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Qiu YY, Tu LQ, Chen M. Prevalence of asthma and allergic rhinitis in children exposed to pets: a meta-analysis. Eur Arch Otorhinolaryngol 2024; 281:1651-1657. [PMID: 38057489 DOI: 10.1007/s00405-023-08351-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/10/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE Pet exposure has always been controversial with childhood asthma and allergic rhinitis. We aimed to understand the prevalence of asthma and allergic rhinitis in children exposed to pets by meta-analysis. METHODS We searched articles published from Jan 1, 2012 to Dec 31, 2022 in the Embase, PubMed, Cochrane Library, and Web of Science databases. We included a cross-sectional study that reported the prevalence of asthma and allergic rhinitis in children exposed to pets. Furthermore, we performed subgroup analyses according to pet type and age. RESULTS In 14 selected studies, the meta-analysis results showed that the pooled prevalence of asthma in children exposed to pets was 19.0% (95% CI 13.3-24.7%), and the pooled prevalence of allergic rhinitis in children exposed to pets was 25.5% (95% CI 12.4-38.5%). The prevalence of asthma in children exposed to cats and dogs was 16.4% (95% CI 9.9-22.8%) and 12.5% (95% CI 8.7-16.2%), respectively. The prevalence of allergic rhinitis was 24.9% (95% CI 2.9-47.0%) and 24.1% (95% CI 2.6-45.6%), respectively. The prevalence of asthma in pet-exposed children was 17.1% (95% CI 12.3-22.0%) in the adolescence group (> 10 years) and 26.3% (95% CI 12.2-40.3%) in the childhood group (0-10 years). The prevalence of allergic rhinitis was 8.6% (95% CI 7.2-10.0%) in the adolescence group and 46.3% (95% CI 44.0-48.6%) in the childhood age group. CONCLUSIONS The prevalence of asthma and allergic rhinitis in children exposed to pets is different. Exposure to pet cats is more prone to illness, and younger children are more susceptible to disease than older children.
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Affiliation(s)
- Yi-Yin Qiu
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Liang-Qian Tu
- Department of Otolaryngology, The Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ming Chen
- Department of Otolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Ludvigsson JF, Loboda A. Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees. Acta Paediatr 2022; 111:1341-1353. [PMID: 35466444 PMCID: PMC9324783 DOI: 10.1111/apa.16370] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 12/24/2022]
Abstract
Aim Millions of Ukrainian children have been internally displaced or fled to other countries because of the Russian war. This systematic review focused on their health needs and future challenges for clinicians. Methods A systematic literature search of the Medline, Embase and MedRxiv databases from 1 January 2010 to 31 March 2022 identified 1628 papers on the health of Ukrainian children and 112 were relevant to this review. Results In 2019, under‐5 mortality was 8 per 1000 live births in Ukraine. Underweight and adverse childhood experiences, including child abuse, were frequent compared to other European countries, while childhood obesity seemed less common. Alcohol consumption was common in women of reproductive age, including during pregnancy, risking foetal alcohol syndrome. Neonatal screening programmes provided low coverage. Vaccine hesitancy was common and vaccination rates were low. Other concerns were measles, HIV, antibiotic resistance and multi‐resistant tuberculosis. Many children are expected to suffer from psychological and physical trauma due to the war. Other healthcare challenges include low COVID‐19 vaccination rates and a preference for secondary and tertiary care, rather than primary care. Many people cannot afford medication. Conclusion Ukrainian children often have poor health and host countries need to be aware of their needs.
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Affiliation(s)
- Jonas F. Ludvigsson
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Paediatrics Orebro University Hospital Orebro Sweden
- Department of Medicine Columbia University College of Physicians and Surgeons New York New York USA
| | - Andrii Loboda
- Department of Paediatrics, Academic and Research Medical Institute Sumy State University Sumy Ukraine
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3
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Ji X, Yao Y, Zheng P, Hao C. The relationship of domestic pet ownership with the risk of childhood asthma: A systematic review and meta-analysis. Front Pediatr 2022; 10:953330. [PMID: 35935350 PMCID: PMC9352935 DOI: 10.3389/fped.2022.953330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/04/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The relationship between pet ownership and childhood asthma remains controversial. In recent years, there have been increasing studies with large sample size. Therefore, we conducted this systematic review and meta-analysis to evaluate the relationship between pet ownership and childhood asthma. METHOD Relevant research was retrieved from PubMed, Cochrane, EMBASE, and Web of science. The retrieval was as of October 1, 2021. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. Stata 15.0 was used to conduct the meta-analysis. RESULTS A total of 60 studies with large sample size published between 1995 and 2021 were included in this systematic review and meta-analysis, which included 18 cohort studies and 42 case-control studies covering 27 countries and 1,871,295 children. As shown by meta-analysis results, cat ownership (OR = 1.18, 95%CI: 1.05∼1.33) and dog ownership (OR = 1.12, 95%CI: 1.0 0∼1.24) have a significant bearing on the occurrence of childhood asthma. Pet ownership was also positively correlated with the occurrence of severe childhood asthma (OR = 1.15, 95%CI: 1.11∼1.20). CONCLUSION Pet ownership, especially cats and dogs, is associated with the occurrence of asthma in children.
