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International Study (international + study)
Terms modified by International Study Selected Abstracts,I have no interest in drinking': a cross-national comparison of reasons why men and women abstain from alcohol useADDICTION, Issue 10 2009Sharon Bernards ABSTRACT Aims To examine country differences in reasons for abstaining including the association of reasons with country abstaining rate and drinking pattern. Participants Samples of men and women from eight countries participating in the GENACIS (Gender Alcohol and Culture: an International Study) project. Methods Surveys were conducted with 3338 life-time abstainers and 3105 former drinkers. Respondents selected all applicable reasons for not drinking from a provided list. Analyses included two-level hierarchical linear modelling (HLM) regression. Findings Reasons for abstaining differed significantly for life-time abstainers compared to former drinkers, by gender and age, and by country-level abstaining rate and frequency of drinking. Life-time abstainers were more likely than former drinkers to endorse ,no interest', ,religion' and ,upbringing' and more reasons overall. Gender differences, especially among former drinkers, suggested that norms restricting drinking may influence reasons that women abstain (,no interest', ,not liking taste') while drinking experiences may be more important considerations for men (,afraid of alcohol problems', ,bad effect on activities'). Younger age was associated with normative reasons (,no interest', ,taste', ,waste of money') and possibly bad experiences (,afraid of problems'). Reasons such as ,religion', ,waste of money' and ,afraid of alcohol problems' were associated with higher country-level rates of abstaining. Higher endorsement of ,drinking is bad for health' and ,taste' were associated with a country pattern of less frequent drinking while ,not liking effects' was associated with higher drinking frequency. Conclusions Reasons for abstaining depend on type of abstainer, gender, age and country drinking norms and patterns. [source] The importance of drinking frequency in evaluating individuals' drinking patterns: implications for the development of national drinking guidelinesADDICTION, Issue 7 2009Catherine Paradis ABSTRACT Aims This paper examines the relationship between frequency of drinking, usual daily consumption and frequency of binge drinking, taking into consideration possible age and gender differences. Participants and design Subjects were 10 466 current drinkers (5743 women and 4723 men) aged between 18 and 76 years, who participated in the GENACIS Canada (GENder Alcohol and Culture: an International Study) study. Setting Canada. Measurements The independent variable was the annual drinking frequency. The dependent variables were the usual daily quantity consumed, annual, monthly and weekly frequency of binge drinking (five drinks or more on one occasion). Findings Logistic regressions show (i) that those who drink less than once a week are less likely than weekly drinkers to take more than two drinks when they do drink; (ii) that the usual daily quantity consumed by weekly drinkers is not related to their frequency of drinking; but that (iii) the risk and frequency of binge drinking increase with the frequency of drinking. Conclusions Given that risk and frequency of binge drinking among Canadians increases with their frequency of drinking, any public recommendation to drink moderately should be made with great caution. [source] Addiction research centres and the nurturing of creativity: The Swiss Institute for the Prevention of Alcohol and Drug Problems.ADDICTION, Issue 5 2009future, present ABSTRACT The aim of this paper is to offer an account of the history, the current status and the future of substance use research at the Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA). Although founded originally by the temperance movement in 1901, its policy has shifted over time towards one which accepts an alcohol-consuming culture made up of self-determined but well-informed consumers, while still supporting those who choose to live an abstinent life. In the beginning, SIPA was involved primarily in collecting alcohol-related information and making it available to professionals and the general public. From the late 1960s SIPA began conducting its own research projects; by the mid-1970s it had set up its own in-house research department. In 2001, SIPA was appointed a World Health Organization (WHO) Collaborating Centre for Substance Abuse, Research, Prevention and Documentation. As a private non-governmental organization, most of its funding comes from external research commissions. SIPA participates in a variety of international projects [e.g. Gender Alcohol and Culture: An International Study (GenACIS), European School Survey Project on Alcohol and Drugs (ESPAD) and Health Behaviour in School-aged Children (HBSC)] and contributes to numerous national research projects dealing with substance use. It has also forged close links with more than 50 other research institutions in Switzerland and world-wide. Thanks to its work over the last 30 years, SIPA has become a chief port of call for alcohol use research in Switzerland. In the future, SIPA will continue to monitor substance use, while stepping up its prevention research activities and ensuring that it is able to react more promptly to emerging phenomena. [source] Disclosure Practices, Enforcement of Accounting Standards, and Analysts' Forecast Accuracy: An International StudyJOURNAL OF ACCOUNTING RESEARCH, Issue 2 2003Ole-Kristian Hope Using a sample from 22 countries, I investigate the relations between the accuracy of analysts' earnings forecasts and the level of annual report disclosure, and between forecast accuracy and the degree of enforcement of accounting standards. I document that firm-level disclosures are positively related to forecast accuracy, suggesting that such disclosures provide useful information to analysts. I construct a comprehensive measure of enforcement and find that strong enforcement is associated with higher forecast accuracy. This finding is consistent with the hypothesis that enforcement encourages managers to follow prescribed accounting rules, which, in turn, reduces analysts' uncertainty about future earnings. I also find evidence consistent with disclosures being more important when analyst following is low and with enforcement being more important when more choice among accounting methods is allowed. [source] Cross-sectional survey of risk factors for asthma in 6,7-year-old children in New Zealand: International Study of Asthma