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Alyami MM, Alasimi AH, Alqarni AA, Balharith FH, Aldhahir AM. Prevalence of asthma triggers and control status among pediatric asthmatic patients in Saudi Arabia. J Asthma 2024; 61:1205-1211. [PMID: 38506494 DOI: 10.1080/02770903.2024.2332917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/22/2024] [Accepted: 03/15/2024] [Indexed: 03/21/2024]
Abstract
AIM This study aims to assess the prevalence of asthma triggers and control status among pediatric asthmatic patients in Saudi Arabia. METHODS From October 2015 to March 2016, an Arabic version of the Asthma Trigger Inventory questionnaire and asthma control test (ACT) were distributed to 200 parents of children diagnosed with asthma at the pulmonary clinic of King Fahad Medical City in Riyadh, Saudi Arabia. Data were collected and analyzed using the Statistical Package for Social Sciences (SPSS) software version 29. Descriptive statistics of the participants were presented in frequencies, percentages, means, and standard deviations for categorical variables. RESULTS The survey data revealed that the most prevalent asthma triggers among pediatric asthmatic children in Saudi Arabia were Arabic incense (Bakhour) with a mean score of 3.76 (±1.3), followed by being excited 3.70 (±1.5), and stress at home 3.58 (±1.4). Furthermore, the degree of asthma control among children with asthma in Saudi Arabia was 72.0% with a mean score of 17.7 (±4.7) for the ACT, indicating partial degree of asthma. CONCLUSIONS Arabic incense (Bakhour) and psychological stimuli emerged as significant determinants of asthma triggers in Saudi Arabian children diagnosed with asthma. Further studies are warranted to elucidate the physiological mechanisms underpinning the response to Arabic incense (Bakhour).
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Affiliation(s)
- Mohammed M Alyami
- Respiratory Therapy Department, Batterjee Medical College, Khamis Mushait, Saudi Arabia
| | - Ahmed H Alasimi
- Department of Respiratory Therapy, Georgia State University, Atlanta, GA, USA
| | - Abdullah A Alqarni
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Respiratory Therapy Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Fahad H Balharith
- Respiratory Therapy Department, Batterjee Medical College, Khamis Mushait, Saudi Arabia
| | - Abdulelah M Aldhahir
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
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2
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Hedman L, Almqvist L, Bjerg A, Andersson M, Backman H, Perzanowski MS, Rönmark E. Early-life risk factors for development of asthma from 8 to 28 years of age: a prospective cohort study. ERJ Open Res 2022; 8:00074-2022. [PMID: 36655222 PMCID: PMC9835990 DOI: 10.1183/23120541.00074-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/16/2022] [Indexed: 01/21/2023] Open
Abstract
Background The objective was to estimate the incidence rate of asthma from age 8 to 28 years and evaluate early-life risk factors for asthma onset at different ages. Methods In 1996, within the Obstructive Lung Disease in Northern Sweden (OLIN) studies, a cohort of 3430 schoolchildren (97% of invited) was recruited at age 8 years to a prospective study about asthma. The cohort was followed annually from age 8 to 19 years and at 28 years by questionnaire surveys (67% of the original cohort participated). Asthma was categorised as never-asthma, onset age ≤8 years, onset age 9-13 years, onset age 14-19 years or onset age >19 years. Results Of the 3430 individuals in the cohort, 690 (20.1%) reported asthma in any survey. The average incidence rate was 10.0/1000 per year at ≤8 years, 11.9/1000 per year at 9-13 years, 13.3/1000 per year at 14-19 years and 6.1/1000 per year at >19 years. The incidence was higher among boys until age 10 years, but from age 15 years, it became higher among girls. Family history of asthma, allergic sensitisation and breastfeeding <3 months were associated with asthma onset throughout the study. Low birthweight, maternal smoking during pregnancy, severe respiratory infection, rhinoconjunctivitis and eczema were associated with asthma onset ≤8 and 9-13 years. Conclusions The incidence of asthma was high during childhood and the teenage period, and decreased substantially during young adulthood. Early-life factors were associated with asthma onset throughout childhood but had also a lasting effect on asthma incidence until adulthood.
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Affiliation(s)
- Linnéa Hedman
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden,These authors contributed equally to first authorship
| | - Linnéa Almqvist
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden,These authors contributed equally to first authorship
| | | | - Martin Andersson
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Helena Backman
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Matthew S. Perzanowski
- Dept of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Eva Rönmark
- Dept of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
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3
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Johnson CC, Havstad SL, Ownby DR, Joseph CLM, Sitarik AR, Biagini Myers J, Gebretsadik T, Hartert TV, Khurana Hershey GK, Jackson DJ, Lemanske RF, Martin LJ, Zoratti EM, Visness CM, Ryan PH, Gold DR, Martinez FD, Miller RL, Seroogy CM, Wright AL, Gern JE. Pediatric asthma incidence rates in the United States from 1980 to 2017. J Allergy Clin Immunol 2021; 148:1270-1280. [PMID: 33964299 PMCID: PMC8631308 DOI: 10.1016/j.jaci.2021.04.027] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Few studies have examined longitudinal asthma incidence rates (IRs) from a public health surveillance perspective. OBJECTIVE Our aim was to calculate descriptive asthma IRs in children over time with consideration for demographics and parental asthma history. METHODS Data from 9 US birth cohorts were pooled into 1 population covering the period from 1980 to 2017. The outcome was earliest parental report of a doctor diagnosis of asthma. IRs per 1,000 person-years were calculated. RESULTS The racial/ethnic backgrounds of the 6,283 children studied were as follows: 55% European American (EA), 25.5% African American (AA), 9.5% Mexican-Hispanic American (MA) and 8.5% Caribbean-Hispanic American (CA). The average follow-up was 10.4 years (SD = 8.5 years; median = 8.4 years), totaling 65,291 person-years, with 1789 asthma diagnoses yielding a crude IR of 27.5 per 1,000 person-years (95% CI = 26.3-28.8). Age-specific rates were highest among children aged 0 to 4 years, notably from 1995 to 1999, with a decline in EA and MA children in 2000 to 2004 followed by a decline in AA and CA children in 2010 to 2014. Parental asthma history was associated with statistically significantly increased rates. IRs were similar and higher in AA and CA children versus lower but similar in EA and MA children. The differential rates by sex from birth through adolescence principally resulted from a decline in rates among males but relatively stable rates among females. CONCLUSIONS US childhood asthma IRs varied dramatically by age, sex, parental asthma history, race/ethnicity, and calendar year. Higher rates in the 0- to 4-year-olds group, particularly among AA/CA males with a parental history of asthma, as well as changes in rates over time and by demographic factors, suggest that asthma is driven by complex interactions between genetic susceptibility and variation in time-dependent environmental and social factors.
