis alérgica en escolares de 6-7 años de ocho áreas españolas, según el ISAAC
Antecedentes: Se presenta la fase III del estudio ISAAC (International Study of Asthma and other Allergies in Childhood) en escolares de 6-7 años de ocho áreas españolas para estimar la tendencia temporal y variaciones geográficas de los síntomas de rinitis alérgica. Material y método: Se comparan las prevalencias de síntomas de rinitis alérgica entre la fase I y fase III, efectuadas entre los años 1993-1994 y 2001-2002, mediante un cuestionario estandarizado y validado según metodología ISAAC, cumplimentado por los padres de los escolares. Participaron ocho centros de Asturias, Barcelona, Bilbao, Cartagena, Castellón, Madrid, Pamplona y Valencia. Se empleó la regresión de Poisson en el aná…
Air Pollution and Recent Symptoms of Asthma, Allergic Rhinitis, and Atopic Eczema in Schoolchildren Aged Between 6 and 7 Years
Abstract Objective The objective of the study was to analyze the relationship between air pollutants and the prevalence of recent symptoms of asthma, allergic rhinitis, and atopic eczema in schoolchildren aged between 6 and 7 years. Patients and Methods The prevalence of recent (previous 12 months) symptoms of allergic diseases was obtained by means of the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC), Spain, with the participation of 7 centers (Asturias, Barcelona, Bilbao, Cartagena, La Coruna, Madrid, and Valencia) and 20 455 schoolchildren aged between 6 and 7 years, from 2002 to 2003. The pollutant detection systems of the aforementioned centers p…
Early exposure to paracetamol or to antibiotics and eczema at school age: Modification by asthma and rhinoconjunctivitis
The association between early exposure to paracetamol or to antibiotics and eczema is conflicting. This study aims to know whether the early exposure to those drugs is associated with eczema at school age, and whether the strength of the association is modified by the presence of asthma or rhinoconjunctivitis. Children aged 6-7 (n = 13908) from the International Study of Asthma and Allergies in Childhood in Spain provided data about current asthma, rhinoconjunctivitis and eczema. Parent-reported information was also obtained on paracetamol and antibiotic consumption during the first year of life. Logistic regression analysis with eczema as outcome and including exposure to paracetamol or to…
Estudio de la presencia de animales domésticos: gatos y perros, y su papel en el asma, la rinitis alérgica y la dermatitis atópica en niños
Objetivo Describir la prevalencia de asma, rinitis alergica (RA) y dermatitis atopica (DA) en ninos de Valencia y el papel de la presencia de animales (gato y perro) en el domicilio del nino en la presencia de manifestaciones de asma, RA y DA. Diseno Estudio retrospectivo con 2 estudios transversales, uno el primer ano de vida del nino y el segundo en referencia al ano anterior a la realizacion de la encuesta. Emplazamiento Un total de 78 centros de ensenanza, 50 de caracter publico y el resto, privado, ubicados en Valencia. Participantes La poblacion de estudio fue de 4.387 ninos seleccionados mediante un muestreo por cluster representativo del total que cursaba sus estudios. Se establecie…
How the presence of rhinoconjunctivitis and the severity of asthma modify the relationship between obesity and asthma in children 67 years old
Summary Background The association between asthma and obesity in children, and the effect modification of allergy on this association have not been fully established. Aims The objective of the study was to know the effect modification of the severity of asthma and of the coexistence of rhinoconjunctivitis (RC) in the relationship between obesity and asthma. Methods A cross-sectional study of 17145 schoolchildren 6‐7 years old from eight Spanish cities who had completed information on height and weight of the ISAAC phase III questionnaire, which also included questions about asthma and RC symptoms and on various risk factors. Body mass index (BMI) was used to define obesity according to inte…
Variaciones geográficas en la prevalencia de síntomas de asma en los niños y adolescentes españoles. International Study of Asthma and Allergies in Childhood (ISAAC) fase III España