and Allergy in Childhood Phase ThreeJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2009Edwin A Mitchell Aim: To identify risk factors for asthma in primary school-aged children in New Zealand. Methods: A cross-sectional survey of 10 873 6,7-year-old children in Auckland, Bay of Plenty, Nelson and Christchurch (a response rate of 85.2%). A questionnaire was completed by the parent or care giver. Results: 22.2% of children wheezed in the last 12 months (current wheeze). Maori children were at greater risk of current wheeze compared with European children (adjusted odds ratio (adjOR) = 1.37; 95% confidence interval = 1.18,1.59). Antibiotics and paracetamol used in the first year of life were associated with an increased risk of current wheeze (adjOR = 1.78 (1.56,2.04) and adjOR = 1.31 (1.06,1.61), respectively). Watching television for 5 or more hours per day was associated with an increased risk of current wheeze (adjOR = 1.44 (1.13,1.83)). Milk and egg consumption in the last 12 months was associated with a reduced risk of current wheeze. Conclusions: This study has identified risk factors for asthma in children aged 6,7 years, although causal pathways cannot be established. These associations have important public health implications if causal. [source] Consumption of vegetables, fruit, and antioxidants during pregnancy and wheeze and eczema in infantsALLERGY, Issue 6 2010Y. Miyake To cite this article: Miyake Y, Sasaki S, Tanaka K, Hirota Y. Consumption of vegetables, fruit, and antioxidants during pregnancy and wheeze and eczema in infants. Allergy 2010; 65: 758,765. Abstract Background:, Two previous cohort studies showed inverse relationships between maternal vitamin E and zinc intake during pregnancy and the risk of wheeze and/or asthma in the offspring. We investigated the association between maternal intake of vegetables, fruit, and selected antioxidants during pregnancy and the risk of wheeze and eczema in the offspring aged 16,24 months. Methods:, Subjects were 763 Japanese mother,child pairs. Data on maternal intake during pregnancy were assessed with a diet history questionnaire. Data on symptoms of wheeze and eczema were based on criteria of the International Study of Asthma and Allergies in Childhood. Results:, Higher maternal intake of green and yellow vegetables, citrus fruit, and ,-carotene during pregnancy was significantly associated with a reduced risk of eczema, but not wheeze, in the offspring {adjusted odds ratios (ORs) between extreme quartiles [95% confidence intervals (CIs)] = 0.41 (0.24,0.71), 0.53 (0.30,0.93), and 0.52 (0.30,0.89), respectively}. Maternal vitamin E consumption during pregnancy was significantly inversely related to the risk of infantile wheeze, but not eczema [adjusted OR (95% CI) = 0.54 (0.32,0.90)]. No statistically significant exposure,response associations were observed between maternal intake of total vegetables, vegetables other than green and yellow vegetables, total fruit, apples, ,-carotene, vitamin C, or zinc and the risk of wheeze or eczema in the children. Conclusions:, Higher maternal consumption of green and yellow vegetables, citrus fruit, and ,-carotene during pregnancy may be protective against the development of eczema in the offspring. Higher maternal vitamin E intake during pregnancy may reduce the risk of infantile wheeze. [source] International variations in associations of allergic markers and diseases in children: ISAAC Phase TwoALLERGY, Issue 6 2010G. Weinmayr To cite this article: Weinmayr G, Genuneit J, Nagel G, Björkstén B, van Hage M, Priftanji A, Cooper P, Rijkjärv M-A, von Mutius E, Tsanakas J, Forastiere F, Doekes G, Garrido JB, Suarez-Varela MM, Bråbäck L, Strachan DP, the ISAAC Phase Two Study Group. International variations in associations of allergic markers and diseases in children: ISAAC Phase Two. Allergy 2010; 65: 766,775. Abstract Background:, Circulating allergen-specific IgE (sIgE) and skin prick tests (SPT) are used to define atopy. Downregulation of local inflammatory responsiveness has been proposed to explain a low prevalence of positive SPTs in less affluent countries. We analysed the association between SPTs, total and allergen-specific IgE and their relationships to allergic symptoms in centres with diverse living conditions. Methods:, Cross-sectional studies of stratified random samples of 8 to 12-year-old children (n = 7461) used the standardized methodology of Phase Two of the International Study of Asthma and Allergies in Childhood (ISAAC). Symptoms of asthma, rhinitis and eczema were ascertained by parental questionnaires. Skin examination, hypertonic saline bronchial challenge, six aeroallergen SPTs and measurements of serum total IgE and sIgE were performed. Results:, In nonaffluent countries, a higher proportion of children with positive SPT had no detectable sIgE (range 37,61%) than in affluent countries (0,37%). Total serum IgE was associated with all disease outcomes among children with both positive SPT and sIgE (P < 0.001), but only with self-reported eczema in children with negative SPTs and negative sIgE. Conclusions:, The international pattern of discordance between SPT and sIgE results did not support the downregulation hypothesis. Among children with no evidence of sensitization to common aeroallergens, increased total IgE contributes little to the risk of wheeze and rhinitis in the general population but may play a role in eczema. [source] Alternaria sensitization and allergic rhinitis with or without asthma in the French Six Cities studyALLERGY, Issue 3 2010Z. A. Randriamanantany To cite this article: Randriamanantany ZA, Annesi-Maesano I, Moreau D, Raherison C, Charpin D, Kopferschmitt C, Lavaud F, Taytard A, De Blay F, Caillaud D. Alternaria sensitization and allergic rhinitis with or without asthma in the French Six Cities study. Allergy 2010; 65: 368,375. Abstract Background:, Allergic sensitization to Alternaria has been related to asthma in various studies, but its association with allergic rhinitis is still controversial. Objectives:, The aim of this study was to assess at the population level the relationships in childhood between Alternaria sensitization and ,past-year rhinoconjunctivitis' (PYRC), ,ever hay fever' (EHF) and ,ever allergic rhinitis caused by allergens other than pollens' (EAR) according to the presence or the absence of asthma. Methods:, This study is part of the Six Cities Study, the French contribution to the International Study of Asthma and Allergies in Childhood (ISAAC) Phase II. Children underwent skin prick test (SPT) to Alternaria and parents filled a standardized medical questionnaire. Results:, Some 6726 children with