Koet, L.B.M. (Lukas) (2015) Worden kinderen nog steeds allergischer? : Een retrospectief onderzoek naar veranderingen in de prevalentie en de mate van allergische sensibilisatie bij kinderen in de periode 1990-2010. thesis, Medicine.
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Abstract
Introduction: Allergic diseases are common in children and have a major impact on quality of life. In the second half of the 20th century the prevalence of allergic diseases increased markedly, but this prevalence seems to have reached a plateau in the western world. Few studies have been done to investigate time trends in the prevalence and degree of sensitization (the presence of specific IgE against allergens). This study investigated changes in the prevalence and degree of sensitization among children over a 20-yr period. Methods: This retrospective study analyzed all allergic sensitization tests of children (0-18 years) which were performed in the clinical laboratory of Isala hospital (Zwolle) during the period 1990-2010. These children were referred for allergy testing by their primary or secondary care physician, because of clinical suspicion of allergic disease. Sensitization to the ten most prevalent allergens (five food and five inhalant allergens) was investigated. Specific IgE analysis was performed using the ImmunoCap system, with a detection limit of 0.35 kU/l. Time trends in the prevalence and degree of sensitization, adjusted for gender and age, were analyzed. Results: 15768 children (8105 boys, 51.4%) with complete sensitization data were included for analysis. The procedure of stepwise allergic sensitization testing changed to some extent between 1990 and 1994. Sensitization data were available up to May 2010. Hence, the regression models were limited to the period 1994-2009 (13302 children). Boys were significantly younger (median age 7.1 years, interquartile range 4.1 to 11.7 years) than girls (median age 9.7 years, interquartile range 5.2 to 14.9 years, p<0.001). 6906 children (43.8%) were sensitized to one or more allergens. The median number of sensitizations in sensitized children was 2 (interquartile range 1 to 4). Polysensitization (sensitization to 5 or more allergens) was found in 1277 children (8.1%). The prevalence of both sensitization and polysensitization varied during the studied period. No clear linear trends were detectable on visual inspection of the data. Multiple logistic regression of the period 1994-2009 showed that the risk of sensitization increased marginally each year (OR=1.02, 95% CI 1.01 to 1.02, p<0.001). The risk of polysensitization decreased slightly each year (OR=0.97, 95% CI 0.96 to 0,99, p<0.001). From 2000 onwards the median number of sensitizations per sensitized child remained stable. Both univariate analysis and multiple logistic regression showed that male sex and increasing age were associated with greater risk of sensitization and polysensitization (p<0.001). Conclusion: Between 1994 and 2009, the prevalence of allergic sensitization increased significantly whilst the degree of sensitization decreased significantly. However, these statistically significant changes were marginal. No clear trends were seen on visual inspection of the data. It appears, therefore, that the observed significant changes are more likely explained by the large study population than by a clinically relevant change in allergic sensitization over time. Overall, it seems that the prevalence and degree of sensitization of Dutch children have not changed over the past two decades.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Begeleider: and Brand, Prof. dr. Paul L.P. and Locatie: Isala klinieken te Zwolle, afdeling kindergeneeskun |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:59 |
| Last Modified: | 25 Jun 2020 10:59 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1966 |
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