233 research outputs found
Early life exposure to farm animals and symptoms of asthma, rhinoconjunctivitis and eczema : an ISAAC Phase Three study
No full textWe are grateful to the children and parents who willingly
cooperated and participated in ISAAC Phase
Three and the coordination and assistance by the
school staff is sincerely appreciated. The authors also
acknowledge and thank the many funding bodies
throughout the world that supported the individual
ISAAC centres and collaborators and their meetings.
The funders of the study had no role in study design;
in the collection, analysis, and interpretation of data;
in the writing of the report; or in the decision to
submit the paper for publication.Background: Associations between early life exposure to farm animals and respiratory symptoms and allergy in children have been reported in developed countries, but little is known about such associations in developing countries.
Objective: To study the association between early life exposure to farm animals and symptoms of asthma, rhinoconjunctivitis and eczema in a worldwide study.
Methods: Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) was carried out in 6- to 7-year-old children in urban populations across the world. Questions about early life exposure to farm animals (at least once/week) were included in an additional questionnaire. The association between such exposures and symptoms of asthma, rhinoconjunctivitis and eczema was investigated with logistic regression. Adjustments were made for gender, region of the world, language, gross national income and 10 other subject-specific covariates.
Results: A positive association was found between early exposure to farm animals and the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema, especially in non-affluent countries. In these countries, odds ratios (ORs) for 'current wheeze', 'farm animal exposure in the first year of life' and 'farm animal exposure in pregnancy' were 1.27 [95% confidence interval (CI) 1.12-1.44] and 1.38 (95% CI 1.21-1.58), respectively. The corresponding ORs for affluent countries were 0.96 (95% CI 0.86-1.08) and 0.95 (95% CI 0.84-1.08), respectively.
Conclusion: Exposure to farm animals during pregnancy and in the first year of life was associated with increased symptoms of asthma, rhinoconjunctivitis and eczema in 6- to 7-year-old children living in non-affluent but not in affluent countries.peer-reviewe
The association between tobacco and the risk of asthma, rhinoconjunctivitis and eczema in children and adolescents : analyses from Phase Three of the ISAAC programme
No full textWe are grateful to the children and parents who participated
in ISAAC Phase Three and the coordination and assistance by the school staff is
sincerely appreciated. The authors also acknowledge and thank the many funding
bodies throughout the world that supported the individual ISAAC centres and
collaborators and their meetings.Background: Exposure to parental smoking is associated
with wheeze in early childhood, but in 2006 the US
Surgeon General stated that the evidence is insufficient
to infer a causal relationship between exposure and
asthma in childhood and adolescents.
Aims:To examine the association between maternal and
paternal smoking and symptoms of asthma, eczema and
rhinoconjunctivitis.
Methods: Parents or guardians of children aged
6-7 years completed written questionnaires about
symptoms of asthma, rhinoconjunctivitis and eczema,
and several risk factors, including maternal smoking in
the child’s first year of life, current maternal smoking
(and amount) and paternal smoking. Adolescents aged
13-14 years self completed the questionnaires on these
symptoms and whether their parents currently smoked.
Results: In the 6-7-year age group there were 220 407
children from 75 centres in 32 countries. In the 13-14-
year age group there were 350 654 adolescents from
118 centres in 53 countries. Maternal and paternal
smoking was associated with an increased risk of
symptoms of asthma, eczema and rhinoconjunctivitis in
both age groups, although the magnitude of the OR is
higher for symptoms of asthma than the other outcomes.
Maternal smoking is associated with higher ORs than
paternal smoking. For asthma symptoms there is a clear
dose relationship (1e9 cigarettes/day, OR 1.27; 10-19
cigarettes/day, OR 1.35; and 20+ cigarettes/day, OR
1.56). When maternal smoking in the child’s first year of
life and current maternal smoking are considered, the
main effect is due to maternal smoking in the child’s first
year of life. There was no interaction between maternal
and paternal smoking.