a mean age of 10 years were examined. The overall prevalence of Alternaria sensitization was 2.8%, 0.8% for monosensitization. Prevalences of symptoms in sensitized children were 27.7% for PYRC, 27.0% for EHF and 30.4% for EAR. Adjusted Odds Ratios (OR) between Alternaria sensitization and allergic rhinitis phenotypes were 2.34 (95% confidence interval: 1.51,3.63) for PYRC, 2.40 (1.65,3.50) for EHF and 2.95 (2.05,4.23) for EAR. The relationship still remained in the case of monosensitization to Alternaria for both PYRC and EAR when excluding the asthmatic children [OR = 3.87 (1.54,9.78) and 2.88 (1.10,7.55) respectively]. Conclusion:, In our population-based sample of children, we found a link between Alternaria sensitization and allergic rhinitis, independently of asthma, which is compatible with the mechanisms of deposition of Alternaria in the upper airways. [source] Genetic variation in CRTh2 influences development of allergic phenotypesALLERGY, Issue 10 2009L. Cameron Background:, Allergic disorders are characterized by an increase in the Th2 cytokines IL-4, IL-5 and IL-13, produced primarily by Th2 cells. These cells are marked by the expression of CRTh2 (chemoattractant receptor-homologous molecule expressed on Th2 cells), a receptor for prostaglandin D2. As genetic variation plays a significant role in the predisposition for allergic disorders, we investigated the influence of single nucleotide polymorphisms (SNPs) in CRTh2. Methods:, In a large study population of German children (n = 4264) from the International Study of Asthma and Allergy in Children (ISAAC II), six polymorphisms in CRTh2 were genotyped. Statistical analyses were performed using single SNP and haplotype analyses. Results:, Uncorrected associations among ,6373G>A, +1431G>C and +1538A>G were observed with a number of allergic phenotypes (P < 0.05). After correction, association between +1431C and specific IgE to food allergens remained significant (P = 0.04). Associations of haplotype (H)3 (containing +1538G) with reduced risk for asthma and H2 (containing +1431C) with increased risk for specific IgE to food allergens also remained significant after correction for multiple testing (P = 0.004). Conclusions:, Genetic variation within CRTh2 modifies the development of allergic sensitization and asthma in a population of German children. [source] Global map of the prevalence of symptoms of rhinoconjunctivitis in children: The International Study of Asthma and Allergies in Childhood (ISAAC) Phase ThreeALLERGY, Issue 1 2009N. Aït-Khaled Background:, Phase One of the International Study of Asthma and Allergies in Childhood (ISAAC) measured the global patterns of prevalence and severity of symptoms of rhinoconjunctivitis in children in 1993,1997. Methods:, International Study of Asthma and Allergies in Childhood Phase Three was a cross-sectional survey performed 5,10 years after Phase One using the same methodology. Phase Three covered all of the major regions of the world and involved 1 059 053 children of 2 age groups from 236 centres in 98 countries. Results:, The average overall prevalence of current rhinoconjunctivitis symptoms was 14.6% for the 13- to 14-year old children (range 1.0,45%). Variation in the prevalence of severe rhinoconjunctivitis symptoms was observed between centres (range 0.0,5.1%) and regions (range 0.4% in western Europe to 2.3% in Africa), with the highest prevalence being observed mainly in the centres from middle and low income countries, particularly in Africa and Latin America. Co-morbidity with asthma and eczema varied from 1.6% in the Indian sub-continent to 4.7% in North America. For 6- to 7-year old children, the average prevalence of rhinoconjunctivitis symptoms was 8.5%, and large variations in symptom prevalence were also observed between regions, countries and centres. Discussion:, Wide global variations exist in the prevalence of current rhinoconjunctivitis symptoms, being higher in high vs low income countries, but the prevalence of severe symptoms was greater in less affluent countries. Co-morbidity with asthma is high particularly in Africa, North America and Oceania. This global map of symptom prevalence is of clinical importance for health professionals. [source] Stabilization of asthma prevalence among adolescents and increase among schoolchildren (ISAAC phases I and III) in Spain,ALLERGY, Issue 12 2004L. García-Marcos Background:, Most studies show a steep increase in asthma prevalence in the last decades, although few studies had applied the same methodology. Recent reports point out the possibility that the epidemic has come to an end. We have studied the prevalence of asthma in a very large sample of children, repeating the study eight years apart. Methods:, Repeated cross-sectional studies using the International Study of Asthma and Allergies in Childhood (ISAAC) protocol in a sample of Spanish schoolchildren 6,7 (parent-reported) and 13,14 (self-reported) years old in 1994,95 (phase I) and 2002,2003 (phase III). The number of participants was 42 417 in phase I and 42 813 in phase III. The participation rate was over 87% (13,14 years) and 70% (6,7 years). Results:, The prevalence of wheezing in the previous year in children aged 13,14 years was 9.0 and 9.3% for boys and 9.6 and 9.2% for girls for phases I and III, respectively. Children 6,7 years of age showed a substantial increase in wheezing in the previous year (7.0 and 10.7% for boys and 5.3 and 8.2% for girls). Other symptoms and severity indexes followed the same patterns. Conclusions:, In the last 8 years, the prevalence of asthma has not changed in 13,14-year-old Spanish children but has increased substantially in 6,7-year olds. [source] Lower prevalence of reported asthma in adolescents with symptoms of rhinitis that received neonatal BCGALLERGY, Issue 8 2004S. S. da Cunha Background:, BCG is a vaccine used against tuberculosis and leprosy and is an immunostimulant that primes TH1 lymphocytes to produce cytokines that antagonize atopy both in animal models and in man. Considering that atopy is the main risk factor for asthma, one can hypothesize that vaccination inducing TH1 responses, such as BCG, can be protective against asthma. Methods:, Objective:,To estimate the association between neonatal BCG vaccination and prevalence of asthma among adolescents. Study design:,Cross-sectional study with schoolchildren aged 12,16 years. The presence of a scar compatible with BCG was used as a surrogate of neonatal vaccination. A self administered structured questionnaire was prepared based on that used by the International Study of Asthma and Allergies in Childhood. The prevalence of asthma was categorized