Allergen sensitization affected the change trend of prevalence of symptoms of rhinitis coexisting with wheeze among adolescents in Guangzhou City from 1994 to 2009

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Rhinitis, with the symptoms of sneezing, runny nose, or nasal obstruction, is the most common upper airway disease among children all over the world 1; numerous studies have shown various associations between rhinitis and asthma. Children suffering with rhinitis may increase the risk of asthma or impair the clinical management of asthma because of the ‘allergic march’ 2, and pose a significant burden on both the individual and society 2. Due to their associations, the prevalence of rhinitis and asthma has often been surveyed together in epidemiologic studies.
After decades of an increase in the global prevalence of rhinitis 7, a few recent studies reported no further increase or even a reverse trend in some areas since the mid‐2000s 10. The same changes were also observed in allergic sensitization 12. Two cross‐sectional studies were conducted following the International Study of Asthma and Allergic disease in Childhood (ISAAC) protocol in 1994 (Phase I) and in 2001 (Phase III) in Guangzhou. Results showed that the prevalence rates of physician‐diagnosed allergic rhinitis in the past 12 months in 13‐ to 14‐year‐old secondary schoolchildren in Guangzhou increased from 17.4% in 1995 to 22.7% in 2001 13.
Among all risk factors, allergen sensitization, as measured by skin prick test (SPT), has been indicated as one of the strongest and most consistent relationships with the development of rhinitis 14. A previous study showed that multiple sensitizations are common, and house dust mites (HDMs) are the most prevalent allergens in patients with rhinitis, asthma, or both in China 16. It is hypothesized that dramatically environmental changes, such as rapid urbanization, and increases in the temperature and humidity in many parts of China over the past decade may have facilitated the growth of HDM populations. This change could be associated with increase in HDM sensitization in Chinese schoolchildren and may contribute to further increases in the prevalence of allergic diseases. For this reason, in 2009–2010, a follow‐up cross‐sectional study on the prevalence of AR, specifically symptoms of rhinitis (SR) with lower airway symptoms and skin sensitization, was conducted in secondary schoolchildren aged 13–14 years from the same schools in Guangzhou using the ISAAC Phase III protocol. The results were compared with those in Phase I and III surveys, which used the same ISAAC core questionnaires and were conducted in 1995 and 2001, respectively. Associations between prevalence of SR, SR with lower airway symptoms, and aeroallergen sensitization were also taken into consideration.

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