Conclusions: This study has confirmed the importance
of maternal smoking, and the separate and additional
effect of paternal smoking. The presence of
a dose-response effect relationship with asthma
symptoms suggests that the relationship is causal,
however for eczema and rhinoconjunctivitis causality is
less certain.peer-reviewe
Translation of questions: the international study of asthma and allergies in childhood (ISAAC) experience
No full textOBJECTIVE:
To explore the consequences of translating the International Study of Asthma and Allergies in Childhood (ISAAC) English core questionnaires on asthma, rhinitis and eczema symptoms into other languages.
DESIGN:
ISAAC Phase III developed 49 language translations for adolescents and 42 for children following standardised guidelines, which included back-translating the questionnaires into English to check their accuracy and meaning. Language deviations were categorised and analysed with regard to influences on the reported symptom prevalence.
RESULTS:
Category 1 deviations for one or more questions were found in seven translations (14%) for adolescents and in three translations (7%) for children. Data for these questions were excluded from the worldwide analyses. Category 2 deviations were identified in the publications, and Category 3 deviations were ignored.
CONCLUSIONS:
Translations of questionnaires should follow a consistent protocol in global epidemiological research. Cultural norms need to be considered when evaluating back-translations into English, as disease labels are not available in every language, nor are they understood in the same way. Deviations from literal translations of English should be permitted if the intent of the original meaning is retained. A web-based tool of medical terminology would be useful for international research requiring the use of translations
The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three: A global synthesis
No full textThis ISAAC Phase Three synthesis provides summarised information on the main findings of the study, regional tables and figures related to the prevalence and severity of current symptoms of asthma, rhinoconjunctivitis and eczema in the main regions of the world. The large number of surveyed children (≈1,200,000), the large number of centres (233) and countries (98) that participated in ISAAC Phase Three makes this study the most comprehensive survey of these diseases ever undertaken. Globally, the prevalence for current asthma, rhinoconjunctivitis and eczema in the 13-14-year age group was 14.1%, 14.6% and 7.3%, respectively. In the 6-7-year age group the prevalence for current asthma, rhinoconjunctivitis and eczema was 11.7%, 8.5% and 7.9%, respectively. The study shows a wide variability in the prevalence and severity of asthma, rhinoconjunctivitis and eczema which occurs not just between regions and countries but between centres in the same country and centres in the same city. This study definitively establishes that the prevalence of those diseases can be very high in non-affluent centres with low socioeconomic conditions. The large variability also suggests a crucial role of local environment characteristics to determine the differences in prevalence between one place and another. Thus, ISAAC Phase Three has provided a large body of epidemiological information on asthma, rhinoconjunctivitis and eczema in childhood from contrasting environments which is expected to yield new clues about the aetiology of those conditions and reasons for their marked global variability. © 2012 SEICAP
Global variation in the prevalence and severity of asthma symptoms : phase three of the International Study of Asthma and Allergies in Childhood (ISAAC)
No full textBackground: Phase Three of the International Study of
Asthma and Allergies in Childhood (ISAAC) measured the
global prevalence and severity of asthma symptoms in
children.
Methods: A cross-sectional questionnaire survey of
798 685 children aged 13–14 years from 233 centres in
97 countries, and 388 811 children aged 6–7 years from
144 centres in 61 countries, was conducted between
2000 and 2003 in .90% of the centres.
Results: The prevalence of wheeze in the past 12 months
(current wheeze) ranged from 0.8% in Tibet (China) to
32.6% in Wellington (New Zealand) in the 13–14 year olds,
and from 2.4% in Jodhpur (India) to 37.6% in Costa Rica in
the 6–7 year olds. The prevalence of symptoms of severe
asthma, defined as >4 attacks of wheeze or >1 night per
week sleep disturbance from wheeze or wheeze affecting
speech in the past 12 months, ranged from 0.1% in Pune
(India) to 16% in Costa Rica in the 13–14 year olds and from
0% to 20.3% in the same two centres, respectively, in the
6–7 year olds. Ecological economic analyses revealed a
significant trend towards a higher prevalence of current
wheeze in centres in higher income countries in both age
groups, but this trend was reversed for the prevalence of
severe symptoms among current wheezers, especially in
the older age group.