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Affiliation(s)
- Xiaoyi Ji
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.,Department of Pediatric, Jiaxing Maternal and Child Health Hospital, Jiaxing, China
| | - Yuan Yao
- Department of Radiology, Jiaxing Maternal and Child Health Hospital, Jiaxing, China
| | - Ping Zheng
- Department of Pediatric, Jiaxing Maternal and Child Health Hospital, Jiaxing, China
| | - Chuangli Hao
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
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Ravn NH, Halling AS, Berkowitz AG, Rinnov MR, Silverberg JI, Egeberg A, Thyssen JP. How does parental history of atopic disease predict the risk of atopic dermatitis in a child? A systematic review and meta-analysis. J Allergy Clin Immunol 2019; 145:1182-1193. [PMID: 31887393 DOI: 10.1016/j.jaci.2019.12.899] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/06/2019] [Accepted: 12/11/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Parental history of atopic disease is a well-established risk factor for the development of atopic dermatitis (AD), but several aspects of this association remain unclear. OBJECTIVE We sought to determine the association of parental history of atopic disease with AD in offspring. METHODS We searched PubMed and EMBASE through June 2018 for relevant records and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled odds ratios (ORs) with 95% CI were calculated using random-effects models. RESULTS A total of 163 records covering 149 unique studies were included. Of these, 119 studies were included in the meta-analysis. Individuals with parental history of atopic disease had increased odds of AD (OR, 1.81; 95% CI, 1.65-1.99). Parental asthma (OR, 1.56; 95% CI, 1.18-2.05) and allergic rhinitis (OR, 1.68; 95% CI, 1.34-2.11) had a smaller effect than AD (OR, 3.30; 95% CI, 2.46-4.42). The effect of maternal and paternal history was comparable for all atopic diseases. An increase in odds was observed when comparing the effect of having 1 (OR, 1.30; 95% CI, 1.15-1.47) or 2 atopic parents (OR, 2.08; 95% CI, 1.83-2.36), as well as having a parent with 1 (OR, 1.49; 95% CI, 1.28-1.74) or more atopic diseases (OR, 2.32; 95% CI, 1.92-2.81). CONCLUSIONS This study provides evidence-based risk estimates that may guide physicians who counsel parents with a history of atopic disease about their children's risk of AD. This information is of particular importance for future efforts toward establishing prophylactic interventions for AD on a general population level.
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Affiliation(s)
- Nina H Ravn
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Anne-Sofie Halling
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | | | - Maria R Rinnov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jonathan I Silverberg
- Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; National Allergy Research Centre, Herlev and Gentofte Hospital, Hellerup, Denmark.
