Lancet. 1998 Apr 25;351(9111):1225-32.
Systematic international comparisons of the prevalences of asthma and other allergic disorders in children are needed for better understanding of their global epidemiology, to generate new hypotheses, and to assess existing hypotheses of possible causes. We investigated worldwide prevalence of asthma, allergic rhinoconjunctivitis, and atopic eczema.
We studied 463,801 children aged 13-14 years in 155 collaborating centres in 56 countries. Children self-reported, through one-page questionnaires, symptoms of these three atopic disorders. In 99 centres in 42 countries, a video asthma questionnaire was also used for 304,796 children.
We found differences of between 20-fold and 60-fold between centres in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema, with four-fold to 12-fold variations between the 10th and 90th percentiles for the different disorders. For asthma symptoms, the highest 12-month prevalences were from centres in the UK, Australia, New Zealand, and Republic of Ireland, followed by most centres in North, Central, and South America; the lowest prevalences were from centres in several Eastern European countries, Indonesia, Greece, China, Taiwan, Uzbekistan, India, and Ethiopia. For allergic rhinoconjunctivitis, the centres with the highest prevalences were scattered across the world. The centres with the lowest prevalences were similar to those for asthma symptoms. For atopic eczema, the highest prevalences came from scattered centres, including some from Scandinavia and Africa that were not among centres with the highest asthma prevalences; the lowest prevalence rates of atopic eczema were similar in centres, as for asthma symptoms.
The variation in the prevalences of asthma, allergic rhinoconjunctivitis, and atopic-eczema symptoms is striking between different centres throughout the world. These findings will form the basis of further studies to investigate factors that potentially lead to these international patterns.
为了更好地了解哮喘和其他过敏性疾病在全球的流行病学情况、提出新的假设并评估现有关于可能病因的假设，需要对儿童哮喘和其他过敏性疾病的患病率进行系统的国际比较。我们调查了全球哮喘、过敏性鼻结膜炎和特应性皮炎的患病率。
我们研究了来自56个国家155个合作中心的463,801名13 - 14岁儿童。儿童通过单页问卷自行报告这三种过敏性疾病的症状。在42个国家的99个中心，还对304,796名儿童使用了视频哮喘问卷。
我们发现，哮喘、过敏性鼻结膜炎和特应性皮炎症状的患病率在不同中心之间相差20倍至60倍，不同疾病在第10百分位数和第90百分位数之间的差异为4倍至12倍。对于哮喘症状，12个月患病率最高的是英国、澳大利亚、新西兰和爱尔兰共和国的中心，其次是北美、中美和南美大多数中心；患病率最低的是几个东欧国家、印度尼西亚、希腊、中国、台湾、乌兹别克斯坦、印度和埃塞俄比亚的中心。对于过敏性鼻结膜炎，患病率最高的中心分布在世界各地。患病率最低的中心与哮喘症状的情况相似。对于特应性皮炎，患病率最高的中心分布零散，包括一些来自斯堪的纳维亚和非洲的中心，这些中心并非哮喘患病率最高的中心；特应性皮炎患病率最低的中心情况与哮喘症状相似。
全球不同中心之间哮喘、过敏性鼻结膜炎和特应性皮炎症状的患病率差异显著。这些发现将为进一步研究潜在导致这些国际模式的因素奠定基础。
