Development of Asthma Symptoms and Allergic Sensitization in Preschool Children – Results of a Prospective Cohort Study
Authors:
P. Čižnár 1; Ľ. Palkovičová 2; K. Rausová 2; H. Patayová 2; J. Babjaková 2; A. Kovalíková 3; E. Reichrtová 2
Authors‘ workplace:
1. Detská klinika LFUK a DFNsP, Bratislava
prednostka doc. MUDr. O. Červeňová, CSc.
1; Vedecko-výskumná základňa Slovenskej zdravotníckej univerzity, Bratislava
riaditeľ doc. MUDr. M. Gajdoš, CSc.
2; Alergologická ambulancia, Stará Ľubovňa
3
Published in:
Čes-slov Pediat 2010; 65 (1): 10-18.
Category:
Original Papers
Overview
Background:
Prevalence and phenotype of asthma vary among different populations. In general, the atopy is considered to be the most significant risk factor for asthma. Atopy is defined as a presence of IgE against food and inhalant allergens. Information about asthma and allergic sensitization in preschool children from Central European region is sporadic.
Methods:
Longitudinal cohort study in years 2002–2008 of 230 children from two environmentally different regions of Slovakia followed from birth to 5th year of life. During the follow-up visits at 18th month, 3rd year and 5th year the symptoms of repeated chest wheezing, physician diagnosed asthma and levels of IgE against most frequent food and inhalant allergens were examined. Concurrently we examined the most important risk factors for asthma and allergy.
Results:
History of repeated symptoms of chest wheezing was most frequent at 3rd year, in 13.8% of children. Percentage of children with physician diagnosed asthma increased until 5th year, when the frequency was 7.2%. No statistically significant differences in wheezing and/or asthma were found between the two regions. Sensitization to food allergens peaked at year 3 (15.7%), sensitization to inhalant allergens was highest at year 5. Sensitization to inhalant allergens reached 16.9 % in Bratislava (industrial region), compared to 6.9 % in Stará Lubovňa (rural region; p=0.046). The only independent risk factor for asthma diagnosis at 5th year was the rate of respiratory infections at 5th year (p=0.027; aOR 1.49; 95% CI 1.0–2.1). The independent risk factor for sensitization against inhalant allergens was sensitization to food allergens (p=0.003; aOR=9.5; 95% CI 2.1–42.4). Protective effect of farming and breast feeding was close to significance. Sensitization against inhalant allergens in 5 year old children with diagnosed asthma has reached 27.3%.
Conclusion:
In children of pre-school age, asthma was mostly connected to respiratory infections. There were no differences between rural and industrial regions of Slovakia. Sensitization rate against inhalant allergens in 5 year old children from industrial region doubled the rate in rural region.
Key words:
bronchial asthma, aero-sensitization, food sensitization, preschool age children
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Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2010 Issue 1
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