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Rodriguez A, Brickley E, Rodrigues L, Normansell RA, Barreto M, Cooper PJ. Urbanisation and asthma in low-income and middle-income countries: a systematic review of the urban-rural differences in asthma prevalence. Thorax 2019; 74:1020-1030. [PMID: 31278168 PMCID: PMC6860411 DOI: 10.1136/thoraxjnl-2018-211793] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 03/20/2019] [Accepted: 04/24/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Urbanisation has been associated with temporal and geographical differences in asthma prevalence in low-income and middle-income countries (LMICs). However, little is known of the mechanisms by which urbanisation and asthma are associated, perhaps explained by the methodological approaches used to assess the urbanisation-asthma relationship. OBJECTIVE This review evaluated how epidemiological studies have assessed the relationship between asthma and urbanisation in LMICs, and explored urban/rural differences in asthma prevalence. METHODS Asthma studies comparing urban/rural areas, comparing cities and examining intraurban variation were assessed for eligibility. Included publications were evaluated for methodological quality and pooled OR were calculated to indicate the risk of asthma in urban over rural areas. RESULTS Seventy articles were included in our analysis. Sixty-three compared asthma prevalence between urban and rural areas, five compared asthma prevalence between cities and two examined intraurban variation in asthma prevalence. Urban residence was associated with a higher prevalence of asthma, regardless of asthma definition: current-wheeze OR:1.46 (95% CI:1.22 to 1.74), doctor diagnosis OR:1.89 (95% CI:1.47 to 2.41), wheeze-ever OR:1.44 (95% CI:1.15 to 1.81), self-reported asthma OR:1.77 (95% CI:1.33 to 2.35), asthma questionnaire OR:1.52 (95% CI:1.06 to 2.16) and exercise challenge OR:1.96 (95% CI:1.32 to 2.91). CONCLUSIONS Most evidence for the relationship between urbanisation and asthma in LMICs comes from studies comparing urban and rural areas. These studies tend to show a greater prevalence of asthma in urban compared to rural populations. However, these studies have been unable to identify which specific characteristics of the urbanisation process may be responsible. An approach to understand how different dimensions of urbanisation, using contextual household and individual indicators, is needed for a better understanding of how urbanisation affects asthma. PROSPERO REGISTRATION NUMBER CRD42017064470.
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Affiliation(s)
- Alejandro Rodriguez
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Facultad de Ciencias Médicas de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
- Fundación Ecuatoriana para la Investigación en Salud, Quito, Ecuador
| | - Elizabeth Brickley
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Laura Rodrigues
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Mauricio Barreto
- Instituto de Saude Coletiva, Universidad Federal da Bahia, Salvador, Brazil
- Centrode de Integração de Dados e Conhecimentos para Saúde (CIDACS), FIOCRUZ, Salvador, Brazil
| | - Philip J Cooper
- Facultad de Ciencias Médicas de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
- Fundación Ecuatoriana para la Investigación en Salud, Quito, Ecuador
- Institute of Infection and Immunity, St George's University of London, London, UK
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Lawson JA, Brozek G, Shpakou A, Fedortsiv O, Vlaski E, Beridze V, Rennie DC, Afanasieva A, Beridze S, Zejda J. An international comparison of asthma, wheeze, and breathing medication use among children. Respir Med 2017; 133:22-28. [PMID: 29173445 DOI: 10.1016/j.rmed.2017.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 11/01/2017] [Accepted: 11/02/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is variation in childhood asthma between countries with typically higher prevalence in "Westernized" nations. We compared asthma, respiratory symptoms, and medication prevalence in Eastern and Central European regions and Canada. METHODS We conducted a cross-sectional survey study of children (5-15 years) from one urban centre in each of Canada, Belarus, Poland, Republic of Georgia (Adjara), Republic of Macedonia, and Ukraine. Surveys were distributed through randomly selected schools to parents (2013-2015). RESULTS The prevalence of asthma differed by country from 20.6% in Canada to 1.5% in Ukraine (p < 0.001). This association remained after confounder adjustment. Except for Canada (58.7%) and Poland (42.5%), less than 10% of children with a history of wheeze had a diagnosis of asthma. Regardless of country, more than 50% of children with a diagnosis of asthma used breathing medications in the past year. Finally, except for Georgia (12.1%), all countries had a prevalence of ever wheeze above 20% (23.8% in Poland to 30.9% in Macedonia). CONCLUSIONS Despite large differences in asthma prevalence, respiratory morbidity was more comparable suggesting asthma prevalence may be underestimated. Further validation of asthma diagnosis is needed. It is important to promote best diagnostic practices among first contact physicians.
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Affiliation(s)
- Joshua A Lawson
- Department of Medicine, University of Saskatchewan, Saskatoon, Canada; Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada.