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Affiliation(s)
| | | | - Dennis R Ownby
- Division of Allergy and Immunology, Augusta University, Augusta, Ga
| | | | | | | | | | - Tina V Hartert
- Vanderbilt University School of Medicine, Nashville, Tenn
| | | | - Daniel J Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Robert F Lemanske
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Lisa J Martin
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | | | - Patrick H Ryan
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Diane R Gold
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass
| | - Fernando D Martinez
- Asthma and Airways Research Center, University of Arizona, Tucson, Ariz; Division of Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Arizona, Tucson, Ariz
| | | | - Christine M Seroogy
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Anne L Wright
- Asthma and Airways Research Center, University of Arizona, Tucson, Ariz; Division of Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Arizona, Tucson, Ariz
| | - James E Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
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4
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Johnson CC, Chandran A, Havstad S, Li X, McEvoy CT, Ownby DR, Litonjua AA, Karagas MR, Camargo CA, Gern JE, Gilliland F, Togias A. US Childhood Asthma Incidence Rate Patterns From the ECHO Consortium to Identify High-risk Groups for Primary Prevention. JAMA Pediatr 2021; 175:919-927. [PMID: 33999100 PMCID: PMC8129904 DOI: 10.1001/jamapediatrics.2021.0667] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/19/2021] [Indexed: 12/17/2022]
Abstract
Importance Asthma is the leading chronic illness in US children, but most descriptive epidemiological data are focused on prevalence. Objective To evaluate childhood asthma incidence rates across the nation by core demographic strata and parental history of asthma. Design, Setting, and Participants For this cohort study, a distributed meta-analysis was conducted within the Environmental Influences on Child Health Outcomes (ECHO) consortium for data collected from May 1, 1980, through March 31, 2018. Birth cohort data of children from 34 gestational weeks of age or older to 18 years of age from 31 cohorts in the ECHO consortium were included. Data were analyzed from June 14, 2018, to February 18, 2020. Exposures Caregiver report of physician-diagnosed asthma with age of diagnosis. Main Outcome and Measures Asthma incidence survival tables generated by each cohort were combined for each year of age using the Kaplan-Meier method. Age-specific incidence rates for each stratum and asthma incidence rate ratios by parental family history (FH), sex, and race/ethnicity were calculated. Results Of the 11 404 children (mean [SD] age, 10.0 [0.7] years; 5836 boys [51%]; 5909 White children [53%]) included in the primary analysis, 7326 children (64%) had no FH of asthma, 4078 (36%) had an FH of asthma, and 2494 (23%) were non-Hispanic Black children. Children with an FH had a nearly 2-fold higher incidence rate through the fourth year of life (incidence rate ratio [IRR], 1.94; 95% CI, 1.76-2.16) after which the rates converged with the non-FH group. Regardless of FH, asthma incidence rates among non-Hispanic Black children were markedly higher than those of non-Hispanic White children during the preschool years (IRR, 1.58; 95% CI, 1.31-1.86) with no FH at age 4 years and became lower than that of White children after age 9 to 10 years (IRR, 0.67; 95% CI, 0.50-0.89) with no FH. The rates for boys declined with age, whereas rates among girls were relatively steady across all ages, particularly among those without an FH of asthma. Conclusions and Relevance Analysis of these diverse birth cohorts suggests that asthma FH, as well as race/ethnicity and sex, were all associated with childhood asthma incidence rates. Black children had much higher incidences rates but only during the preschool years, irrespective of FH. To prevent asthma among children with an FH of asthma or among Black infants, results suggest that interventions should be developed to target early life.
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Affiliation(s)
| | - Aruna Chandran
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Suzanne Havstad
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan
| | - Xiuhong Li
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Cynthia T. McEvoy
- Department of Pediatrics, Oregon Health & Science University, Portland
| | - Dennis R. Ownby
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan
| | - Augusto A. Litonjua
- Division of Pediatric Pulmonary Medicine, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston
| | - James E. Gern
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison
| | - Frank Gilliland
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Alkis Togias
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
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5
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Zhou J, Li W, Wen X, Zeng D, Lin J, Chen S, Zang N, Deng Y, Xie X, Ren L, Liu E. Establishing a patient registry study database of dust mite allergic asthma in children: design, methodology and preliminary exploration. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:993. [PMID: 34277793 PMCID: PMC8267296 DOI: 10.21037/atm-21-2566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/15/2021] [Indexed: 11/17/2022]
Abstract
Background Asthma is a heterogeneous disease with different phenotypes, endotypes and responses to treatment. Dust mite allergic asthma (DMAA) is the most common type in children. Compared with randomized control trials, a patient registry study (PRS) can reflect the real physical condition and clinical diagnosis more comprehensively. Methods Children who visited the asthma clinic of the Children’s Hospital of Chongqing Medical University between August 2018 and August 2020, and met the inclusion criteria and also agreed to participate, were enrolled in the registry study. Clinical information, laboratory tests and peripheral blood samples were collected after informed consent was given by guardians. Results To date, 208 children have been enrolled in the patient registry database of DMAA. They are mainly male, with >50% having a history of allergic rhinitis, cesarean section, positive family history and passive smoking. Eosinophils and total immunoglobulin E levels were all significantly higher than normal. According to results for the childhood asthma control test (c-ACT) and ratio of forced expiratory volume in 1 s to predicted value after inhaled corticosteroid treatment, the uncontrolled group had higher hemoglobin (Hb) levels than the control group. The group exhibiting abnormal pulmonary function was older, and had longer disease duration, higher fractional exhaled nitric oxide and Hb than the group in which pulmonary function was restored. Conclusions We have preliminarily established a registered study database of children with DMAA. By cluster analysis and using blood samples, we can further study the different pathophysiological mechanisms in order to provide more individualized and targeted treatments for all children.