Conclusion: Wide variations exist in the symptom
prevalence of childhood asthma worldwide. Although
asthma symptoms tend to be more prevalent in more
affluent countries, they appear to be more severe in less
affluent countries.peer-reviewe
Acetaminophen use and risk of asthma, rhinoconjunctivitis and eczema in adolescents : ISAAC Phase Three
No full textRationale: There is epidemiological evidence that the use of acetaminophen may increase the risk of developing asthma. Objectives: To investigate the risk of asthma and other allergic disorders associated with the current use of acetaminophen in 13- to 14-year-old children in different populations worldwide. Methods: As part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three, 13- to 14-year-old children completed written and video questionnaires obtaining data on current symptoms of asthma, rhinoconjunctivitis, and eczema, and a written environmental questionnaire obtaining data on putative risk factors, including acetaminophen use in the past 12 months. Measurements and Main Results: The primary outcome measure was the odds ratio (OR) of current asthma symptoms associated with acetaminophen use calculated by logistic regression. A total of 322,959 adolescent children from 113 centers in 50 countries participated. In the multivariate analyses the recent use of acetaminophen was associated with an exposure-dependent increased risk of current asthma symptoms (OR, 1.43 [95% confidence interval, 1.33–1.53] and 2.51 [95% confidence interval, 2.33–2.70] for medium and high versus no use, respectively). Acetaminophen use was also associated with an exposure-dependent increased risk of current symptoms of rhinoconjunctivitis and eczema. Conclusions: Acetaminophen use may represent an important risk factor for the development and/or maintenance of asthma, rhinoconjunctivitis, and eczema in adolescent children.peer-reviewe
Which population level environmental factors are associated with asthma, rhinoconjunctivitis and eczema? Review of the ecological analyses of ISAAC Phase One.
No full textThe International Study of Asthma and Allergies in Childhood (ISAAC) Phase One showed large worldwide variations in the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema, up to 10 to 20 fold between countries. Ecological analyses were undertaken with ISAAC Phase One data to explore factors that may have contributed to these variations, and are summarised and reviewed here.In ISAAC Phase One the prevalence of symptoms in the past 12 months of asthma, rhinoconjunctivitis and eczema were estimated from studies in 463,801 children aged 13 - 14 years in 155 centres in 56 countries, and in 257,800 children aged 6-7 years in 91 centres in 38 countries. Ecological analyses were undertaken between symptom prevalence and the following: Gross National Product per capita (GNP), food intake, immunisation rates, tuberculosis notifications, climatic factors, tobacco consumption, pollen, antibiotic sales, paracetamol sales, and outdoor air pollution.Symptom prevalence of all three conditions was positively associated with GNP, trans fatty acids, paracetamol, and women smoking, and inversely associated with food of plant origin, pollen, immunisations, tuberculosis notifications, air pollution, and men smoking. The magnitude of these associations was small, but consistent in direction between conditions. There were mixed associations of climate and antibiotic sales with symptom prevalence.The potential causality of these associations warrant further investigation. Factors which prevent the development of these conditions, or where there is an absence of a positive correlation at a population level may be as important from the policy viewpoint as a focus on the positive risk factors. Interventions based on small associations may have the potential for a large public health benefit
Siblings, asthma, rhinoconjunctivitis and eczema: a worldwide perspective from the International Study of Asthma and Allergies in Childhood.
No full textBACKGROUND: Associations of larger families with lower prevalences of hay fever, eczema and objective markers of allergic sensitization have been found fairly consistently in affluent countries, but little is known about these relationships in less affluent countries.
METHODS: Questionnaire data for 210,200 children aged 6-7 years from 31 countries, and 337,226 children aged 13-14 years from 52 countries, were collected by Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC). Associations of disease symptoms and labels of asthma, rhinoconjunctivitis and eczema were analysed by numbers of total, older and younger siblings, using mixed (multi-level) logistic regression models to adjust for individual covariates and at the centre level for region, language and national affluence.