according to the report of lifetime wheeze, lifetime asthma, lifetime asthma among those referring allergy and among those referring allergy and sneezing. Results:, Neonatal BCG vaccination was not associated with the overall prevalence of reported wheezing or asthma. However, in the subgroup reporting current allergy and sneezing, neonatal BCG was associated with a 37% reduction of prevalence of lifetime asthma. Conclusions:, In the population we surveyed, neonatal BCG scar was associated with a reduction in the risk of asthma only in individuals with a past history suggestive of allergic rhinitis. [source] Prevalence of self-perceived allergic diseases and risk factors in Italian adolescentsPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 6 2009Sonia Brescianini The aim of the study was to assess the symptoms prevalence of allergic diseases in a population of 11,15 yr old schoolchildren, to evaluate the associations between asthma and other symptoms and identify risk factors for asthma, rhinitis and eczema syndromes. A sample of 481 students was studied using an International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Prevalence of different kind of self-reported symptoms was calculated. Using a logistic regression approach, we tried to identify risk factors for three syndromes , rhinitis, eczema and asthma. The highest and the lowest prevalence rates of self-reported symptoms were recorded for rhinitis (43.6%) and for eczema (8.1%), respectively. The prevalence of asthma was 15.7%. Univariate analysis showed a mutual association between wheeze and rhinitis symptoms. Multivariate logistic regression model for eczema syndrome revealed female gender as a significant risk factor. The polytomic logistic multivariate regression revealed female gender and family history of allergy as significant risk factors for rhinitis syndrome only, and maternal smoking and familial allergy for rhinitis and asthma together. In particular, familial allergy yields a 400% higher chance of developing asthma and rhinitis together. The synergistic effect of familial allergy on rhinitis and asthma syndromes suggests the implementation of preventive measures in children with family history of these diseases. [source] Cross-sectional study of allergic disorders associated with breastfeeding in Japan: The Ryukyus Child Health StudyPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 5 2007Yoshihiro Miyake Uncertainties remain as to whether breastfeeding is protective against childhood allergic disorders. Positive relationships of breastfeeding with asthma and atopic eczema were observed in two previous Japanese studies. This cross-sectional study investigated the association between the feeding pattern after birth and the prevalence of allergic disorders during the past 12 months in Japanese schoolchildren. Study subjects were 24,077 children aged 6,15 yr in Okinawa. The outcomes were based on diagnostic criteria from the International Study of Asthma and Allergies in Childhood. Allowance was made for age, sex, number of siblings, smoking in the household, paternal and maternal history of asthma, atopic eczema, and allergic rhinitis, and paternal and maternal educational level. Breastfeeding, regardless of exclusivity, for 13 months or longer and exclusive breastfeeding for 4,11 months were independently associated with a higher prevalence of atopic eczema, particularly among children without a parental allergic history. A clear positive dose,response relationship was observed between prolonged duration of breastfeeding, regardless of exclusivity, but not exclusive breastfeeding, and the prevalence of atopic eczema. We found a significant positive trend for atopic eczema across the three categories (formula milk, partial and exclusive breastfeeding) in the first 4 months of life although the odds ratio for exclusive breastfeeding was not statistically significant. No material association was found between the feeding pattern after birth and the prevalence of wheeze or allergic rhinoconjunctivitis. Prolonged breastfeeding may be associated with a higher prevalence of atopic eczema in Japanese children. [source] PhadiatopTM compared to skin-prick test as a tool for diagnosing atopy in epidemiological studies in schoolchildrenPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 3 2007Luis Garcia-Marcos The validity of the PhadiatopTM test as compared to the skin-prick test (SPT) for diagnosing atopy in the epidemiological field has not been studied in schoolchildren. The aim of the present study was to evaluate its validity for classifying schoolchildren 9,12 yr old into atopics and non-atopics. A total of 621 children whose parents authorized both a SPT and a blood extraction from all children participating in the phase II of the International Study of Allergies in Children (ISAAC) in Cartagena (Spain) were included in the analysis. A positive SPT was that with at least a wheal having a maximum diameter of 3 mm, once the negative value had been subtracted. PhadiatopTM was performed according to the manufacturer instructions. Diagnostic tests using SPT as the gold standard were calculated for the whole group of children and also for those with asthma or rhinoconjunctivitis and for children without any of them. The results of the tests were: sensitivity 85.0% (95% CI 82.2,87.8%), specificity 85.5% (95%CI 82.7,88.3%), positive predictive value 72.7% (95%CI 69.0,76.1%), negative predictive value 92.7% (95%CI 90.6,94.7%) and accuracy 85.3% (95%CI 82.3,88.0%). The results improved among the symptomatic groups. PhadiatopTM can be used as a valid alternative to SPT in the epidemiological setting to diagnose atopy. [source] Determinants of atopic sensitization in Turkish school children: Effects of pre- and post-natal events and maternal atopyPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 1 2004Semanur Kuyucu Emergence of new environmental risk factors, and/or loss of protective factors of a traditional lifestyle may explain the increase, or variations in prevalence of allergic diseases. The aim of this study was to delineate the prevalence and spectrum of, and to reveal the causal and/or protective factors for atopic sensitization among a heterogenous cohort of Turkish children, for the first time in our country. The study design adhered to International Study of Asthma and Allergies in Childhood (ISAAC) phase II protocol. A self-administered parental questionnaire about demographic characteristics and detailed risk factors, and skin-prick test with 13 allergens were employed in a clustered random sample of 8,11-yr-old Turkish school children. Atopy was defined as the presence of