| | - Grzegorz Brozek
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | | | - Olga Fedortsiv
- Horbachevsky State Medical University, Ternopil, Ukraine
| | - Emilija Vlaski
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Macedonia
| | | | - Donna C Rennie
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada; College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Anna Afanasieva
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | | | - Jan Zejda
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
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Beridze V, Abuladze L, Partenadze N, Bakhtadze T, Lawson J, Zejda JE. Childhood asthma in Batumi, Georgia: Prevalence and environmental correlates. J Asthma 2017; 55:43-49. [PMID: 27901622 DOI: 10.1080/02770903.2016.1247169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE A relative lack of data for Eastern Europe and unknown epidemiology of childhood asthma in Batumi (Georgia) justified a study aimed at determining the prevalence of physician-diagnosed asthma and related respiratory conditions, a comparison of the prevalence of these conditions between urban and rural children, and identification of their environmental correlates. METHODS Subjects of the cross-sectional population-based study were 3238 urban and 2081 rural children aged 5-17 years whose respiratory status was assessed using the ISAAC questionnaire. RESULTS The overall prevalence of asthma was larger in rural children than in urban children (2.8% vs. 1.8%, respectively; p = 0.01). Spastic bronchitis occurred with similar frequency in urban (7.8%) and rural children (6.5%). Compared with urban children, rural subjects had dry cough at night (13.1 vs 8.2%, p < 0.001) and attacks of dyspnea (4.7 vs 2.4%, p < 0.001) more often. The prevalence of other symptoms did not differ significantly between urban and rural subjects. Results of multivariate analyses showed that both asthma and spastic bronchitis were associated (p < 0.05) with parental history of asthma, dampness in the house, and poor financial standing of the family. In addition, asthma was related to coal/wood-based heating whereas spastic bronchitis was associated with passive smoking and lower parental education. CONCLUSIONS The findings show a low prevalence of ever-diagnosed asthma in the examined population. Nosological tradition and similar correlates of asthma and spastic bronchitis suggest that some cases of asthma might be included in the diagnostic category of spastic bronchitis.
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Affiliation(s)
- Vakhtang Beridze
- a Faculty of Natural Sciences and Health Care, Shota Rustaveli State University , Batumi , Georgia
| | - Lia Abuladze
- b Maternity and Child Health Center , Batumi , Georgia
| | | | - Tamar Bakhtadze
- a Faculty of Natural Sciences and Health Care, Shota Rustaveli State University , Batumi , Georgia
| | - Joshua Lawson
- c Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan , Saskatoon , Canada
| | - Jan E Zejda
- d Department of Epidemiology , School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
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Brozek G, Shpakou A, Lawson J, Zejda J. Rural Dwelling and Temporal Trends in Relation to Childhood Asthma and Related Conditions in Belarus: A Repeated Cross-sectional Survey. J Agromedicine 2016; 20:332-40. [PMID: 26237724 DOI: 10.1080/1059924x.2015.1042616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
There is a lack of asthma research in Belarus, with no investigation of temporal trends. The purpose of the study was to determine the prevalence of asthma and related conditions comparing urban and rural children while investigating temporal changes in the region of Grodno, Belarus. A repeated cross-sectional survey design was used. Parents completed surveys on behalf of the child. Data collection was based on the International Study of Asthma and Allergies in Children (ISAAC) survey and included 5020 urban and rural children aged 7-15 years in 2009-2010 and 4953 children in 2014 from the Grodno Region. Asthma prevalence in 2009 was 1.4% compared with 1.8% in 2014, whereas spastic bronchitis prevalence was higher (2009: 6.8%; 2014: 8.5%). After adjustment for confounders, rural dwelling showed a statistically significant inverse association with each of the allergic conditions or symptoms. However, asthma (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 0.69-1.50) was not associated with rural dwelling. A diagnosis of asthma was more likely in 2014 compared with 2009 (OR = 1.57, 95% CI = 1.05-2.33), as was spastic bronchitis (OR = 1.26, 95% CI = 1.06-1.51). Maternal smoking was associated with the presence of respiratory symptoms. The data showed that the prevalence of diagnosed asthma was comparable between urban and rural areas but lower than other regions, there was generally an increase in the prevalence of asthma and related conditions, and that temporal changes did not vary by urban-rural status. The prevalence of spastic bronchitis was over 3 times higher than that of asthma. These findings also suggest that the presence of undiagnosed asthma in children is occurring in the Grodno Region.