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Affiliation(s)
- Juan Zhou
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,Department of Pediatrics, Guizhou Provincial People's Hospital, Medical College of Guizhou University, Guiyang, China
| | - Weiguo Li
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xiang Wen
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Dan Zeng
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Jilei Lin
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Shiyi Chen
- Chongqing Key Laboratory of Pediatrics, Chongqing, China.,Pediatric Research Institute Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Na Zang
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yu Deng
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xiaohong Xie
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Luo Ren
- Chongqing Key Laboratory of Pediatrics, Chongqing, China.,Pediatric Research Institute Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Enmei Liu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
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6
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Vlaski E, Stavrikj K, Kimovska M, Cholakovska VC, Lawson JA. Divergent trends in the prevalence of asthma-like symptoms and asthma in a developing country: three repeated surveys between 2002 and 2016. Allergol Immunopathol (Madr) 2020; 48:475-483. [PMID: 32284265 DOI: 10.1016/j.aller.2019.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/22/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION AND OBJECTIVES There have been differences in temporal trends of asthma prevalence by geographic region and economic prosperity. The aim of this study was to assess temporal trends in asthma prevalence among young adolescents in Skopje, Republic of North Macedonia as a developing country with a low asthma prevalence. SUBJECTS AND METHODS Data were obtained from three cross-sectional surveys (2002, 2006, and 2016) of adolescents (12-15 years) from randomly selected schools in Skopje. Trends in the prevalence of asthma and asthma-like symptoms were investigated descriptively and using multiple logistic regression to adjust for potential confounding factors. RESULTS The prevalence of asthma increased, although the changes were not statistically significant (2002: 1.7%; 2006: 2.0%; 2016: 2.8%; p=0.075). Statistically significant (p<0.05) reductions in wheeze prevalence over time (2002, 2006, 2016) were observed for current wheeze (8.8%, 7.2%, 5.5%), exercise-induced wheeze (14.2%, 7.9%, 1.9%), and night dry cough (16.5%, 13.5%, 9.6%). After adjustment for potential confounding factors, there was an increase in asthma likelihood by year compared to 2002 (2006: OR=1.22, 95%CI=0.67-2.22; 2016: OR=2.45, 95%CI=1.24-4.84). In the adjusted analyses, associations between year and the asthma-like symptoms confirmed the descriptive results, except for current wheeze, where statistical significance disappeared. CONCLUSIONS Divergent trends in prevalence with a decrease in asthma-like symptoms and an increase in physician-diagnosed asthma in Skopje during a period of 14 years were established. Improved asthma labelling and effective preventative treatment of symptoms may explain some of these changes, although changes in environment and lifestyle could not be ruled out.
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Affiliation(s)
- E Vlaski
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Republic of North Macedonia.
| | - K Stavrikj
- Department of Immunology, University Children's Clinic, Skopje, Republic of North Macedonia
| | - M Kimovska
- Intensive Care Unit, University Children's Clinic, Skopje, Republic of North Macedonia
| | - V C Cholakovska
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Republic of North Macedonia
| | - J A Lawson
- Department of Medicine and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
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7
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Barbiellini Amidei C, Zingone F, Zanier L, Canova C. Risk of Prevalent Asthma among Children Affected by Inflammatory Bowel Disease: A Population-Based Birth Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124255. [PMID: 32549223 PMCID: PMC7345598 DOI: 10.3390/ijerph17124255] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/06/2020] [Accepted: 06/09/2020] [Indexed: 02/07/2023]
Abstract
Literature on the risk of asthma among children with inflammatory bowel disease (IBD) is limited and has reported discording results. To the best of our knowledge, no previous study has evaluated the association between asthma and childhood onset IBD, focusing on pediatric IBD with onset between 10 and 17 years, early-onset IBD (EO-IBD) between 0 and 9 years, and very early-onset IBD (VEO-IBD) between 0 and 5 years, all conditions characterized by different clinical progressions. A nested matched case-control design on a longitudinal cohort of 213,515 newborns was adopted. Conditional binomial regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) of asthma among children with IBD compared with controls. We found 162 children with IBD and 1620 controls. Overall, childhood onset IBD was associated with increased risks of being affected by asthma (OR: 1.49 95% CI 1.05–2.12), although a significant risk was only present among males (OR: 1.60 95% CI 1.02–2.51). Children with Crohn’s disease and ulcerative colitis had similarly increased risks, although they failed to attain statistical significance. Risks of asthma based on age at IBD onset were inversely related to age, with the lowest non-significant risks for pediatric IBD and EO-IBD, while children affected by VEO-IBD had the highest risk of asthma (OR: 2.75 95% CI 1.26–6.02). Our study suggests the presence of a higher prevalence of asthma among both male children with IBD and children with VEO-IBD. It could be advisable to pay greater attention to possible respiratory symptoms among these categories at higher risk.
