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Worldwide time trends in prevalence of symptoms of rhinoconjunctivitis in children: Global Asthma Network Phase I

Strachan, David P, Rutter, Charlotte E, Asher, M Innes, Bissell, K, Chiang, Chen-Yuan, El Sony, Asma, Ellwood, Eamon, Ellwood, Philippa, García-Marcos, Luis, Marks, Guy B, Morales, Eva, Mortimer, Kevin ORCID: https://orcid.org/0000-0002-8118-8871, Pearce, Neil, Pérez-Fernández, Virginia, Robertson, Steven and Silverwood, Richard J (2021) 'Worldwide time trends in prevalence of symptoms of rhinoconjunctivitis in children: Global Asthma Network Phase I'. Pediatric Allergy and Immunology. (In Press)

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Abstract

BACKGROUND
The Global Asthma Network (GAN), by using the International Study of Asthma and Allergies in Childhood (ISAAC) methodology, has updated trends in prevalence of symptoms of childhood allergic diseases, including non-infective rhinitis and conjunctivitis ("rhinoconjunctivitis") which is reported here.

METHODS
Prevalence and severity of rhinoconjunctivitis were assessed by questionnaire among schoolchildren in GAN Phase I and ISAAC Phases I and III surveys 15-23 years apart. Absolute rates of change in prevalence were estimated for each centre and modelled by multi-level linear regression to compare trends by age group, time period and per-capita national income.

RESULTS
27 GAN centres in 14 countries surveyed 74,361 13-14-year-olds ("adolescents") and 45,434 6-7-year-olds ("children"), with average response proportions of 90% and 79% respectively. Many centres showed highly significant (p<0.001) changes in prevalence of rhinoconjunctivitis in the past year ("current rhinoconjunctivitis"), compared to ISAAC. The direction and magnitude of centre-level trends varied significantly (p<0.001) both within and between countries. Overall, current rhinoconjunctivitis prevalence decreased slightly from ISAAC Phase III to GAN: -1.32% per 10 years, 95%CI [-2.93%, +0.30%] among adolescents; -0.44% [-1.29%, +0.42%] among children. Together, these differed significantly (p<0.001) from the upward trend within ISAAC. Among adolescents, centre-level trends in current rhinoconjunctivitis were highly correlated with those for eczema symptoms (rho=0.72, p<0.0001) but not with centre-level trends in asthma symptoms (rho=0.15, p=0.48). Among children, these correlations were positive but not significant.

CONCLUSION
Symptoms of non-infective rhinoconjunctivitis among schoolchildren may no longer be on the increase globally, although trends vary substantially within and between countries.

Item Type: Article
Subjects: QW Microbiology and Immunology > Immunotherapy and Hypersensitivity > QW 900 Anaphylaxis and hypersensitivity. Allergens
WF Respiratory System > WF 100 General works
WF Respiratory System > WF 140 Diseases of the respiratory system (General)
WS Pediatrics > Diseases of Children and Adolescents > By System > WS 280 Respiratory system
WV Otolaryngology > Nose and Paranasal Sinuses > WV 300 General works
WW Ophthalmology > Diseases. Color Perception > WW 160 Eye infections. Hypersensitivity diseases (General or not elsewhere classified)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1111/pai.13656
Depositing User: Julie Franco
Date Deposited: 09 Sep 2021 12:42
Last Modified: 09 Sep 2021 12:43
URI: https://archive.lstmed.ac.uk/id/eprint/18837

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