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Affiliation(s)
- Grzegorz Brozek
- a Department of Epidemiology , School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
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Brozek G, Lawson J, Shpakou A, Fedortsiv O, Hryshchuk L, Rennie D, Zejda J. Childhood asthma prevalence and risk factors in three Eastern European countries--the Belarus, Ukraine, Poland Asthma Study (BUPAS): an international prevalence study. BMC Pulm Med 2016; 16:11. [PMID: 26762156 PMCID: PMC4712510 DOI: 10.1186/s12890-016-0172-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/07/2016] [Indexed: 12/03/2022] Open
Abstract
Background The prevalence of asthma and other allergic diseases among children living in Eastern is not well described. Our objective was to estimate and compare the prevalence of asthma, respiratory symptoms and allergic diseases in children in Belarus, Ukraine, and Poland as well as to identify risk factors for these conditions. We also sought to profile and compare children with asthma between locations. Methods Data were collected as a part of an international, multicenter, cross-sectional study of childhood asthma: The Belarus Ukraine Poland Asthma Study (BUPAS). Subjects were children aged 7–13 years attending primary and secondary schools in the urban and surrounding rural area of Grodno (Belarus), Ternopil (Ukraine) and Silesia Region (Poland). Physician-diagnosed respiratory diseases and symptoms as well as allergic diseases were ascertained using the ISAAC questionnaire completed by the parents. Results In total there were 4019 children from Belarus (rural: 2018, urban: 2001), 4493 from Ukraine (1972; 2521), and 4036 from Poland (2002, 2034). The overall response rate was 76.7 %. Groups were similar in case of gender and age (p > 0.05). Almost all analyzed respiratory and allergic conditions differed significantly between countries including asthma [Poland (rural, urban): 3.5 %, 4.1 %; Ukraine: 1.4 %, 2.1 %; Belarus: 1.4 %, 1.5 %], spastic bronchitis (Poland: 2.7 %, 3.2 %; Ukraine: 7.5 %, 6.5 %; Belarus: 6.4 %, 7.9 %), and chest wheeze in the last year (Poland: 4.8 %, 5.2 %; Ukraine: 11.5 %, 13.0 %; Belarus: 10.7 %, 10.0 %). These differences remained after adjustment for potential confounders. Risk factor associations were generally similar between outcomes. Symptom characteristics of children with asthma between countries were not consistent. The ratio of current wheeze:diagnosis of asthma differed by country: (Rural areas: Belarus: 10.9:1, Ukraine: 17.3:1, Poland: 2.4:1; Urban areas: Belarus: 8.1:1, Ukraine: 7.3:1 Poland: 1.9:1). Conclusions The findings show large between-country differences and relatively low prevalence of asthma and allergic diseases in children of Western Belarus and Ukraine. There is evidence for underdiagnosis of asthma in these regions.
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Affiliation(s)
- Grzegorz Brozek
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
| | - Joshua Lawson
- Department of Medicine and Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada.
| | - Andrei Shpakou
- Department of Sport Medicine and Rehabilitation, Yanka Kupala State University of Grodno, Grodno, Belarus.
| | - Olga Fedortsiv
- Department of Paediatrics with Children Surgery №1, Horbachevsky State Medical University, Ternopil, Ukraine.
| | - Leonid Hryshchuk
- Department of Tuberculosis, Horbachevsky State Medical University, Ternopil, Ukraine.
| | - Donna Rennie
- College of Nursing and Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada.
| | - Jan Zejda
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
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Shirinde J, Wichmann J, Voyi K. Environmental tobacco smoke and the risk of eczema symptoms among school children in South Africa: a cross-sectional study. BMJ Open 2015; 5:e008234. [PMID: 26310401 PMCID: PMC4554914 DOI: 10.1136/bmjopen-2015-008234] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the association between eczema ever (EE) and current eczema symptoms (ES) in relation to exposure to environmental tobacco smoke (ETS). DESIGN A cross-sectional study using the International Study of Asthma and Allergies in Childhood questionnaire. SETTING 16 schools were randomly selected from two neighbourhoods situated in Ekurhuleni Metropolitan Municipality, Gauteng Province, South Africa. PARTICIPANTS From a total population of 3764 school children aged 12-14 years, 3468 completed the questionnaire (92% response rate). A total of 3424 questionnaires were included in the final data analysis. PRIMARY OUTCOME The prevalence of EE and current ES was the primary outcome in this study. RESULTS Data were analysed using Multilevel Logistic Regression Analysis (MLRA). The likelihood of EE was increased by exposure to ETS at home (OR 1.30 95% CI 1.01 to 1.67) and at school (OR 1.26 95% CI 1.00 to 1.60). The likelihood of EE was lower for males (OR 0.66 95% CI 0.51 to 0.84). The likelihood of ES was increased by ETS at home (OR 1.93 95% CI 1.43 to 2.59) and school (1.44 95% CI 1.09 to 1.90). The likelihood of ES was again lower for males (OR 0.56 95% CI 0.42 to 0.76). Smoking by mother/female guardian increased the likelihood of EE and ES, however, this was not significant in the multivariate analysis. CONCLUSIONS Symptoms of eczema were positively associated with exposure to ETS at home and school. The results support the hypothesis that ETS is an important factor in understanding the occurrence of eczema.