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Affiliation(s)
- Claudio Barbiellini Amidei
- Unit of biostatistics, Epidemiology and Public Health. Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35100 Padua, Italy;
| | - Fabiana Zingone
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology Section, University Hospital of Padua, 35100 Padua, Italy;
| | - Loris Zanier
- Epidemiological Service, Health Directorate, 33100 Udine, Italy;
| | - Cristina Canova
- Unit of biostatistics, Epidemiology and Public Health. Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35100 Padua, Italy;
- Correspondence:
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8
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Hohmann C, Keller T, Gehring U, Wijga A, Standl M, Kull I, Bergstrom A, Lehmann I, von Berg A, Heinrich J, Lau S, Wahn U, Maier D, Anto J, Bousquet J, Smit H, Keil T, Roll S. Sex-specific incidence of asthma, rhinitis and respiratory multimorbidity before and after puberty onset: individual participant meta-analysis of five birth cohorts collaborating in MeDALL. BMJ Open Respir Res 2019; 6:e000460. [PMID: 31673365 PMCID: PMC6797252 DOI: 10.1136/bmjresp-2019-000460] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/22/2019] [Accepted: 08/31/2019] [Indexed: 01/07/2023] Open
Abstract
Introduction To understand the puberty-related sex shift in the prevalence of asthma and rhinitis as single entities and as respiratory multimorbidities, we investigated if there is also a sex-specific and puberty-related pattern of their incidences. Methods We used harmonised questionnaire data from 18 451 participants in five prospective observational European birth cohorts within the collaborative MeDALL (Mechanisms of the Development of Allergy) project. Outcome definitions for IgE-associated and non-IgE-associated asthma, rhinitis and respiratory multimorbidity (first occurrence of coexisting asthma and rhinitis) were based on questionnaires and the presence of specific antibodies (IgE) against common allergens in serum. For each outcome, we used proportional hazard models with sex–puberty interaction terms and conducted a one-stage individual participant data meta-analysis. Results Girls had a lower risk of incident asthma (adjusted HR 0.67, 95% CI 0.61 to 0.74), rhinitis (0.73, 0.69 to 0.78) and respiratory multimorbidity (0.58, 0.51 to 0.66) before puberty compared with boys. After puberty onset, these incidences became more balanced across the sexes (asthma 0.84, 0.64 to 1.10; rhinitis 0.90, 0.80 to 1.02; respiratory multimorbidity 0.84, 0.63 to 1.13). The incidence sex shift was slightly more distinct for non-IgE-associated respiratory diseases (asthma 0.74, 0.63 to 0.87 before vs 1.23, 0.75 to 2.00 after puberty onset; rhinitis 0.88, 0.79 to 0.98 vs 1.20, 0.98 to 1.47; respiratory multimorbidity 0.66, 0.49 to 0.88 vs 0.96, 0.54 to 1.71) than for IgE-associated respiratory diseases. Discussion We found an incidence ‘sex shift’ in chronic respiratory diseases from a male predominance before puberty to a more sex-balanced incidence after puberty onset, which may partly explain the previously reported sex shift in prevalence. These differences need to be considered in public health to enable effective diagnoses and timely treatment in adolescent girls.
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Affiliation(s)
- Cynthia Hohmann
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Theresa Keller
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike Gehring
- Department of Pulmonology, University Medical Centre Groningen Thoraxcentre, Groningen, The Netherlands
| | - Alet Wijga
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Marie Standl
- Institute of Epidemiology, Helmholtz Zentrum Munchen Deutsches Forschungszentrum fur Umwelt und Gesundheit, Neuherberg, Germany
| | - Inger Kull
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children's Hospital, Stockholm, Sweden
| | - Anna Bergstrom
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Irina Lehmann
- Molecular Epidemiology Unit, Charité Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Andrea von Berg
- Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
| | - Joachim Heinrich
- Institute of Epidemiology, Helmholtz Zentrum Munchen Deutsches Forschungszentrum fur Umwelt und Gesundheit, Neuherberg, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig Maximilians University Munich, Munchen, Germany
| | - Susanne Lau
- Department of Paediatric Pneumology, Immunology and Intensive Care Unit, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrich Wahn
- Department of Paediatric Pneumology, Immunology and Intensive Care Unit, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Josep Anto
- Universitat Pompeu Fabra, Barcelona, Spain.,ISGlobal, Barcelona, Spain
| | - Jean Bousquet
- University Hospital Centre Montpellier, Montpellier, France.,UVSQ, UMR-S 1168, Université de Versailles, Saint-Quentin-en-Yvelines, France
| | - Henriette Smit
- Utrecht University, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
| | - Thomas Keil
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany.,Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Stephanie Roll
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
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Borna E, Nwaru BI, Bjerg A, Mincheva R, Rådinger M, Lundbäck B, Ekerljung L. Changes in the prevalence of asthma and respiratory symptoms in western Sweden between 2008 and 2016. Allergy 2019; 74:1703-1715. [PMID: 31021427 DOI: 10.1111/all.13840] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 02/06/2019] [Accepted: 02/18/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Asthma is a common chronic inflammatory disease of the airways, with a noticeable increase in prevalence during the second half of the 20th century. Recent studies assessing the prevalence trends among adults have been inconsistent. We investigated the changes in the prevalence of asthma, respiratory symptoms, and risk factors between 2008 and 2016 in western Sweden. METHODS The West Sweden Asthma Study (WSAS) is a population-based study which started in 2008 (WSAS I) and then repeated in 2016 (WSAS II) in western Sweden. Randomly selected individuals aged 16-75 years (N = 18 087 in 2008 and N = 24 534 in 2016) completed a questionnaire regarding obstructive lung diseases, respiratory symptoms, potential risk factors, and also questions from the GA2 LEN survey. RESULTS The prevalence of reported ever asthma, physician-diagnosed asthma, use of asthma medication, and current asthma increased significantly from 9.6% to 11%, 8.3% to 10%, 8.6% to 9.8%, and 8.1% to 9.1%, respectively, between 2008 and 2016. There were also increases in the prevalence of respiratory symptoms during the same period. The greatest increase occurred in young adults aged 16-25 years. Female gender, allergic rhinitis, obesity, and family history of asthma remained the strongest risk factors for asthma in 2016 as it was in 2008. CONCLUSION There were moderate increases in asthma and respiratory symptoms in adults in western Sweden between 2008 and 2016, the greatest increase occurring in younger adults. The potential risk factors for asthma remained the same during the study period.
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Affiliation(s)
- Eivind Borna
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
| | - Bright I. Nwaru
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Wallenberg Center for Molecular and Translational Medicine University of Gothenburg Gothenburg Sweden
| | - Anders Bjerg
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Astrid Lindgren Children’s Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women´s and Children´s Health Karolinska Institutet Stockholm Sweden
| | - Roxana Mincheva
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
- Respiratory Medicine & Allergology Department Sahlgrenska University Hospital Gothenburg Sweden
| | - Madeleine Rådinger
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
| | - Bo Lundbäck
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
| | - Linda Ekerljung
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
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Skrzypek M, Kowalska M, Kobza J, Wypych A, Czech EM, Niewiadomska E, Bała MM. Community-based survey as a basis for evidence-based public health: children living in Upper Silesian Industrial Zone. Cent Eur J Public Health 2019; 26:171-176. [PMID: 30419617 DOI: 10.21101/cejph.a5130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of the study was to estimate changes in the prevalence of respiratory diseases and disorders between 2003/2004 and 2011/2012 in 13-16 years old children living in Bytom, one of the biggest cities in the Silesia agglomeration and provide the evidence for local policy makers. METHODS Data from two cross-sectional surveys, based on the Polish version of the International Study of Allergy and Asthma in Childhood (ISAAC) questionnaire, conducted in 2003/2004 and 2011/2012 was used. Response rate in the first and the second survey was 68% and 35%, respectively. The number of analyzed observations was 4,041 and 707 from the first and the second survey. The selection bias was controlled with the propensity score matching and potential determinants of analyzed respiratory diseases and disorders were controlled in the multivariable logistic regression model. RESULTS We found statistically significant increase in asthma ever diagnosed by medical doctor (4.5% vs. 9.6%; p < 0.01), seizures of dyspnea (8.2% vs. 27.7%; p < 0.01), and chest wheeze (9.6% vs. 19.2%; p < 0.01). CONCLUSION Our study revealed significant increase in the prevalence of respiratory diseases and disorders after 8 years in adolescents living in the Upper Silesian Industrial Zone. This is a relevant finding which provides the evidence for decision makers in the scope of local public health policies.
