巴伐利亚州学龄前儿童的特应性疾病和气道相关症状：时间趋势分析

Atopic diseases and airway-related symptoms in Bavarian children before starting primary school: Time trend analyses.

作者信息

Pirner Christina, Korbely Christine, Heinze Stefanie, Huß Jonas, Summer Burkhard, Oppel Eva, Nowak Dennis, Herr Caroline, Kutzora Susanne

机构信息

Institute for Medical Informatics, Biometry and Epidemiology (IBE) at the Ludwig-Maximilians-University Munich, Marchioninistraße 15, 81377, Munich, Germany; Pettenkofer School of Public Health, Marchioninistraße 15, 81377, Munich, Germany; Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany.

Bavarian Health and Food Safety Authority, Pfarrstraße 3, 80538, Munich, Germany.

出版信息

Respir Med. 2022 Jan;191:106707. doi: 10.1016/j.rmed.2021.106707. Epub 2021 Dec 2.

DOI:10.1016/j.rmed.2021.106707

PMID:34894592

Abstract

BACKGROUND

After decades of rising prevalence of atopic and airway-related diseases, studies showed stagnating prevalence in western industrialised countries. Objective of this study is to analyse the time trend of prevalence of atopic diseases and airway-related symptoms among Bavarian children before starting primary school.

MATERIALS AND METHODS

Five cross-sectional studies from 2004/2005, 2006/2007, 2012/2013, 2014/2015 and 2016/2017 took place in urban and rural regions in Bavaria, Germany. Using standardized parent questionnaires children's atopic diseases and airway-related symptoms were surveyed. Logistic regression analysis (Bonferroni correction: adjusted significance level 0.005) was performed to analyse prevalence of symptoms and diseases from 2004 to 2017 for time trends.

RESULTS

The surveys included 27384 Bavarian children aged 5-6 years (52.6% male). In all children the calculated 12-month prevalence of symptoms '≥four episodes of wheeze' (p-value = .0880) and 'rhinoconjunctivitis' (p-value = .3994) reported by parents stagnated, whereas 'wheeze' (p-value<.0001; OR = 0.97; CI = [0.96-0.98]) and 'rhinitis' (p-value = .0007; OR = 0.98; CI = [0.97-0.99]) decreased. In all children the calculated lifetime prevalence of physician-diagnosed 'asthma' (p-value = .5337), and 'hay fever' (p-value = .8206) stagnated, whereas of 'bronchitis' (p-value<.0001; OR = 0.98; CI = [0.98-0.99]) decreased over time. The calculated lifetime prevalence of physician-diagnosed 'atopic eczema' (p-value = .0002; OR = 0.98; CI = [0.97-0.99]) decreased in all children, whereas the calculated 12-month prevalence of the symptom 'itchy rash' increased (p-value = .0033; OR = 1.07; CI = [1.05-1.08]) over time.

CONCLUSIONS

Several calculated prevalence of children's atopic diseases and airway-related symptoms reported by parents stagnated in a subgroup of Bavarian children before starting primary school between 2004 and 2017. The time trend of prevalence in 'wheeze', 'rhinitis' and 'bronchitis' decreased. Prevalence of 'atopic eczema' decreased over time, whereas 'itchy rash' increased.

摘要

背景

在特应性疾病和气道相关疾病患病率数十年持续上升之后，研究表明西方工业化国家的患病率已趋于平稳。本研究的目的是分析巴伐利亚州即将入学儿童的特应性疾病患病率和气道相关症状的时间趋势。

材料与方法

2004/2005年、2006/2007年、2012/2013年、2014/2015年和2016/2017年在德国巴伐利亚州的城乡地区开展了五项横断面研究。通过标准化的家长问卷对儿童的特应性疾病和气道相关症状进行调查。采用逻辑回归分析（Bonferroni校正：调整后的显著性水平为0.005）来分析2004年至2017年症状和疾病患病率的时间趋势。

结果

调查纳入了27384名5-6岁的巴伐利亚儿童（52.6%为男性）。在所有儿童中，家长报告的“≥4次喘息发作”（p值=0.0880）和“ rhinoconjunctivitis”（p值=0.3994）这两种症状的12个月患病率趋于平稳，而“喘息”（p值<0.0001；OR=0.97；CI=[0.96-0.98]）和“鼻炎”（p值=0.0007；OR=0.98；CI=[0.97-0.99]）患病率下降。在所有儿童中，医生诊断的“哮喘”（p值=0.5337）和“花粉症”（p值=0.8206）的终生患病率趋于平稳，而“支气管炎”（p值<0.0001；OR=0.98；CI=[0.98-0.99]）患病率随时间下降。在所有儿童中，医生诊断的“特应性皮炎”的终生患病率下降（p值=0.0002；OR=0.98；CI=[0.97-0.99]），而症状“皮疹瘙痒”的12个月患病率随时间增加（p值=0.0033；OR=1.07；CI=[1.05-1.08]）。