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A nationwide study of asthma incidence and its determinants in preschool children during five years of follow up
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: Many studies on asthma prevalence have been published, but the number of studies on asthma incidence in preschool children is limited.

A number of studies on asthma prevalence have been published, but there are few studies on asthma incidence in preschool children. In this project a nationwide sample of preschool children were followed with the aim to estimate 5-year asthma incidence and its determinants.

Methods: Parents of 5886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded in 2002 to a baseline postal questionnaire with questions regarding symptoms indicating possible asthma or atopic conditions, and a number of other variables. In 2007, 4255 of the parents responded to an almost identical questionnaire.

Results: A large number of potential baseline determinants for 5-year asthma incidence were identified. Of these, food allergy, wheezing last 12 months, rhinitis, parental rhinitis, parental asthma, ever asthma, age, and eczema, on rank order of importance, remained significant in multivariate logistic regression analysis. The asthma incidence was highly dependent on presence or absence of these variables. Given the variable mix in the present study population, the incidence ranged from 2.9% in the oldest to 5.8% in the youngest children, corresponding to an annual asthma incidence of 0.6% to 1.2%.

Conclusions: The incidence of asthma is highly dependent on the composition of the underlying population. However, an annual incidence in range a half to one percent in preschool children in the general population appears probable.

Keyword [en]
asthma, incidence rate, preschool children, determinants, parental atopy
National Category
Family Medicine
Research subject
Family Medicine
Identifiers
URN: urn:nbn:se:uu:diva-120591OAI: oai:DiVA.org:uu-120591DiVA: diva2:303646
Available from: 2010-03-15 Created: 2010-03-15 Last updated: 2011-08-15
In thesis
1. A Nationwide Study of Asthma and Allergy in Swedish Preschool Children: with Special Reference to Environment, Daycare, Prevalence, Co-ocurrence and Incidence
Open this publication in new window or tab >>A Nationwide Study of Asthma and Allergy in Swedish Preschool Children: with Special Reference to Environment, Daycare, Prevalence, Co-ocurrence and Incidence
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The aim of this project was to study the age and sex specific occurrence of atopic and non-atopic asthma and other atopic manifestations in a nationwide sample of Swedish pre-school children.

Methods: All 70 allergen avoidance day-care centres (AADC) with 84 sections and 140 matched ordinary day-care centres with 440 sections in 62 municipalities across Sweden were sampled. In 2000 the staff at each section responded to a questionnaire on indoor and outdoor environment at the section. In 2002 parents of 5,886 children attending the AADCs and ODCs responded to a postal questionnaire regarding symptoms indicating prevalent asthma, allergic rhinitis, eczema, and food, furred pet and pollen allergy and other data in their children. In 2007, parents of 4255 children responded to an almost identical follow-up questionnaire.

Results: The AADCs had far more strict rules than ODCs on furred pets and smoking at home and on perfume use, and the indoor environment was better, owing to better cleaning. The age specific asthma prevalence was curvilinear with a peak at age 3 of 11.4% among boys and 9.8% among girls. In addition the prevalence increased by municipality population density, a proxy for degree of urbanisation. There was a highly significant co-occurrence between all asthma-atopic manifestations, but there was no evidence of ordered sequence of manifestation onset. The asthma incidence was highly dependent on presence or absence of co-occurrence variables. Given the variable mix in the present study population, the annual asthma incidence ranged from 0.6% to 1.2%.

Conclusions: AADCs had more strict rules and a better indoor environment than ODCs. The asthma prevalence was affected by age, sex and degree of urbanisation. There was close co-occurrence between all asthma and atopic manifestations but no evidence of ordered sequence of onsets. The annual asthma incidence was strongly dependent of co-occurrence conditions.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 69 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 542
Keyword
Asthma, rhinitis, eczema, allergy, indoor environment, daycare centre, prevalence, incidence epidemiology
National Category
Family Medicine
Research subject
Family Medicine
Identifiers
urn:nbn:se:uu:diva-121426 (URN)978-91-554-7759-2 (ISBN)
Public defence
2010-05-07, Brömssalen, ingång 11, Länssjukhuset, Gävle, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2010-04-16 Created: 2010-03-23 Last updated: 2010-05-10

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Bröms, KristinaEriksson, MargarethaSvärdsudd, Kurt

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