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Affiliation(s)
- Michał Skrzypek
- Department of Biostatistics, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Małgorzata Kowalska
- Department of Epidemiology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Kobza
- Public Health Department, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Agata Wypych
- Department of Epidemiology, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Elżbieta M Czech
- Department of Biostatistics, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Ewa Niewiadomska
- Department of Biostatistics, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Małgorzata M Bała
- Department of Hygiene and Dietetics, Medical Faculty, Jagiellonian University Medical College, Krakow, Poland
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Averina M, Brox J, Huber S, Furberg AS, Sørensen M. Serum perfluoroalkyl substances (PFAS) and risk of asthma and various allergies in adolescents. The Tromsø study Fit Futures in Northern Norway. ENVIRONMENTAL RESEARCH 2019; 169:114-121. [PMID: 30447498 DOI: 10.1016/j.envres.2018.11.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 05/14/2023]
Abstract
BACKGROUND Exposure to environmental pollutants may contribute to the development of asthma and other allergies. The aim of this study was to investigate possible associations between asthma and other allergies with exposure to perfluoroalkyl substances (PFASs) in adolescents from the Arctic region of Norway. METHODS The Tromsø study Fit Futures 1 (TFF1) and 3-year follow-up Fit Futures 2 study (TFF2) included 675 adolescents that completed a questionnaire about health conditions and underwent a clinical examination with blood tests and fractional nitric oxide (FeNO) measurement. Serum concentrations of 18 PFASs were measured by UHPLC-MS/MS method. RESULTS Total PFASs (ΣPFAS) serum concentration over 4th quartile was positively associated with asthma in the TFF1 (OR 3.35 (95% CI 1.54-7.29), p = 0.002). Total perfluorooctane sulfonate (ΣPFOS), linear PFOS (linPFOS), linear perfluorohexane sulfonate (linPFHxS) concentrations over 4th quartiles were associated with 2 times higher odds of asthma in the TFF1. The positive associations between ΣPFAS, ΣPFOS, linPFOS and asthma remained statistically significant in the TFF2. ΣPFAS and linPFHxS concentrations over 3rd tertiles were associated with positive marker of eosinophilic airways inflammation FeNO> 25 ppb. Concentrations of ΣPFOS and linPFOS over 3rd quartiles were positively associated with self-reported nickel allergy (OR 2.25 (95% CI 1.17-4.35) p = 0.016 and OR 2.53 (95% CI 1.30-4.90) p = 0.006, respectively). Allergic rhinitis, self-reported pollen allergy, food allergy and atopic eczema were not associated with PFASs concentrations. CONCLUSIONS This study of Norwegian adolescents showed a positive association between several PFASs and asthma, as well as between PFOS and nickel allergy.
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Affiliation(s)
- Maria Averina
- Department of Laboratory Medicine, University Hospital of North Norway, 9038 Tromsø, Norway; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Jan Brox
- Department of Laboratory Medicine, University Hospital of North Norway, 9038 Tromsø, Norway; Department of Medical Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sandra Huber
- Department of Laboratory Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Anne-Sofie Furberg
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
| | - Martin Sørensen
- Department of Pediatric and Adolescent medicine, University Hospital of North Norway, Tromsø, Norway; Pediatric Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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12
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Shin JY, Sohn KH, Shin JE, Park M, Lim J, Lee JY, Yang MS. Changing patterns of adult asthma incidence: results from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database in Korea. Sci Rep 2018; 8:15052. [PMID: 30302007 PMCID: PMC6177405 DOI: 10.1038/s41598-018-33316-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 09/24/2018] [Indexed: 11/09/2022] Open
Abstract
This study was conducted to assess the changes in the annual incidence of adult asthma in Korea where the prevalence of asthma had increased steadily in recent decades. A population-based cohort study was conducted using the National Health Insurance Service–National Sample Cohort (NHIS-NSC), which consisted of 746,816 adults aged >20 years between 2004 and 2012. Asthma was defined by two or more physician claims on the basis of a primary diagnostic code for asthma and administration of asthma medications within 1 year. The incidence rates and annual percent change were calculated, and the influence of age and sex on the incidence rates was studied. The annual asthma incidence increased from 3.63 in 2004 to 6.07 per 1,000 person-years in 2008. Since 2008, the asthma incidence did not change significantly. The asthma incidence was higher in women than in men throughout the study periods (p < 0.001) and higher in older than younger age groups (p < 0.001). The asthma incidence did not change in all ages since 2008, except for the 20 s who showed a steady increase. The incidence of asthma in adults reached plateau in Korea, which is consistent with the results from studies in other countries.