Objetivo: Analizar las variaciones geograficas en la prevalencia de sintomas relacionados con el asma en ninos y adolescentes espanoles. Poblacion y metodos: Durante los anos 2001 y 2002, el International Study of Asthma and Allergies in Childhood (ISAAC) fase III estudio a 28.445 ninos de 6-7 anos de 10 areas (A Coruna, Asturias, Barcelona, Bilbao, Cartagena, Castellon, Madrid, Pamplona, San Sebastian y Valencia) y 31.257 adolescentes de 13-14 anos de 11 areas (las anteriores mas Valladolid) espanolas. Los sintomas de asma se recogieron en un cuestionario escrito completado por los padres de los ninos o por los propios adolescentes. Las variaciones geograficas de las prevalencias de los si…
Childhood intermittent and persistent rhinitis prevalence and climate and vegetation: a global ecologic analysis
Abstract Background The effect of climate change and its effects on vegetation growth, and consequently on rhinitis, are uncertain. Objective To examine between- and within-country associations of climate measures and the normalized difference vegetation index with intermittent and persistent rhinitis symptoms in a global context. Methods Questionnaire data from 6- to 7-year-olds and 13- to 14-year-olds were collected in phase 3 of the International Study of Asthma and Allergies in Childhood. Associations of intermittent (>1 symptom report but not for 2 consecutive months) and persistent (symptoms for ≥2 consecutive months) rhinitis symptom prevalences with temperature, precipitation, vapor…
Atopic dermatitis and indoor use of energy sources in cooking and heating appliances
Abstract Background Atopic dermatitis (AD) prevalence has considerably increased worldwide in recent years. Studying indoor environments is particularly relevant, especially in industrialised countries where many people spend 80% of their time at home, particularly children. This study is aimed to identify the potential association between AD and the energy source (biomass, gas and electricity) used for cooking and domestic heating in a Spanish schoolchildren population. Methods As part of the ISAAC (International Study of Asthma and Allergies in Childhood) phase III study, a cross-sectional population-based survey was conducted with 21,355 6-to-7-year-old children from 8 Spanish ISAAC cent…
Asthma attributable to atopy: does it depend on the allergen supply?
The use of the population attributable fraction (PAF) of asthma owing to atopy has not been widely used in epidemiological studies on childhood asthma, especially to compare regions of the same country. The present study includes 1039 children from Cartagena, Spain (Mediterranean coast) and 663 from Madrid (centre of Spanish plateau) using the ISAAC phase II methodology (questionnaire and prick test to the most common allergens). While there were no differences in asthma symptoms between school children (aged 10–11 yr) from Madrid and Cartagena, atopy to any allergen was significantly higher in those from Madrid (40.9% vs. 29.3%, respectively, p < 0.0001). However, children from Madrid were…
Stabilization of asthma prevalence among adolescents and increase among schoolchildren (ISAAC phases I and III) in Spain.
Background: Most studies show a steep increase in asthma prevalence in the last decades, although few studies had applied the same methodology. Recent reports point out the possibility that the epidemic has come to an end. We have studied the prevalence of asthma in a very large sample of children, repeating the study eight years apart. Methods: Repeated cross-sectional studies using the International Study of Asthma and Allergies in Childhood (ISAAC) protocol in a sample of Spanish schoolchildren 6–7 (parent-reported) and 13–14 (self-reported) years old in 1994–95 (phase I) and 2002–2003 (phase III). The number of participants was 42 417 in phase I and 42 813 in phase III. The participat…
A different pattern of risk factors for atopic and non-atopic wheezing in 9-12-year-old children
Few epidemiological studies have compared the risk factors of asthma or wheezing between atopic and non-atopic children. The objective of this study was to determine if there are specific risk factors for current wheezing related to atopic status in schoolchildren. Schoolchildren 9-12 yr of age from three Spanish cities (n = 2720) were subject to a cross-sectional study of asthma risk factors (by questionnaire) and atopy (by skin prick test) according to the ISAAC phase-II protocol. Risk factors for current wheezing (in the last 12 months) as reported by parents were investigated among the atopic (positive prick test to at least one allergen) and the non-atopic (negative prick test) childre…
Parents' smoking habit and prevalence of atopic eczema in 6-7 and 13-14 year-old schoolchildren in Spain. ISAAC phase III.
