Allergy related disorders among 2-year olds and adolescents in Mid-Norway-prevalence, severity and impact: PACT 2005 Young-HUNT 1995-97
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Background Allergy related disorders represent a major health problem in most developed countries and the disorders have increased during the last 50 years. Few populationbased studies have focused on these disorders in early childhood and few have evaluated the severity of atopic dermatitis (AD). Having AD as well as other chronic disease is assumed to be associated with reduced mental health. Adolescents with AD are thought to be especially vulnerable, but few studies have included particularly large numbers of young people. AimsTo study the prevalence and co-variation of allergy related disorders (wheeze, asthma, atopic dermatitis and allergic rhinoconjunctivitis) and allergen sensitisation among 2-year olds in a general population (papers I and II)To study the severity of atopic dermatitis among 2-year olds in a general population (paper II)To study the prevalence and impact of atopic dermatitis among adolescents in a general population (paper III)To study gender differences in relation to allergy related disorders and allergen sensitisation (papers I, II and III)Material and Methods Questionnaire data from a total population of 4783 two-year olds and data from the clinical examination of a subsample of 390 children were obtained from the PACT (Prevention of Allergy among Children in Trondheim) study in 2005. Skin prick tests as well as severity scoring of atopic dermatitis was performed in the subsample. The Young-HUNT 1 study was conducted as a cross-sectional, population-based survey in 1995-97. Students aged 13-19 years completed a comprehensive selfadministered questionnaire on health and life-style during one school lesson. Results PACT questionnaire data from 4783 two-year olds (50.2 % girls) and data from the clinical examination and skin prick test from a subsample of 390 (48.5 % girls) were analyzed. Among the 4783 two-year olds the prevalence of reported wheeze was 26 %, doctor diagnosed asthma 7 %, atopic dermatitis (AD) 17 % and allergic rhinoconjunctivitis 3 %. Twenty-one percent had been allergy tested, and of these nearly 60 % reported a positive allergy test. In the subsample, the corresponding prevalence of AD was 21 %, but 16 % when diagnosed by the UK Working Party’s Criteria. More than 70 % of the children with AD had mild disease according to the different scoring systems for AD. Questionnaire data from 8817 adolescents (49.7 % girls) aged 13-19 years were eligible for analyses. The prevalence of AD was 13.6 % in girls and 6.7 % in boys. Among teenagers with AD, mental distress was higher for boys (OR 2.1 CI 1.6-2.9) compared with girls (OR 1.3 CI 1.1-1.6). Among the toddlers more boys than girls had an allergy related disorder or a positive allergy test. However, among the adolescents more girls than boys had AD. Conclusions Almost 40 % of the 2-year olds had an allergy related disorder, but less than 10 % had a positive skin prick test (SPT). Boys were more likely than girls to have an allergy related disorder or a positive SPT indicating a gender difference in the natural history of allergy related disorders. The amount of recognized allergic disorders among 2-year olds represents a major burden for affected families and a special challenge for the medical profession. Fortunately, the severity of atopic dermatitis (AD) is mild in most (70 %) of the 2 year-olds. Self-reported mental distress among adolescents with AD differed with regard to sex and age. AD and mental distress as well as most other chronic complaints were reported more prevalently among girls. For adolescents with AD, the association between symptoms and mental distress was stronger for boys than girls. Among adolescents, 10 % reported AD, and in this age group twice as many girls as boys had AD. This indicates a shift in gender preponderance, as there were more boys with AD at 2 years of age.
UtgiverNorges teknisk-naturvitenskapelige universitet, Det medisinske fakultet, Institutt for samfunnsmedisin
SerieDoktoravhandlinger ved NTNU, 1503-8181; 2010:107
Dissertations at the Faculty of Medicine, 0805-7680; 437