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Affiliation(s)
- Ji-Yeon Shin
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Kyoung-Hee Sohn
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Eun Shin
- Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Korea
| | - Mira Park
- Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Korea
| | - Jiseun Lim
- Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Korea
| | - Jin Yong Lee
- Public Health Medical Service, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
| | - Min-Suk Yang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. .,Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
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13
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Boeschoten SA, Buysse CMP, Merkus PJFM, van Wijngaarden JMC, Heisterkamp SGJ, de Jongste JC, van Rosmalen J, Cochius-den Otter SCM, Boehmer ALM, de Hoog M. Children with severe acute asthma admitted to Dutch PICUs: A changing landscape. Pediatr Pulmonol 2018; 53:857-865. [PMID: 29635844 PMCID: PMC6032863 DOI: 10.1002/ppul.24009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 03/14/2018] [Indexed: 12/23/2022]
Abstract
UNLABELLED The number of children requiring pediatric intensive care unit (PICU) admission for severe acute asthma (SAA) around the world has increased. OBJECTIVES We investigated whether this trend in SAA PICU admissions is present in the Netherlands. METHODS A multicenter retrospective cohort study across all tertiary care PICUs in the Netherlands. Inclusion criteria were children (2-18 years) hospitalized for SAA between 2003 and 2013. Data included demographic data, asthma diagnosis, treatment, and mortality. RESULTS In the 11-year study period 590 children (660 admissions) were admitted to a PICU with a threefold increase in the number of admissions per year over time. The severity of SAA seemed unchanged, based on the first blood gas, length of stay and mortality rate (0.6%). More children received highflow nasal cannula (P < 0.001) and fewer children needed invasive ventilation (P < 0.001). In 58% of the patients the maximal intravenous (IV) salbutamol infusion rate during PICU admission was 1 mcg/kg/min. However, the number of patients treated with IV salbutamol in the referring hospitals increased significantly over time (P = 0.005). The proportion of steroid-naïve patients increased from 35% to 54% (P = 0.004), with a significant increase in both age groups (2-4 years [P = 0.026] and 5-17 years [P = 0.036]). CONCLUSIONS The number of children requiring PICU admission for SAA in the Netherlands has increased. We speculate that this threefold increase is explained by an increasing number of steroid-naïve children, in conjunction with a lowered threshold for PICU admission, possibly caused by earlier use of salbutamol IV in the referring hospitals.
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Affiliation(s)
- Shelley A Boeschoten
- Department of Pediatric Intensive Care, Erasmus Medical Centre, Sophia's Children Hospital, Rotterdam, The Netherlands
| | - Corinne M P Buysse
- Department of Pediatric Intensive Care, Erasmus Medical Centre, Sophia's Children Hospital, Rotterdam, The Netherlands
| | - Peter J F M Merkus
- Department of Pediatrics, Division of Respiratory Medicine, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Jacob M C van Wijngaarden
- Department of Pediatric Intensive Care, Erasmus Medical Centre, Sophia's Children Hospital, Rotterdam, The Netherlands
| | - Sabien G J Heisterkamp
- Department of Pediatric Intensive Care, Academic Medical Centre, Emma's Children Hospital, Amsterdam, The Netherlands
| | - Johan C de Jongste
- Department of Pediatrics, Erasmus Medical Centre, Sophia's Children Hospital, Rotterdam, The Netherlands
| | - Joost van Rosmalen
- Department of Biostatistics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Suzan C M Cochius-den Otter
- Department of Pediatric Intensive Care, Erasmus Medical Centre, Sophia's Children Hospital, Rotterdam, The Netherlands
| | | | - Matthijs de Hoog
- Department of Pediatric Intensive Care, Erasmus Medical Centre, Sophia's Children Hospital, Rotterdam, The Netherlands
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Osokogu OU, Pacurariu A, Mosseveld M, Rijnbeek P, Weibel D, Verhamme K, Sturkenboom MCJM. Impact of different assumptions on estimates of childhood diseases obtained from health care data: A retrospective cohort study. Pharmacoepidemiol Drug Saf 2018; 27:612-620. [PMID: 29691919 PMCID: PMC6001570 DOI: 10.1002/pds.4413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 01/29/2018] [Accepted: 02/04/2018] [Indexed: 11/17/2022]
Abstract
Purpose Accurate estimates of disease incidence in children are required to support pediatric drug development. Analysis of electronic health care records (EHR) may yield such estimates but pediatric‐specific methods are lacking. We aimed to understand the impact of assumptions regarding duration of disease episode and length of run‐in period on incidence estimates from EHRs. Methods Children aged 0 to 17 years (5–17 years for asthma) registered in the Integrated Primary Care Information database between 2002 and 2014 were studied. We tested the impact of the following: maximum duration of disease episode (0, 14, 30, 60, and 90 days) on recurrent diseases (acute otitis media [common] and acute pyelonephritis [rare]); and database run‐in period on chronic diseases—asthma (common) and type 1 diabetes (DM) (rare). We calculated incidence rate ratios with 95% confidence intervals and stratified using 1‐year age categories. Results Altogether, 503 495 children were registered. The incidence of acute otitis media was highest in <2‐year‐old children; using 30 days disease duration as reference, the rate increased with 8% if the duration was 14 days and decreased with 8% when extended to 60 days. Disease duration did not impact acute pyelonephritis (rare). No run‐in (to exclude prevalent cases) versus 24‐month run‐in period overestimated the incidence rate for asthma and DM by a factor of 2. Conclusions Analysis of EHR allows for estimation of disease incidence in children, but assumptions regarding episode length and run‐in period impact the incidence estimates. Such assumptions may be routinely explored.
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Affiliation(s)
- Osemeke U Osokogu
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Alexandra Pacurariu
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Mees Mosseveld
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Peter Rijnbeek
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Daniel Weibel
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Katia Verhamme
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands
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Ben Ayed H, Yaïch S, Ben Jmaa M, Jedidi J, Ben Hmida M, Trigui M, Kassis M, Karray R, Mejdoub Y, Feki H, Damak J. Pediatric respiratory tract diseases: Chronological trends and perspectives. Pediatr Int 2018; 60:76-82. [PMID: 28891268 DOI: 10.1111/ped.13418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 08/30/2017] [Accepted: 09/05/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND The aim of this study was to describe the epidemiological profile of childhood respiratory tract diseases (RTD) in the region of Sfax, Tunisia, and to evaluate their trends over a 13 year period. METHODS We conducted a retrospective study of all children hospitalized with RTD aged under 14 years. We collected data from the regional morbidity register of the university hospital of Sfax from 2003 to 2015. RESULTS A total of 10 797 RTD patients were enrolled from 49 880 pediatric hospitalizations (21.7%). A male predominance was noted (60%). The median age was 8 months (IQR, 2-36 months). Acute bronchitis (AB) accounted for 53.8%, followed by asthma (15%), pneumonia (14%) and acute upper respiratory infection (AURI; 7.2%). The hospital incidence rate (HIR) of RTD was 34/10 000 inhabitants/year. It was 18.2; 5.07; 4.7 and 2.4/10 000 inhabitants for AB, asthma, pneumonia and AURI, respectively. We noted a significant increase in the HIR of RTD with an annual percentage change (APC) of 10.94% (P < 0.001); in the HIR of AB (APC, 5.27%; P < 0.001); and in asthma HIR (APC, 11.2%; P < 0.001). Otherwise, a significant decrease in AURI HIR was observed (APC, -8.8%; P < 0.001). AB lethality rate increased significantly, with an APC of 7.4% (P < 0.001). Projected trends analysis up to 2024 showed a significant rise in AB and in asthma, while AURI would significantly decrease. CONCLUSIONS RTD continues to be a serious health problem over time in terms of morbidity and mortality. Preventive and curative strategies are needed urgently.