Abstract Background and Aims Atopic eczema (AE) is the most frequent inflammatory skin disease in childhood in the western world. Several studies have reported a significant increase of prevalence in recent decades and the environmental factors implicated in its aetiology, including environmental tobacco smoke. This study aims to investigate the possible association of AE prevalence in Spanish schoolchildren aged 6-7 and 13-14 years in relation to their parents’ smoking habits. Methods We conducted a cross-sectional population-based study with 6-7 year-old (n = 27805) and 13-14 year-old (n = 31235) schoolchildren from 10 Spanish centres. AE prevalence was assessed using the International St…
The Nutrition in Early Life and Asthma (NELA) birth cohort study: Rationale, design, and methods.
Background Primary prevention strategies for asthma are lacking. Its inception probably starts in utero and/or during the early postnatal period as the developmental origins of health and disease (DOHaD) paradigm suggests. Objectives The main objective of Nutrition in Early Life and Asthma (NELA) cohort study is to unravel whether the following factors contribute causally to the developmental origins of asthma: (1) maternal obesity/adiposity and foetal growth; (2) maternal and child nutrition; (3) outdoor air pollution; (4) endocrine disruptors; and (5) maternal psychological stress. Maternal and offspring biological samples are used to assess changes in offspring microbiome, immune system,…
Asthma phenotypes identified by latent class analysis in the ISAAC phase II Spain study.
SummaryBackground Classification of respiratory symptoms may help to identify different underlying asthma phenotypes reflecting differences in aetiology and prognosis of wheezing disease among children. Objective To determine childhood asthma phenotypes based on respiratory symptoms from a widely used questionnaire to further classify phenotypes in international settings. Methods Between 2000 and 2002 cross-sectional studies were performed in four centres in Spain. Parental questionnaires were used to collect information on allergic diseases in more than 4000 children aged 8–12 years. In addition, objective markers for allergic sensitization and bronchial hyperresponsiveness (BHR) were meas…
Overweight/obesity and respiratory and allergic disease in children : international study of asthma and allergies in childhood (ISAAC) phase two
Background: Childhood obesity and asthma are increasing worldwide. A possible link between the two conditions has been postulated. Methods: Cross-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. Results: Overweight (odds ratio=1.14, 95%-confidence i…
Maternal post-natal tobacco use and current parental tobacco use is associated with higher body mass index in children and adolescents: an international cross-sectional study
Background: We investigated whether maternal smoking in the first year of life or any current parental smoking is associated with childhood or adolescent body mass index (BMI). Methods: Secondary analysis of data from a multi-centre, multi-country, cross-sectional study (ISAAC Phase Three). Parents/guardians of children aged 6-7 years completed questionnaires about their children's current height and weight, whether their mother smoked in the first year of the child's life and current smoking habits of both parents. Adolescents aged 13-14 years completed questionnaires about their height, weight and current parental smoking habits. A general linear mixed model was used to determine the asso…
The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three: A global synthesis
This ISAAC Phase Three synthesis provides summarised information on the main findings of the study, regional tables and figures related to the prevalence and severity of current symptoms of asthma, rhinoconjunctivitis and eczema in the main regions of the world. The large number of surveyed children (≈1,200,000), the large number of centres (233) and countries (98) that participated in ISAAC Phase Three makes this study the most comprehensive survey of these diseases ever undertaken. Globally, the prevalence for current asthma, rhinoconjunctivitis and eczema in the 13-14-year age group was 14.1%, 14.6% and 7.3%, respectively. In the 6-7-year age group the prevalence for current asthma, rhin…
Evolución temporal de la prevalencia de síntomas de rinitis alérgica en escolares de 13-14 años de 8 áreas españolas entre 1993-1994 y 2001-2002 según el Estudio Internacional sobre Asma y Alergias en la Infancia (ISAAC)
Fundamento y objetivo Estimar la evolucion temporal de la prevalencia de sintomas de rinitis alergica y sus variaciones geograficas. Pacientes y metodo Durante 2001-2002 se efectuo la tercera fase del estudio ISAAC, cuyos resultados se compararon con los de la primera fase (1993-1994). Este estudio transversal incluyo a 30.046 escolares de 13-14 anos en 9 centros (Asturias, Barcelona, Bilbao, Cartagena, Castellon, Madrid, Pamplona, Valencia y Valladolid). Se empleo un cuestionario sobre sintomas de rinitis cumplimentado por los escolares en colegios e institutos con una participacion entre el 100 y el 75,8%. Se emplearon modelos de regresion de Poisson para estudiar la evolucion. Resultados…
[Geographic variation in the prevalence of asthma symptoms in Spanish children and adolescents. International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3, Spain].
