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Prevalence of asthma and allergy in Hong Kong schoolchildren: an ISAAC study
1Dept of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.
Insights
Childhood asthma and allergies are rising in Hong Kong, with significant increases in prevalence since 1992. This study highlights a concerning trend in respiratory symptoms among schoolchildren, emphasizing the need for further research into environmental factors.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology of Respiratory Diseases
- Environmental Health
Background:
- Increasing prevalence of childhood asthma and allergic diseases in Western countries contrasts with less defined trends in Chinese populations.
- Understanding temporal changes in pediatric allergic diseases is crucial for public health interventions.
Purpose of the Study:
- To determine the prevalence of asthma and allergic diseases in Hong Kong schoolchildren.
- To compare current prevalence rates with historical data to identify trends.
- To investigate factors associated with current wheeze and severe asthma attacks.
Main Methods:
- Utilized the International Study of Asthma and Allergy in Childhood (ISAAC) protocol for data collection in 4,665 schoolchildren (aged 13-14).
- Administered written and video questionnaires assessing asthma, wheeze, respiratory symptoms, rhinitis, and eczema.
- Collected additional data on parental education and smoking status; employed logistic regression for analysis.
Main Results:
- Prevalence rates: asthma ever (11%), wheeze ever (20%), current wheeze (12%), current rhinitis (52%), current eczema (15%).
- Higher prevalence in boys; significant associations found between current wheeze/severe attacks and male sex, current rhinitis, current eczema, and active smoking.
- Compared to 1992 data, prevalence of asthma ever increased by 71% and wheeze ever by 255%.
Conclusions:
- Significant increase in asthma and wheeze prevalence among Hong Kong schoolchildren from 1992 to 1994-1995.
- Current rhinitis, eczema, and active smoking are key risk factors for wheezing symptoms.
- Environmental factors likely play a critical role in the rising incidence of pediatric asthma and allergies.
Abstract:
Asthma and allergic disease in children is increasing in many Western countries but such trend has not been well-defined in Chinese populations. This paper aims to determine the prevalence of asthma and allergic disease in Hong Kong schoolchildren and compare it with previous data to identify a changing trend. We studied 4,665 schoolchildren aged 13-14 yrs using the International Study of Asthma and Allergy in Childhood (ISAAC) protocol to determine prevalence rates for asthma, wheeze, respiratory symptoms, rhinitis and eczema in 1994-1995. Additional questions on education levels of the parents and smoking status were also asked. Concordance between responses to the written and video questionnaires was good (76% for wheeze ever, 80% for current wheeze). Prevalence rates for asthma ever, wheeze ever, and current wheeze were 11, 20 and 12%, respectively, and were greater in boys (p < 0.05). Rhinitis affected slightly over half of the subjects (52%), and eczema was reported by a sixth (15%), whilst current rhinitis and current eczema were present in 44% and 3.6% of children, respectively. In multiple logistic regression: odds ratio male sex (OR) 1.47; (95% confidence interval (95% CI) 1.15-1.86); current rhinitis (OR 3.00; 95% CI 2.36-3.81); current eczema (OR 2.34; 95% CI 1.40-3.93); and active smoking (OR 2.00; 95% CI 1.38-2.89) were associated with current wheeze; whilst severe wheezing attack was associated with: current rhinitis (OR 2.72; 95% CI 1.47-5.02); current eczema (OR 6.13; 95% CI 2.82-13.33); and active smoking (OR 4.62; 95% CI 2.43-8.76). Age, parental education and passive smoking were not important factors. When compared to previous epidemiological data obtained in 1992, the prevalence rates for asthma ever and wheeze ever had increased by 71 and 255%, respectively, in Hong Kong schoolchildren. The severity of asthma and respiratory symptoms showed a similar increasing trend. Further studies should aim to identify the role of the environment in the pathogenesis of asthma.