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Affiliation(s)
- Joyce Shirinde
- Department of Environmental Health, Tshwane University of Technology, Pretoria, South Africa
| | - Janine Wichmann
- Health Sciences Faculty, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Kuku Voyi
- Health Sciences Faculty, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
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Brozek G, Lawson J, Szumilas D, Zejda J. Increasing prevalence of asthma, respiratory symptoms, and allergic diseases: Four repeated surveys from 1993-2014. Respir Med 2015; 109:982-90. [PMID: 26153339 DOI: 10.1016/j.rmed.2015.05.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 05/04/2015] [Accepted: 05/11/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Published data shows different prevalence trends depending on the region of Europe. AIM The aim of the study was to analyze time trends of the frequency of the respiratory symptoms and allergic diseases in school children (Silesia, Poland) over the last 21 years. METHODS We compared the results of four population-based surveys performed in a town of Chorzow in 1993, 2002, 2007 and 2014 in children aged 7-10 years. All four studies had the same study protocol, recruitment (cluster, school-based sampling), questionnaire (WHO respiratory health questionnaire) and the same principal investigator The surveys included 1130 children in 1993, 1421 children in 2002, 1661 children in 2007 and 1698 in 2014. RESULTS The results covered a 21 year span and showed a statistically significant (p < 0.05) increase in the prevalence of the following physician-diagnosed disorders (1993-2002-2007-2014): asthma (3.4%-4.8%-8.6%-12,6%); allergic rhinitis (4.3%-11.9%-15.9%-13.9%); atopic dermatitis (3.6%-7.9%-12.0%-13.9%); allergic conjunctivitis (4.3%-7.9%-8.3%-7.9%); A simultaneous increasing trend (p < 0.05) in the attacks of dyspnea (3.9%-5.9%-7.0%-7.3%) and symptoms (wheeze, dyspnea, cough) induced by exercise (7.5%-10.6%-22.0%-22.4%) and - at the same time - decrease (p < 0.05) in the prevalence of cough (31.6%-19.6%15.4%-14.4%). Among children with diagnosed asthma during the 21 year span there was significantly (p < 0.05) increased proportion of treated children (51.3%-51.3%-69.5%-60.7%) and a lower frequency of presenting current symptoms. CONCLUSIONS Our findings are in line with the concept of a real increase in the occurrence of asthma and allergic disease in children. The pattern involves not only physician-diagnosed allergic diseases but also occurrence of symptoms related to respiratory disorders. Diagnosed asthma is better treated and better controlled.
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Affiliation(s)
- Grzegorz Brozek
- Department of Epidemiology, School of Medicine, Medical University of Silesia in Katowice, Medykow 18 Str, 40-752 Katowice, Poland.
| | - Joshua Lawson
- Department of Medicine and Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK S7N 2Z4, Canada.
| | - Dawid Szumilas
- Department of Epidemiology, School of Medicine, Medical University of Silesia in Katowice, Medykow 18 Str, 40-752 Katowice, Poland.
| | - Jan Zejda
- Department of Epidemiology, School of Medicine, Medical University of Silesia in Katowice, Medykow 18 Str, 40-752 Katowice, Poland.