at least one positive skin reaction to any allergen tested. The association between a total of 78 risk factors and different aspects of atopy were analyzed in 1144 children with multivariate logistic regression analysis. The overall prevalence of atopy was 20.6%. Most common sensitizations were to grass pollens, Dermatophagoides pteronyssinus and Blatella germanica. Day care attendance, high paternal education level, male gender and maternal asthma were significant risk factors for atopy. Breastfeeding more than 6 months (compared with 0,6 months), maternal smoking during pregnancy and a birth weight under 2500 g were inversely related to (or protective factors for) atopic sensitization. Maternal atopic disease had significant effects on risk factors pattern. In children with a maternal atopy history a low birth weight, day care attendance and maternal smoking during the first year of life independently increased the risk of atopic sensitization. Gender, breastfeeding and paternal education did not show any association with atopy in this group of children. A history of measles and low gestational age were significant protective factors for mite sensitization. This study showed that children of atopic mothers showed a different profile of risk factors associated with atopic sensitization, when compared with other children. Prenatal and early childhood events had important associations with atopic sensitization. [source] Increasing prevalence of allergic rhinitis but not asthma among children in Hong Kong from 1995 to 2001 (Phase 3 International Study of Asthma and Allergies in Childhood)PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 1 2004So-Lun Lee There is a worldwide belief that the prevalence of asthma and other allergic diseases is increasing but the measures used in many studies are susceptible to systematic errors. We examined the trend of asthma, allergic rhinitis and eczema prevalence in school children aged 6,7 years in Hong Kong from 1995 to 2001 using standardized ISAAC methodology. There were 4448 and 3618 children participating in 2001 and 1995, respectively. The prevalence of life-time rhinitis (42.4% vs. 38.9%, p < 0.01), current rhinitis (37.4% vs. 35.1%, p < 0.03), current rhinoconjunctivitis (17.2 vs. 13.6%, p < 0.01) and life-time eczema (30.7% vs. 28.1%, p = 0.01) increased significantly. There was no significant change in prevalence of life-time asthma, life-time wheeze and current wheeze albeit a significant increase in severe asthma symptoms. We investigated a number of potential risk factors including sex, family history of atopy, sibship size, birth weight, respiratory tract infections, pet ownership and exposure to tobacco smoke. However, the increases in prevalence of rhinitis and eczema could not be entirely explained by the change of prevalence of these risk factors. The odds ratio OR for the study period remained significantly associated with current rhinitis (OR 1.31, 95% confidence intervals CI 1.17,1.46), current rhinoconjunctivitis (OR 1.63, 95% CI 1.41,1.87) and life-time eczema (OR 1.30, 95% CI 1.16,1.45) after adjustment for these confounding variables using logistic regression model. Further study is warranted to elucidate the factors contributing to the observable change in the prevalence of rhinitis in our population. [source] Atopy among schoolchildren in northern and southern Sweden in relation to pet ownership and early life eventsPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 1 2001L. Bråbäck Studies have suggested a higher prevalence of asthma and allergies in northern, as compared to southern, Scandinavia. The aim of this study was to evaluate regional differences in atopy in relation to pet ownership and certain early life events among schoolchildren (n = 2108) aged 10,11 years from Linköping in southern Sweden and Östersund in northern Sweden. The parents completed a questionnaire, comprising questions on home environment, heredity, socio-economic conditions, and the core questions on symptoms from the International Study of Asthma and Allergies in Childhood. The children were skin-prick tested to eight common inhalant allergens. Information on maternal smoking habits, gestational age, and anthropometric measures were obtained from the Swedish Medical Birth Registry. The prevalence of atopic symptoms and sensitization to pollen were similar in Östersund and in Linköping. A higher prevalence of sensitization to animal dander among children in Östersund could be linked to a higher occurrence of pets in the community. Current cat ownership was related to less sensitivity to cat allergen but only in children with an atopic heredity. Ponderal index > 30 kg/m3 was related to an increased risk of atopic sensitization, both in Linköping (adjusted odds ratio 2.1; 95% confidence interval 1.1,4.0) and in Östersund (adjusted odds ratio 2.0; 95% confidence interval 1.1,3.5). Maternal smoking during pregnancy was related to an increased risk of atopic sensitization among children in Linköping, whereas current smoking was associated with a decreased risk of sensitization in Östersund. In conclusion, we demonstrated that a high occurrence of pets in the community was associated with sensitization, whereas atopic symptoms were essentially unaffected. This study has also suggested an association between body size at birth and atopic sensitization at 10,11 years of age. [source] High body mass index and dietary pattern are associated with childhood asthmaPEDIATRIC PULMONOLOGY, Issue 12 2006Soo-Jong Hong MD Abstract The increasing prevalence of asthma has coincided with an increase of body mass index (BMI) in both children and adults. We investigated the relationship between BMI and the symptom prevalence of asthma and the possible influences of dietary pattern. This was a community-based, cross-sectional study of 24,260 school children aged 6,12 years. Prevalences of asthma and potential confounding factors were assessed using a Korean version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire which was completed by parents. We analyzed the relationship between BMI and symptoms of asthma and the possible influences of dietary pattern. A significant positive association between high BMI and previous 12-month prevalence of wheeze remained in boys (adjusted odds ratio, 1.610; 95% confidence interval, 1.274,2.033) but not in girls. In addition, there were significant associations between high BMI and lifetime prevalence of wheeze, previous 12-month wheeze, exercise-induced wheeze, diagnosis, and treatment of asthma. There were significant associations between high BMI and previous 12-month wheeze regardless of breast-milk feeding or whole-milk feeding. Frequent intake of fresh seafood, fresh fruits, and vegetables was associated with reduced prevalence of current asthma symptoms and was also associated with decreased BMI. These results indicate that BMI may be an independent risk factor for the development of asthma symptoms in boys. Intake of fresh seafood, fresh fruit, and vegetables, which may be associated with decreased BMI, may contribute to protect against the development of asthma symptoms in Korean elementary schoolchildren. Pediatr Pulmonol. 