Prevalence and risk factors for allergic rhinitis in primary schoolchildren in Budapest

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Summary

Objective

There is growing evidence that the prevalence of allergic diseases is increasing, especially among children. The aim of this study was to evaluate the incidence and risk factors of allergic rhinitis in 6–12-year-old schoolchildren in Budapest.

Methods

A total of 6335 children aged between 6 and 12 years attending 21 randomly selected primary schools in Budapest were surveyed in September 2007 by using a questionnaire consisting in part of questions compiled by the International Study of Asthma and Allergies in Childhood and in part of questions based on our own experience.

Results

3933 of the questionnaires (1976 M/1957 F) were appropriately completed by the parents. The prevalence of current allergic rhinitis was 14.9% (n = 530), that of physician-diagnosed allergic rhinitis was 11.6% (n = 413), and that of cumulative allergic rhinitis was 26.5% (n = 943). Male gender (p < 0.001), family history of atopy (p < 0.001), eczema (p < 0.001), urticaria (p < 0.001), itchy-watery eyes (p < 0.001), coughing (p < 0.001), wheezing (p < 0.001), a hearing impairment (p < 0.001), itching of the palate (p < 0.001), frequent upper airway infection (p < 0.001), frequent rhinosinusitis (p < 0.001), a history of tonsillectomy (p < 0.01), a history of adenoidectomy (p < 0.001), antibiotics given in the first year of life (p < 0.001), paracetamol given in the first year of life (p < 0.001), living in a green area (p < 0.001), the consumption of soft drinks containing preservatives or colourants (p < 0.04), feather bedding (p < 0.01), living in a house made of concrete (p < 0.001), living not far from an air-polluting factory or mine (p < 0.001), and long-lasting disease before the appearance of the allergy (p < 0.001) were all significant factors involving an increased risk of allergic rhinitis symptoms.

The frequent consumption of tomatoes, nuts, margarine and butter significantly affected the cumulative allergic rhinitis prevalence.

Results

Overall, the 12-month prevalence of allergic rhinitis in these 6–12-year-old children in Budapest was 14.9%, which is higher than reported from other European countries.

Our findings differ from those on other cohorts in that exposure to ragweed and to indoor environmental factors in concrete housing estates in Budapest may be of particular importance as concerns allergic sensitization.

Introduction

The prevalence of allergic rhinitis (AR) in childhood has recently shown a sharp increase worldwide. There is a great geographical variation in the incidence both among and within countries [1]. The prevalence of childhood AR ranges from 2.2% to 45.1% [1]. There is currently considerable concern that the prevalence of AR and other allergic diseases is increasing in the developed and developing countries. This is thought to be due mainly to factors associated with the “western lifestyle”, with its rapid changes in environmental and behavioural factors, rather than to a genetic predisposition [2], [3], [4]. Hungarian prevalence surveys on childhood AR have been performed with different study methods, in different regions and ages and with different time courses, but the results have not yet been published. Despite the considerable research efforts, the aetiology of AR remains poorly understood. A family history of atopic diseases seems to be a major risk factor, but various environmental factors and the life style are also considered important in the evolution of the disease [3], [5]. The main and potential risk factors contributing to the development of AR are still unclear. In Hungary, a striking seasonal pattern of high fever is observed during the months of July–September, with a peak in August, corresponding to the main ragweed pollen season. The aim of the present study was to collect relevant data on the prevalence of AR in 6–12-year-old schoolchildren in Budapest and to shed light on the risk factors that may play roles in the aetiology of the disease.

Section snippets

Methods

The study was conducted in Budapest in September 2007. 21 primary schools in 8 districts of Budapest were chosen by simple random sampling by the Central Data Processing and Registration Office of the Ministry of Home Affairs. At the initial teacher–parent meetings, 6335 questionnaires were distributed to the parents of the 6–12-year-old pupils. Instructions were given by the teachers before the questionnaires were completed. The questionnaires were collected immediately after the

Results

The parents of 3933 children completed the questionnaire. These comprised 1976 (50.2%) boys and 1957 (49.8%) girls. The prevalence data for current AR, physician-diagnosed AR and cumulative AR are shown in Table 1. Male gender (p < 0.001, OR = 0.680, 95%CI = 0.585–0.791) was significantly associated with the cumulative AR symptoms. Of the 1212 (34%) children reported to have been diagnosed as having an atopic disease (Table 2, Table 3), 363 (10.2%) had eczema, 171 (4.8%) had a food allergy, 220

Discussion

The results obtained from this study showed that more than one-quarter of the 6–12-year-old children in Budapest had AR (the prevalence of cumulative AR was 26.5%) (Table 1). The Worldwide ISAAC Phase Three study showed that the prevalence of AR ranged between 2.2% and 45.1% [1]. Our results indicate moderate figures within this interval. This survey provides the first published prevalence data on diagnosed allergic diseases in schoolchildren in Budapest. There have been no comparable studies

Acknowledgements

The authors would like to thank the pupils, their parents and the heads, teachers and secretaries of the schools for their help and co-operation during the data collection phase. They are also grateful to the librarians at Heim Pál Hospital for Sick Children in Budapest for the reference retrievals.

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