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Shpakou A. Epidemiological studies as a basis of information for diagnosis of the allergic diseases of the respiratory system and skin of the children 6–7 and 13–14 years in the Grodno region. MEDICAL SCIENCE PULSE 2015. [DOI: 10.5604/01.3001.0003.3182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Widespread, medical and social consequences, impact on quality of life and the significant cost of allergic diseases justify a number of measures for the prevention of diseases. What is clear is that official statistics may not match the true prevalence of allergic diseases in general, especially asthma. Aim of the study: Estimate the prevalence of asthma and allergic diseases, the main symptoms of allergic and respiratory among urban and rural children aged 6–7 years and 13–14 years in the Grodno region carried out in accordance with internationally recognized research methodology. Material and methods: The survey questionnaire (based on a survey ISAAC) 2187 was attended by parents of children 6–7 years and 13–14 years of Grodno and region (1091 children from the city, and in 1096 from the village). 955 children aged 6–7 years, 1232 at the age of 13–14 years. Knowing this with asthma may be suspected in patients, who feel shortness of breath accompanied by wheezing, tightness in the chest or cough and allergic diseases (allergic rhinitis and atopic dermatitis), analyzed the incidence of these symptoms and diseases among children.Results: Demonstrated a low incidence of asthma among children in the age group of standardized. Parents of 30 children (1.37% respondents) confirms the existence of disease in children under physician diagnose disease. Prevalence of asthma among urban children was 1.74% (19 people) and rural – 1.0% (11 children). With a deeper analysis of responses established with 60 children (2.74%) had in the last 12 months wheezing in the chest and coughing. The incidence of allergic rhinitis and atopic dermatitis is about 4% and 10%. These diseases often found only among children with asthma. Conclusions: Since the identification of asthma in children based on the diagnosis by the doctor is not high, can’t be excluded that this reflects a failure to recognize the disease. Noted marked differences in the prevalence of respiratory symptoms, manifesting linking asthma and asthma with allergic diseases. It seems necessary to continuously monitor these phenomena through the continuation of epidemiolog-ical studies as a basis for the development of information and implementation of prevention programs and epidemiological evaluation of the effectiveness of prevention at regional and international.
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Affiliation(s)
- Andrei Shpakou
- Yanka Kupala State University of Grodno, Belarus, University of Medical Science of Bialystok, Poland
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Sá-Sousa A, Jacinto T, Azevedo LF, Morais-Almeida M, Robalo-Cordeiro C, Bugalho-Almeida A, Bousquet J, Fonseca JA. Operational definitions of asthma in recent epidemiological studies are inconsistent. Clin Transl Allergy 2014; 4:24. [PMID: 25136441 PMCID: PMC4136946 DOI: 10.1186/2045-7022-4-24] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/15/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The best combination of questions to define asthma in epidemiological asthma studies is not known. We summarized the operational definitions of asthma used in prevalence studies and empirically assess how asthma prevalence estimates vary depending on the definition used. METHODS We searched the Thomson Reuters ISI Web of knowledge and included (1) cross-sectional studies (2) on asthma prevalence (3) conducted in the general population and (4) containing an explicit definition of asthma. The search was limited to the 100 most-cited papers or published since January 2010. For each paper, we recorded the asthma definition used and other variables. Then we applied the definitions to the data of the Portuguese National Asthma survey (INAsma) and of the 2005-2006 National Health and Nutrition Examination Survey (NHANES) computing asthma prevalence estimates for the different definitions. RESULTS Of 1738 papers retrieved, 117 were included for analysis. Lifetime asthma, diagnosed asthma and current asthma were defined in 8, 12 and 29 different ways, respectively. By applying definitions of current asthma on INAsma and NHANES data, the prevalence ranged between 5.3%-24.4% and 1.1%-17.2%, respectively. CONCLUSIONS There is considerable heterogeneity in the definitions of asthma used in epidemiological studies leading to highly variable estimates of asthma prevalence. Studies to inform a standardized operational definition are needed. Meanwhile, we propose a set of questions to be reported when defining asthma in epidemiological studies.