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Affiliation(s)
- Houda Ben Ayed
- Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Sourour Yaïch
- Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Maïssa Ben Jmaa
- Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Jihene Jedidi
- Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Mariem Ben Hmida
- Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Maroua Trigui
- Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Mondher Kassis
- Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Raouf Karray
- Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Yosra Mejdoub
- Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Habib Feki
- Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Jamel Damak
- Department of Community Health and Epidemiology, Hedi Chaker University Hospital, Sfax, Tunisia
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Backman H, Räisänen P, Hedman L, Stridsman C, Andersson M, Lindberg A, Lundbäck B, Rönmark E. Increased prevalence of allergic asthma from 1996 to 2006 and further to 2016-results from three population surveys. Clin Exp Allergy 2017; 47:1426-1435. [DOI: 10.1111/cea.12963] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/17/2017] [Accepted: 05/26/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Helena Backman
- Department of Public Health and Clinical Medicine; Division of Occupational and Environmental Medicine/the OLIN unit; Umeå University; Umeå Sweden
| | - Petri Räisänen
- Department of Public Health and Clinical Medicine; Division of Occupational and Environmental Medicine/the OLIN unit; Umeå University; Umeå Sweden
| | - Linnea Hedman
- Department of Public Health and Clinical Medicine; Division of Occupational and Environmental Medicine/the OLIN unit; Umeå University; Umeå Sweden
- Department of Health Sciences; Luleå University; Luleå Sweden
| | | | - Martin Andersson
- Department of Public Health and Clinical Medicine; Division of Occupational and Environmental Medicine/the OLIN unit; Umeå University; Umeå Sweden
| | - Anne Lindberg
- Department of Public Health and Clinical Medicine; Division of Medicine/the OLIN unit; Umeå University; Umeå Sweden
| | - Bo Lundbäck
- Krefting Research Centre; Institute of Medicine; University of Gothenburg; Gothenburg Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine; Division of Occupational and Environmental Medicine/the OLIN unit; Umeå University; Umeå Sweden
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Mastrorilli C, Posa D, Cipriani F, Caffarelli C. Asthma and allergic rhinitis in childhood: what's new. Pediatr Allergy Immunol 2016; 27:795-803. [PMID: 27862336 DOI: 10.1111/pai.12681] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2016] [Indexed: 12/23/2022]
Abstract
Novel approaches are currently offered for the diagnostic workup and therapeutic management of allergic rhinitis and asthma. New predictive biomarkers of allergy and asthma are available. Primary and secondary prevention, earlier intervention, and modification of the natural history of allergic rhinitis and asthma are being intensively investigated. This review highlights advances in the understanding of the etiology, diagnosis, and management of atopic airway diseases in childhood, as well as prenatal and early-life risk factors and strategies for prevention.
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Affiliation(s)
- Carla Mastrorilli
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.,Department of Pediatric Pneumology and Immunology, Charité Universitätsmedizin, Berlin, Germany
| | - Daniela Posa
- Department of Pediatric Pneumology and Immunology, Charité Universitätsmedizin, Berlin, Germany
| | - Francesca Cipriani
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo Caffarelli
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
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Xu D, Wang Y, Chen Z, Li S, Cheng Y, Zhang L, Zhao L. Prevalence and risk factors for asthma among children aged 0-14 years in Hangzhou: a cross-sectional survey. Respir Res 2016; 17:122. [PMID: 27677381 PMCID: PMC5039889 DOI: 10.1186/s12931-016-0439-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 09/21/2016] [Indexed: 11/10/2022] Open
Abstract
Background Asthma is a global problem. Prevalence varies among different countries and cities. We aimed to obtain the prevalence, describe the characteristics, and discover factors that may relate to asthma in Hangzhou. Methods This cross-sectional study was conducted in Hangzhou. The subjects were children aged 14 years and younger. A control group of non-asthma children that matched in age and sex with each asthmatic patient was also randomly selected and interviewed. International Study of Asthma and Allergies in Childhood and National Epidemiology study of Asthma and Allergies in China questionnaires were used in this survey. Results We have questionnaired 13,877 children, and 665 (4.8 %) children were diagnosed asthma. The guardians regarded the cost of asthma management affordable in 49.4 %, tolerable in 46.9 %, and intolerable in 3.7 %. Both guardians and children have been absent from work or school due to children’s asthma. Respiratory tract infection was the most common trigger of asthma attacks (85.1 %). Other common causes included cold air, house dust, exercise, fish and shrimp, pollen, and et al. Interestingly, we also found in children 6 years and older, some triggers happened more than that in children 5 years and younger. Those factors included exercise, emotional changes, house dust, pollen, renovation works in the home, mosquito–repellent incense and pets (all the p values were <0.05). We compared some factors may relate to asthma development. Higher percentage of family history of asthma, personal history of allergy (atopic dermatitis, drug allergy and food allergy), comorbidities (allergic rhinitis, sinusitis, adenoidal hypertrophy, and urticaria), caesarean birth and complications ever happened during pregnancy were discovered in asthma children than in non-asthma children (all the p values were <0.05). Exclusive breastfeeding within first 6 months and keeping animals had higher percentage in non-asthma children than in asthma (both the p values were <0.05). Inhaled corticosteroid (ICS)/ICS + long-acting beta2 agonists (LABA) was applied to 46.2 % of patients. Traditional Chinese medicine (TCM) was used in 44.2 % of asthma children, while leukotriene receptor antagonist (LTRA) was used in 36.4 % of them. The adherence scored higher in TCM than in ICS/ICS + LABA (P = 0.003) and LTRA. Conclusions In conclusion, we conducted an epidemiology study in Hangzhou. The prevalence of childhood asthma was 4.8 %. Asthma was an economic and social burden to both children and guardians. Risk factors of asthma development may include caesarean birth, personal history of allergy and concomitant allergic diseases. Exclusive breastfeeding within first 6 months and keeping animals might be protecting factors. TCM was really popular in China besides ICS/ICS + LABA and LTRA.