Objective TO analyze geographic variations in the prevalence of symptoms related to asthma in Spanish children and adolescents. Population and methods In 2001 and 2002, the Spanish arm of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3 collected information on 28 445 children in the age bracket of 6-7 years in 10 metropolitan areas (A Coruna, Asturias, Barcelona, Bilbao, Cartagena, Castellon, Madrid, Pamplona, San Sebastian, and Valencia) and on 31 257 adolescents in the bracket 13-14 years in 11 areas (the previously named areas plus Valladolid). An asthma symptom questionnaire was filled in by parents or the adolescents themselves. Differences in symptoms betw…
How pediatricians in Spain manage the first acute wheezing episode in an atopic infant. Results from the TRAP study.
Abstract Background Although the treatment of asthma has been addressed in several guidelines, the management of the first acute wheezing episode in infants has not often been evaluated. We surveyed practicing pediatricians in Spain about the treatment they would provide in a simulated case. Material and methods A random sample of 3000 pediatricians and physicians who normally treated children was surveyed. The questionnaire inquired about how they would treat a first mild-to-moderate wheezing attack in a 5-month-old boy with a personal and family history of allergy. Pediatricians were asked about their professional background. Results A total of 2347 questionnaires were returned with usefu…
A multi-centre study of candidate genes for wheeze and allergy: the International Study of Asthma and Allergies in Childhood Phase 2
BACKGROUND: Common polymorphisms have been identified in genes suspected to play a role in asthma. We investigated their associations with wheeze and allergy in a case-control sample from Phase 2 of the International Study of Asthma and Allergies in Childhood. METHODS: We compared 1105 wheezing and 3137 non-wheezing children aged 8-12 years from 17 study centres in 13 countries. Genotyping of 55 candidate single nucleotide polymorphisms (SNPs) in 14 genes was performed using the Sequenom System. Logistic regression models were fitted separately for each centre and each SNP. A combined per allele odds ratio and measures of heterogeneity between centres were derived by random effects meta-ana…
Contaminación del aire y síntomas recientes de asma, rinitis alérgica y eccema atópico en escolares de 6 y 7 años
Resumen Introduccion El objetivo del estudio ha sido analizar la relacion entre contaminantes del aire y la prevalencia de sintomas recientes de asma, rinitis alergica y eccema atopico, en escolares de 6 y 7 anos. Pacientes y metodos La prevalencia de sintomas de enfermedades alergicas recientes (ultimos 12 meses) se obtuvo mediante el cuestionario del estudio ISAAC (International Study of Asthma and Allergies in Childhood) Espana, con la participacion de 7 centros (Asturias, Barcelona, Bilbao, Cartagena, La Coruna, Madrid y Valencia) y 20.455 escolares de 6 y 7 anos, durante 2002–2003. De los sistemas de deteccion de contaminantes de los centros citados se obtuvieron datos de las concentra…