RESULTS: In both age groups, inverse trends (P < 0.0001) were observed for reported 'hay fever ever' and 'eczema ever' with increasing numbers of total siblings, and more specifically older siblings. These inverse associations were significantly (P < 0.005) stronger in more affluent countries. In contrast, symptoms of severe asthma and severe eczema were positively associated (P < 0.0001) with total sibship size in both age groups. These associations with disease severity were largely independent of position within the sibship and national GNI per capita.
CONCLUSIONS: These global findings on sibship size and childhood asthma, rhinoconjunctivitis and eczema suggest at least two distinct trends. Inverse associations with older siblings (observations which prompted the 'hygiene hypothesis' for allergic disease) are mainly a phenomenon of more affluent countries, whereas greater severity of symptoms in larger families is globally more widespread
The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three: A global synthesis
No full textThis ISAAC Phase Three synthesis provides summarised information on the main findings of the study, regional tables and figures related to the prevalence and severity of current symptoms of asthma, rhinoconjunctivitis and eczema in the main regions of the world. The large number of surveyed children (≈1,200,000), the large number of centres (233) and countries (98) that participated in ISAAC Phase Three makes this study the most comprehensive survey of these diseases ever undertaken. Globally, the prevalence for current asthma, rhinoconjunctivitis and eczema in the 13-14-year age group was 14.1%, 14.6% and 7.3%, respectively. In the 6-7-year age group the prevalence for current asthma, rhinoconjunctivitis and eczema was 11.7%, 8.5% and 7.9%, respectively. The study shows a wide variability in the prevalence and severity of asthma, rhinoconjunctivitis and eczema which occurs not just between regions and countries but between centres in the same country and centres in the same city. This study definitively establishes that the prevalence of those diseases can be very high in non-affluent centres with low socioeconomic conditions. The large variability also suggests a crucial role of local environment characteristics to determine the differences in prevalence between one place and another. Thus, ISAAC Phase Three has provided a large body of epidemiological information on asthma, rhinoconjunctivitis and eczema in childhood from contrasting environments which is expected to yield new clues about the aetiology of those conditions and reasons for their marked global variability
Childhood intermittent and persistent rhinitis prevalence and climate and vegetation: A global ecologic analysis
No full textBackground: The effect of climate change and its effects on vegetation growth, and consequently on rhinitis,are uncertain.Objective: To examine between- and within-country associations of climate measures and the normalizeddifference vegetation index with intermittent and persistent rhinitis symptoms in a global context.Methods: Questionnaire data from 6- to 7-year-olds and 13- to 14-year-olds were collected in phase 3 of theInternational Study of Asthma and Allergies in Childhood. Associations of intermittent (>1 symptom reportbut not for 2 consecutive months) and persistent (symptoms for -2 consecutive months) rhinitis symptomprevalences with temperature, precipitation, vapor pressure, and the normalized difference vegetation indexwere assessed in linear mixed-effects regression models adjusted for gross national income and populationdensity. The mean difference in prevalence per 100 children (with 95% confidence intervals [CIs]) perinterquartile range increase of exposure is reported.Results: The country-level intermittent symptom prevalence was associated with several country-levelclimatic measures, including the country-level mean monthly temperature (6.09-C; 95% CI, 2.06e10.11-C per 10.4-C), precipitation (3.10 mm; 95% CI, 0.46e5.73 mm; per 67.0 mm), and vapor pressure(6.21 hPa; 95% CI, 2.17e10.24 hPa; per 10.4 hPa) among 13- to 14-year-olds (222 center in 94 countries).The center-level persistent symptom prevalence was positively associated with several center-level climaticmeasures. Associations with climate were also found for the 6- to 7-year-olds (132 center in 57countries).Conclusion: Several between- and within-country spatial associations between climatic factors and intermittentand persistent rhinitis symptom prevalences were observed. These results provide suggestive evidencethat climate (and future changes in climate) may influence rhinitis symptom prevalence
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