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Affiliation(s)
- Dan Xu
- Department of Pulmonology, The Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou, 310003, Zhejiang Province, China
| | - Yingshuo Wang
- Department of Pulmonology, The Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou, 310003, Zhejiang Province, China
| | - Zhimin Chen
- Department of Pulmonology, The Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou, 310003, Zhejiang Province, China.
| | - Shuxian Li
- Department of Pulmonology, The Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou, 310003, Zhejiang Province, China
| | - Yungai Cheng
- Department of Pulmonology, The Children's Hospital of Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou, 310003, Zhejiang Province, China
| | - Li Zhang
- Department of Internal Medicine, Hangzhou Children's Hospital, 201 Wenhui Road, Hangzhou, 310014, Zhejiang Province, China
| | - Lingzhi Zhao
- Department of Pediatric, Yueqing People's Hospital, 338 Qingyuan Road, Yueqing, Wenzhou, 325600, Zhejiang Province, China
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Vargas MHM, Campos NE, de Souza RG, da Cunha AA, Nuñez NK, Pitrez PM, Donadio MVF. Protective effect of early prenatal stress on the induction of asthma in adult mice: Sex-specific differences. Physiol Behav 2016; 165:358-64. [PMID: 27568231 DOI: 10.1016/j.physbeh.2016.08.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/23/2016] [Accepted: 08/23/2016] [Indexed: 12/29/2022]
Abstract
Adversities faced during the prenatal period can be related to the onset of diseases in adulthood. However, little is known about the effects on the respiratory system. This study aimed to evaluate the effects of prenatal stress in two different time-points during pregnancy on pulmonary function and on the inflammatory profile of mice exposed to an asthma model. Male and female BALB/c mice were divided into 3 groups: control (CON), prenatal stress from the second week of pregnancy (PNS1) and prenatal stress on the last week of pregnancy (PNS2). Both PNS1 and PNS2 pregnant females were submitted to restraint stress. As adults, fear/anxiety behaviors were assessed, and animals were subjected to an asthma model induced by ovalbumin. Pulmonary function, inflammatory parameters in bronchoalveolar lavage (BAL) and histology were evaluated. There was a significant decrease in the number of entries and time spent in the central quadrant on the open field test for the PNS1 animals. Females (PNS1) showed improved pulmonary function (airway resistance, tissue damping and pulmonary elastance), significant increase in the percentage of neutrophils and lymphocytes and a decrease in eosinophils when compared to controls. There was a significant decrease in inflammatory cytokines in BAL of both males (IL-5 and IL-13) and females (IL-4, IL-5 and IL-13) from PNS1 and PNS2 when compared to the CON group. Prenatal stress starting from the beginning of pregnancy reduces the impact of asthma development in adult female mice, showing an improved pulmonary function and a lower inflammatory response in the lungs.
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Affiliation(s)
- Mauro Henrique Moraes Vargas
- Laboratory of Pediatric Respirology, Infant Center, Institute of Biomedical Research (IPB), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Natália Evangelista Campos
- Laboratory of Pediatric Respirology, Infant Center, Institute of Biomedical Research (IPB), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Rodrigo Godinho de Souza
- Laboratory of Pediatric Respirology, Infant Center, Institute of Biomedical Research (IPB), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Aline Andrea da Cunha
- Laboratory of Pediatric Respirology, Infant Center, Institute of Biomedical Research (IPB), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Nailê Karine Nuñez
- Laboratory of Pediatric Respirology, Infant Center, Institute of Biomedical Research (IPB), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Paulo Márcio Pitrez
- Laboratory of Pediatric Respirology, Infant Center, Institute of Biomedical Research (IPB), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Márcio Vinícius Fagundes Donadio
- Laboratory of Pediatric Respirology, Infant Center, Institute of Biomedical Research (IPB), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
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Caminati M, Durić-Filipović I, Arasi S, Peroni DG, Živković Z, Senna G. Respiratory allergies in childhood: Recent advances and future challenges. Pediatr Allergy Immunol 2015; 26:702-10. [PMID: 26582212 DOI: 10.1111/pai.12509] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2015] [Indexed: 12/17/2022]
Abstract
The burden of allergic airway diseases still represents a major health problem in childhood. Despite many different options are currently available for the diagnostic work-up and management, the overall disease control in terms of impact on quality of life, morbidity and mortality, is not yet satisfactory. The extreme variability of individual risk factors and severity determinants may account for it. On the other side, the knowledge of the multifaceted allergy background could pave the way to primary prevention, early intervention and disease course modification. In fact, most of current research is focusing on the identification of biological and clinical predictive markers of allergy and asthma onset. This review aims at summarizing the latest achievements concerning the complex inter-relation between genetic predisposition and environmental factors, and their impact on prevention strategies and early identification of at risk subjects. An update on the diagnostic and monitoring tools as well as an insight into the newest treatments options is also provided.
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Affiliation(s)
- Marco Caminati
- Allergy Unit, Verona University and General Hospital, Verona, Italy
| | | | - Stefania Arasi
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - Diego G Peroni
- Department of Pediatrics, University of Ferrara, Ferrara, Italy.,International Inflammation (in-FLAME) Network of the World Universities Network, Ferrara, Italy
| | - Zorica Živković
- Children's Hospital for Lung Diseases and Tuberculosis, Medical Center 'Dr Dragisa Misovic', Belgrade, Serbia.,Faculty of Pharmacy, European University, Novi Sad, Serbia
| | - Gianenrico Senna
- Allergy Unit, Verona University and General Hospital, Verona, Italy
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