2006; 41:1118,1124. © 2006 Wiley-Liss, Inc. [source] Maternal history, sensitization to allergens, and current wheezing, rhinitis, and eczema among children in Costa RicaPEDIATRIC PULMONOLOGY, Issue 4 2002Manuel E. Soto-Quiros MD Abstract Little is known about the factors associated with asthma, allergic rhinitis, and eczema in Latin American countries. We investigated the relation between potential risk factors and current wheezing, allergic rhinitis, and eczema among 208 Costa Rican children aged 10,13 years participating in phase II of the International Study of Asthma and Allergies in Childhood (ISAAC). The geometric mean (,±,SD) serum total IgE level of children with current wheezing was significantly higher than that of children without current wheezing (533.8,±,5.2 vs. 144.7,± 6.0 IU/mL, P,<,0.01). In a multivariate analysis, a maternal history of asthma, skin test reactivity (STR) to house dust mites, and STR to Alternaria were significantly associated with current wheezing. Children who had a maternal history of asthma had 2.4 times higher odds of current wheezing than those without maternal history of asthma (95% CI for OR,=,1.1,5.3). Sensitization to either house dust mite or Alternaria was associated with 3.3 times increased odds of current wheezing (95% CI for OR for STR to dust mite,=,1.6,6.7; 95% CI for OR for STR to Alternaria,=,1.1,11.0). In a multivariate analysis, STR to house dust mite and STR to cat dander were significantly associated with allergic rhinitis, and a maternal history of eczema and STR to dog dander were associated with eczema in the child. The interaction between familial factors and lifestyle changes resulting from social reforms implemented 60 years ago may explain the high prevalence of atopic diseases in Costa Rica. Pediatr Pulmonol. 2002; 33:237,243. © 2002 Wiley-Liss, Inc. [source] Trends in asthma prevalence and severity in Omani schoolchildren: Comparison between ISAAC phases I and IIIRESPIROLOGY, Issue 5 2008Omar A. AL-RAWAS Background and objective: This study evaluated changes in the prevalence of asthma symptoms and asthma severity in Omani school children over time. Methods: Two cross-sectional surveys, in 1995 and 2001, were conducted as part of the International Study of Asthma and Allergies in Children on Omani schoolchildren in two different age groups (6,7 and 13,14 years). Results: There were 7067 children surveyed in 1995 (3893 in the younger and 3174 in the older group) and 7879 in 2001 (4126 in the younger and 3753 in the older group). Over the 6 years there was a significant increase in the prevalence of current wheeze ,any wheeze during the past 12 months' (from 7.1% to 8.4%; P = 0.035) in the younger group with no significant change in asthma diagnosis (10.5% vs 10.6%) or any other asthma symptoms. In the older group, all asthma symptoms remained unchanged except speech-limiting wheeze which declined from 4.0% to 2.8% (P = 0.007). In both surveys, more than 60% of current wheezers reported severe asthma symptoms, while only 60% of these reported a diagnosis of asthma. Conclusion: The prevalence of both asthma and severe asthma remains high among Omani children. There is significant ,under-diagnosis' and/or ,under-treatment' of asthmatic children which requires urgent evaluation and intervention. [source] An inverse correlation between estimated tuberculosis notification rates and asthma symptomsRESPIROLOGY, Issue 2 2002PHILIPPA SHIRTCLIFFE Background: A recent ecological analysis demonstrated a strong inverse relationship between tuberculosis notification rates and the prevalence of asthma symptoms in 13,14-year-old children as obtained from the International Study of Asthma and Allergies in Childhood (ISAAC). However, the analysis was confined to the 23 countries in which the tuberculosis notification rates were considered to be of sufficient validity. Methods: A similar analysis was performed using estimated tuberculosis incidence rates obtained from the World Health Organization Global Tuberculosis Programme and asthma symptom prevalence data from ISAAC for both the 6,7 and 13,14 years age groups in 38 and 55 countries, respectively. Results: For the 6,7-year-old children, there was a significant inverse relationship between estimated tuberculosis incidence and the prevalence of key asthma symptoms. However, in the 13,14 year age group, a significant inverse relationship was only demonstrated for ,asthma ever'. Conclusion: The present study extends the inverse relationship between tuberculosis rates and asthma prevalence to the 6,7-year-old age group and suggests that the association, if causal, may be stronger at this younger age. [source] A case-control study of risk factors for asthma in New Zealand childrenAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2001Kristin Wickens Objective: As in other English-speaking countries, asthma is a major and increasing health problem in New Zealand. This study examined the risk factors for asthma in children aged 7,9. Methods: Cases and controls were randomly selected from participants in the Wellington arm of the International Study of Asthma and Allergies in Childhood (ISAAC). Cases were children with a previous diagnosis of asthma and current medication use (n=233), and controls were children with no history of wheezing and no diagnosis of asthma (n=241). Results: After controlling for confounders, factors significantly associated with asthma were maternal (OR=3.36, 95% Cl 1.88,5.99) and paternal asthma (OR=2.67, 95% Cl 1.42,5.02), and male sex (OR=1.81, 95% Cl 1.17,2.81). Children from social classes 5 and 6 or with unemployed parents (OR=2.32, 95% Cl 1.22,4.44) were significantly more likely to have asthma than children in social classes 1 and 2. There was no significant association between having polio vaccination (OR=2.48, 95% Cl 0.83,7.41), hepatitis B vaccination (OR=0.66, 95% Cl 0.42,1.04) or measles/mumps/rubella vaccination (OR=1.43, 95% Cl 0.85,2.41) and asthma. Conclusions: This study has confirmed the associations of family history and lower socio-economic status with current asthma in 7,9 year old children. The role of