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Kongress Medizin und Gesellschaft 2007

17. bis 21.09.2007, Augsburg

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International variations in the prevalence of rhinoconjunctivitis and the role of atopy: results from phase two of the International Study of Asthma and Allergies in Childhood (ISAAC)

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  • Gudrun Weinmayr - Universität Ulm, Ulm
  • Francesco Forastiere - Local Health Authority Rome, Rome
  • Stephan Weiland - Universität Ulm, Ulm
  • Gisela Büchele - Universität Ulm, Ulm
  • Tamuna Abramidze - Centre of Allergy and Immunology, Tbilisi
  • Isabella Annesi-Maesano - Medical School St-Antoine, Paris
  • Bengt Björkstén - Karolinska Institutet Stockholm, Stockholm
  • Bert Brunekreef - University of Utrecht, Utrecht
  • William Cookson - University of Oxford, Oxford
  • Erika von Mutius - University of Munich, Munich
  • Riccardo Pistelli - Catholic University, Rome
  • David Strachan - St. Georges's Hospital Medical School, London
  • ISAAC Phase II Study Group

Kongress Medizin und Gesellschaft 2007. Augsburg, 17.-21.09.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gmds447

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/gmds2007/07gmds447.shtml

Published: September 6, 2007

© 2007 Weinmayr et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Background: The relative importance of atopy in the etiology of non-infectious rhinitis is still unclear. We investigated the association of rhinoconjunctivitis with atopic sensitization to seasonal and perennial allergens.

Methods: Random samples (n 1000) of children (8-12 years) in 30 centres in 22 countries were studied with standardized questionnaires on occurrence and severity of allergic diseases. Skin prick tests were performed for six common aeroallergens of seasonal and perennial occurrence. In 18 centres additional allergens of local relevance were included

Results: 12 months prevalence of rhinoconjunctivitis symptoms ranged from 1.5% to 24.5%. The prevalence of sensitization ranged from 0.1% to 25.8% for seasonal allergens and from 1.4% to 45.2% for perennial allergens.

The prevalence rate ratio (PRR) for the association between rhinoconjunctivitis and seasonal allergens (adjusted for perennial allergens) ranged from 0.5 to 9.0%. The combined PRR was higher in affluent countries (gross national income 9200$ per capita per year) than in non-affluent countries (PRR = 3.6; 95%-CI:2.6-5.0 and PRR = 1.6; 95%-CI:1.1-2.4, respectively). For perennial allergens the PRR (adjusted for seasonal allergens) ranged from 0.8 to 4.1. The combined PRR was 2.2 (95%-CI:1.8-2.6) for affluent countries and 1.5 (95%-CI:1.1-2.1) for non-affluent countries. The combined adjusted population attributable fraction for seasonal allergens was 35.9% (95%-CI:23.6%-46.2%) and 1.3% (95%-CI:0%-2.8%) for affluent and non-affluent countries, respectively. For perennial allergens, the combined adjusted population attributable fraction was 25.0% (95%-CI:18.1%-31.4%) for affluent countries and 12.6% (95%-CI:2.7%-21.6%) for non-affluent countries.

Conclusions: The association of rhinoconjunctivitis with sensitization to seasonal allergens varies strongly worldwide and is weaker among non-affluent centres, where it is not significant in some centres. This difference is also visible for perennial allergens, though less pronounced. Moreover, perennial allergens seem to have more relative importance in non-affluent centres. Overall, the influence of sensitization seems to be weaker than has been often assumed.