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Affiliation(s)
- Ana Sá-Sousa
- Center for research in health technologies and information systems.– CINTESIS, Universidade do Porto, Porto, Portugal
| | - Tiago Jacinto
- Center for research in health technologies and information systems.– CINTESIS, Universidade do Porto, Porto, Portugal
- Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal
| | - Luís Filipe Azevedo
- Center for research in health technologies and information systems.– CINTESIS, Universidade do Porto, Porto, Portugal
- Health Information and Decision Sciences Department – CIDES, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Mário Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisboa, Portugal
| | - Carlos Robalo-Cordeiro
- Allergy and Clinical Immunology Department, Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | | | - Jean Bousquet
- Hôpital Arnaud de Villeneuve, Centre Hospitalier Universitaire Montpellier, Montpellier, France
- Centre de recherche en Epidémiologie et Santé des Populations, CESP Inserm U1018, Villejuif, France
| | - João Almeida Fonseca
- Center for research in health technologies and information systems.– CINTESIS, Universidade do Porto, Porto, Portugal
- Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal
- Health Information and Decision Sciences Department – CIDES, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
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Underdiagnosis of childhood asthma: A comparison of survey estimates to clinical evaluation. Int J Occup Med Environ Health 2014; 26:900-9. [PMID: 24464568 DOI: 10.2478/s13382-013-0162-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 11/28/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Diagnostic patterns play a role in asthma prevalence estimates and could have implications for disease management. We sought to determine the extent to which questionnaire-derived estimates of childhood asthma reflect the disease's true occurrence. MATERIALS AND METHODS Children aged 6-12 years from Katowice, Poland, were recruited from a cross-sectional survey (N = 1822) via primary schools. Students were categorized into three mutually exclusive groups based on survey responses: "Asthma" (previously diagnosed asthma); "Respiratory symptoms" (no previous diagnosis of asthma and one or more respiratory symptoms during last year), "No respiratory symptoms" (no previous diagnosis of asthma or respiratory symptoms). A sample of children from each group (total N = 456) completed clinical testing to determine asthma presence according to GINA recommendations. RESULTS Based on the survey, 5.4% of children were classified with asthma, 27.9% with respiratory symptoms, and 66.7% with no respiratory symptoms or asthma. All previously known 41 cases of asthma were confirmed. New diagnoses of asthma were made in 21 (10.9%) and 8 (3.6%) of subjects from the "Respiratory symptoms" (N = 192) and "No respiratory symptoms" (N = 223) groups, respectively. The overall prevalence of childhood asthma, incorporating the results of clinical examination, was 10.8% (95% CI: 9.4-12.2), compared to the questionnaire-derived figure of 5.4% (95% CI: 4.4-6.5%) and affected females more than males. CONCLUSIONS Asthma prevalence was underestimated in this population possibly resulting from under-presentation or under-diagnosis. This could have potential implications for proper management and well-being of children. Questionnaire estimates of prevalence should be considered carefully in the context of regional diagnostic patterns.
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Hur K, Liang J, Lin SY. The role of secondhand smoke in allergic rhinitis: a systematic review. Int Forum Allergy Rhinol 2013; 4:110-6. [DOI: 10.1002/alr.21246] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 09/22/2013] [Accepted: 10/04/2013] [Indexed: 01/25/2023]
Affiliation(s)
- Kevin Hur
- Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins University; Baltimore MD
| | - Jonathan Liang
- Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins University; Baltimore MD
| | - Sandra Y. Lin
- Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins University; Baltimore MD
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Kraai S, Verhagen LM, Valladares E, Goecke J, Rasquin L, Colmenares P, Del Nogal B, Hermans PW, de Waard JH. High prevalence of asthma symptoms in Warao Amerindian children in Venezuela is significantly associated with open-fire cooking: a cross-sectional observational study. Respir Res 2013; 14:76. [PMID: 23870058 PMCID: PMC3723947 DOI: 10.1186/1465-9921-14-76] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 07/15/2013] [Indexed: 11/16/2022] Open
Abstract
Background The International Study on Asthma and Allergies in Childhood (ISAAC) reported a prevalence of asthma symptoms in 17 centers in nine Latin American countries that was similar to prevalence rates reported in non-tropical countries. It has been proposed that the continuous exposure to infectious diseases in rural populations residing in tropical areas leads to a relatively low prevalence of asthma symptoms. As almost a quarter of Latin American people live in rural tropical areas, the encountered high prevalence of asthma symptoms is remarkable. Wood smoke exposure and environmental tobacco smoke have been identified as possible risk factors for having asthma symptoms. Methods We performed a cross-sectional observational study from June 1, 2012 to September 30, 2012 in which we interviewed parents and guardians of Warao Amerindian children from Venezuela. Asthma symptoms were defined according to the ISAAC definition as self-reported wheezing in the last 12 months. The associations between wood smoke exposure and environmental tobacco smoke and the prevalence of asthma symptoms were calculated by means of univariate and multivariable logistic regression analyses. Results We included 630 children between two and ten years of age. Asthma symptoms were recorded in 164 of these children (26%). The prevalence of asthma symptoms was associated with the cooking method. Children exposed to the smoke produced by cooking on open wood fires were at higher risk of having asthma symptoms compared to children exposed to cooking with gas (AOR 2.12, 95% CI 1.18 - 3.84). Four percent of the children lived in a household where more than ten cigarettes were smoked per day and they had a higher risk of having asthma symptoms compared to children who were not exposed to cigarette smoke (AOR 2.69, 95% CI 1.11 - 6.48). Conclusion Our findings suggest that children living in rural settings in a household where wood is used for cooking or where more than ten cigarettes are smoked daily have a higher risk of having asthma symptoms.
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