vaccinations requires further research. [source] A multi-centre study of candidate genes for wheeze and allergy: the International Study of Asthma and Allergies in Childhood Phase 2CLINICAL & EXPERIMENTAL ALLERGY, Issue 12 2009J. Genuneit Summary Background Common polymorphisms have been identified in genes suspected to play a role in asthma. We investigated their associations with wheeze and allergy in a case,control sample from Phase 2 of the International Study of Asthma and Allergies in Childhood. Methods We compared 1105 wheezing and 3137 non-wheezing children aged 8,12 years from 17 study centres in 13 countries. Genotyping of 55 candidate single nucleotide polymorphisms (SNPs) in 14 genes was performed using the Sequenom System. Logistic regression models were fitted separately for each centre and each SNP. A combined per allele odds ratio and measures of heterogeneity between centres were derived by random effects meta-analysis. Results Significant associations with wheeze in the past year were detected in only four genes (IL4R, TLR4, MS4A2, TLR9, P<0.05), with per allele odds ratios generally <1.3. Variants in IL4R and TLR4 were also related to allergen-specific IgE, while polymorphisms in FCER1B (MS4A2) and TLR9 were not. There were also highly significant associations (P<0.001) between SPINK5 variants and visible eczema (but not IgE levels) and between IL13 variants and total IgE. Heterogeneity of effects across centres was rare, despite differences in allele frequencies. Conclusions Despite the biological plausibility of IgE-related mechanisms in asthma, very few of the tested candidates showed evidence of association with both wheeze and increased IgE levels. We were unable to confirm associations of the positional candidates DPP10 and PHF11 with wheeze, although our study had ample power to detect the expected associations of IL13 variants with IgE and SPINK5 variants with eczema. [source] Mycobacterium tuberculosis infection may protect against allergy in a tuberculosis endemic areaCLINICAL & EXPERIMENTAL ALLERGY, Issue 1 2006C. C. Obihara Summary Background Epidemiological studies have shown an inverse relation of mycobacterial infection and the frequency of allergic diseases and asthma. Recent evidence suggests that allergic inflammation may be inhibited in the presence of chronic and persistent infections, such as that by Mycobacterium tuberculosis (MTB). The relation of tuberculin skin test (TST) size, an accepted marker of MTB infection and the frequency of allergic disease symptoms has not been reported from an area where MTB infection is endemic. Objective To investigate the association of TST and allergic disease symptoms, in children living in a tuberculosis (TB) endemic area. Methods In this cross-sectional study, 841 children aged 6,14 years from randomly selected household addresses in two poor communities of Cape Town, South Africa, were investigated with TST and standardized International Study on Asthma and Allergies in Childhood-based questionnaire on allergic disease symptoms. Results Children with positive TST (10 mm) were significantly less likely to have allergic disease symptoms, in particular allergic rhinitis (AR) (adjusted odds ratio 0.43; 95% confidence interval 0.24,0.79) than those with negative TST. This association remained significant after adjusting for possible confounders and correcting for the effect of clustering (>1 child per household address) in the sample. There was a significant inverse linear trend in the relation of TST size in millimetre and the frequency of allergic disease symptoms, in particular AR (P<0.001). Conclusions These results of inverse association of strong TST reaction and allergic disease symptoms in children from a TB endemic area are in support of the hypotheses that allergic inflammation may be inhibited by chronic infections, such as MTB. [source] High levels and gender difference of exhaled nitric oxide in Chinese schoolchildrenCLINICAL & EXPERIMENTAL ALLERGY, Issue 7 2005G. W. K. Wong Summary Background Exhaled nitric oxide (eNO) may represent a useful noninvasive marker of airway inflammation, but data on the reference population values in schoolchildren are limited. No reference eNO study in Asian children has been published. Methods Levels of eNO in a sample of 531 schoolchildren aged 11,18 years recruited from five schools (three international schools) in Hong Kong were measured online by a chemiluminescence analyser according to ERS/ATS standard. Each student also completed an International Study of Asthma and Allergic disease in Childhood questionnaire. Results Among the children without a physician's diagnosis of asthma or symptoms of wheeze, rhinitis and eczema, there were 258 Chinese and 33 Caucasians. In control Chinese children, the eNO level (median: interquantile range) was significantly higher (P<0.001) in males (17.0 parts per billion (p.p.b.); 10.7,36.6) than in females (10.8 p.p.b.; 7.8,17.6). When compared with Caucasian control males (11.6 p.p.b.; 8.2,19.3) and females (9.1 p.p.b.; 7.5,11.9), the Chinese children had significantly higher eNO levels for both males (P=0.011) and females (P=0.037). For Chinese asthmatic males, the median eNO (interquartile range) was 39.8 p.p.b. (12.5,73.8), and for asthmatic females, 18.0 (9.6,56.3). After controlling for sex in Chinese controls, eNO did not have any significant correlation with height, weight and body mass index or body surface area. Conclusions This study demonstrates a gender difference of eNO level in healthy Chinese schoolchildren. When compared with Caucasians, Chinese children have significantly higher eNO levels. [source] Bronchial hyper-responsiveness to hypertonic saline and blood eosinophilic markers in 8,13-year-old schoolchildrenCLINICAL & EXPERIMENTAL ALLERGY, Issue 8 2004G. De Meer Summary Background In adult asthma, bronchial hyper-responsiveness (BHR) to indirect stimuli reflects eosinophilic activation more closely than BHR to stimuli that directly cause smooth muscle contraction. Aim To assess the relationship between BHR to the indirect stimulus hypertonic saline (HS), blood eosinophil numbers, and serum eosinophilic cationic protein (ECP) in children with and without current wheeze. Methods A cross-sectional survey among 8,13-year-old schoolchildren, using the International Study of Asthma and Allergic disease in Childhood questionnaire, bronchial challenge with HS, skin prick tests, serum IgE, blood eosinophil counts and ECP (in a subset). Based upon the presence of current wheeze (WHE) and BHR, we defined three case groups (WHE+BHR+, WHE,BHR+, WHE+BHR,) and the reference group (WHE,BHR,). By regression analyses, each case group was compared with the reference group for differences in atopic sensitization, blood eosinophil counts and serum ECP. Results Complete data were obtained for 470 children. BHR was present in 103 children (22%), 66 being asymptomatic and 37 symptomatic. Children of all three case groups were more often atopic. Sensitization to indoor allergens particularly occurred in children with BHR, irrespective of symptoms (P<0.05). Children with WHE+BHR+ had highest values for blood eosinophils and serum ECP (P<0.05). Children with WHE,BHR+ had less severe responsiveness. In atopic children with WHE,BHR+, serum ECP was higher than in children with WHE-BHR-(P<0.05). Conclusions BHR to HS is associated with blood markers of eosinophilic activation, particularly in atopic children. [source] Pollen counts in relation to the prevalence of allergic rhinoconjunctivitis, asthma and atopic eczema in the International Study of Asthma and Allergies in Childhood (ISAAC)CLINICAL & EXPERIMENTAL ALLERGY, Issue 12 2003M. L. Burr Summary Background Although pollens are major allergens associated with allergic rhinoconjunctivitis and asthma, there is little information about the relative prevalence of these conditions in populations with different pollen exposures. Objective The purpose of this study was to investigate the relationship between pollen exposure and allergic symptoms among children in different countries. Methods An ecological analysis was conducted to see whether pollen exposure (pollen counts, and duration and severity of pollen seasons) is associated with symptoms of allergic rhinoconjunctivitis, asthma and atopic eczema in 28 centres within 11 countries (nine being in Europe). Data on the prevalence of symptoms in 13,14-year olds were based on the responses to the written questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC). The analysis was adjusted for gross national product and mean annual relative humidity. Results There was little relationship between pollen exposure and symptom prevalence, except for a significant inverse association between grass pollen counts and lifetime prevalence of the symptoms of allergic rhinitis (P=0.03). Almost all the regression coefficients were negative. The associations were even weaker and all non-significant when the analyses were conducted within countries, using a random intercept fixed slope model, but there was still no evidence of a positive association between pollen exposure and symptoms. Conclusion There is a weak but consistent tendency for the prevalence of allergic symptoms to be inversely associated with pollen exposure. This finding accords with evidence from several countries, suggesting that the prevalence of hayfever and asthma tends to be lower in rural than in urban areas, and lowest among people living on farms. Exposure to allergenic pollen in early life does not appear to increase the risk of acquiring symptoms of respiratory allergy, and may even give some protection against them. [source] Prevalence and risk factors of asthma and allergic diseases among schoolchildren in Bolu, TurkeyACTA PAEDIATRICA, Issue 4 2008Fahrettin Talay Abstract Aim: In this study we aimed to detect the prevalence and risk factors of asthma and allergic diseases in children aged between 7 and 14 years old at rural and urban areas of Bolu, Turkey. Methods: Questionnaire of International Study of Asthma and Allergies in Childhood (ISAAC) phase one and questionnaire including questions about family, demographic, socio-economic characteristics of children were applied to 931 schoolchildren who were selected by randomized sampling. Results: In children, the prevalence of diseases and symptoms were as follows: wheeze ever: 15.5%, asthma: 5.6%, nasal symptoms ever: 41.4%, allergic rhinitis: 23.2%, itchy rash ever: 5.9% and eczema: 5.0%. In multivariate regression analysis, presence of allergic disease in the family was risk factor for wheezing (OR = 1.74, 95% CI = 1.19,2.76), asthma (OR = 2.19, CI = 1.06,4.52), allergic rhinitis (OR = 2.68, CI = 1.80,3.98) and eczema (OR = 2.33, CI = 1.17,4.65); living in shanties was risk factor for allergic rhinitis (OR = 5.26, CI = 2.1,13.16); a monthly income below $300 was risk factor for asthma (OR = 2.54, CI = 1.06,6.08). Conclusion: It was detected that the prevalence of allergic rhinitis and its symptoms was more common in schoolchildren living in Bolu. Presence of allergic disease in fathers or mothers and low socio-economic level increase the risk of asthma and other allergic diseases in children. [source] International study of wheezing in infants: risk factors in affluent and non-affluent countries during the first year of lifePEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 5 2010Luis Garcia-Marcos Garcia-Marcos L, Mallol J, Solé D, Brand PLP and EISL group. International study of wheezing in infants: risk factors in affluent and non-affluent countries during the first year of life. Pediatr Allergy Immunol 2010: 21: 878,888. © 2010 John Wiley & Sons A/S Risk factors for wheezing during the first year of life (a major cause of respiratory morbidity worldwide) are poorly known in non-affluent countries. We studied and compared risk factors in infants living in affluent and non-affluent areas of the world. A population-based study was carried out in random samples of infants from centres in Latin America (LA) and Europe (EU). Parents answered validated questionnaires referring to the first year of their infant's life during routine health visits. Wheezing was stratified into occasional (1,2 episodes, OW) and recurrent (3 + episodes, RW). Among the 28687 infants included, the most important independent risk factors for OW and RW (both in LA and in EU) were having a cold during the first 3 months of life [OR for RW 3.12 (2.60,3.78) and 3.15 (2.51,3.97); population attributable fraction (PAF) 25.0% and 23.7%]; and attending nursery school [OR for RW 2.50 (2.04,3.08) and 3.09 (2.04,4.67); PAF 7.4% and 20.3%]. Other risk factors were as follows: male gender, smoking during pregnancy, family history of asthma/rhinitis, and infant eczema. Breast feeding for >3 months protected from RW [OR 0.8 (0.71,0.89) in LA and 0.77 (0.63,0.93) in EU]. University studies of mother protected only in LA [OR for OW 0.85 (0.76,0.95) and for RW 0.80 (0.70,0.90)]. Although most risk factors for wheezing are common in LA and EU; their public health impact may be quite different. Avoiding nursery schools and smoking in pregnancy, breastfeeding babies >3 months, and improving mother's education would have a substantial impact in lowering its prevalence worldwide. [source] | ||||||||||||||||||||||||||||||||||