2. ISEE 2007 PREVALENCE STUDY OF ALLERGY DISEASES IN CHILDREN IN THE CZECH REPUBLIC Růžena Kubínová, Center of Environmental Health, National Institute of Public Health, Prague, Czech Republic

3. Prevalence of allergy diseases in children cross-sectional study, 2006  Main goals:  Current prevalence of allergy diseases in the age groups 5, 9, 13 and 17 years  Trend in allergy diseases prevalence since 1996  Cooperation of u specialists from health institutions u 61 pediatric practitioners  Total of 7075 children in study (93% of the scheduled number)  Geographical coverage: 18 cities in the Czech Republic

4. Cooperating sites

5. Prevalence of allergy diseases around the world  It is currently estimated that about 20 % of the world population suffers from allergy diseases  The GINA report of 2004 shows a two-fold increase of asthma during the last 10 years from 150 to 300 millions of people  Europe – increase is markable through the whole Europe  There are significant regional and social factors contributing to markable differences in prevalence of the disease, although on the relatively small territory of individual countries. u England – variance in the prevalence of asthma symptoms 10 – 30%, similarly in Spain and Italy (ISAAC study) u Switzerland – up to two-fold differences in the evaluation of asthma prevalence in eight cantons (SAPALDIA study)

6. Prevalence of allergy diseases in the Czech Republic 32 %  A total of 2250 allergic patients in the group of 7075 children 32 % 33 % prevailing asthma and pollinosis boys 33 % prevailing asthma and pollinosis 31 % girls 31 %  Symptoms of diseases during the last 12 months were reported in 65 % of allergic patients (21 % children in study)  Prevalence reported by parents was by 3 % lower than the prevalence reported by doctors  Conformity between parents and doctors was attained in 84 % of cases

7. Prevalence of allergy diseases in the cities, the 2006 study Prevalence 18 – 28% Prevalence >30%

8. Outline of monitored diagnoses and their prevalence in the study group Cumulative prevalence (life-long): 8 %  Asthma 8 %(symptoms of disease in the last year 58 %) 13 %  Pollinosis13 % (75 %) 12 %  Constitutional dermatitis 12 % (51 %)  Most represented combination of diagnoses: 3,4 % u pollinosis with const. dermatitis 3,4 % 3,1 % u asthma with pollinosis3,1 %  bronchitis recurring as another allergy disease3 %

9.  Evaluation of asthma seriousness based of five questions  Correlation to pulmonary function FEV1  Full control over asthma in the study group: 44 % asthma patients  Asthma is better controlled in older children 0 10 20 30 40 50 60 5 years9 years13 years17 years % of asthmatics 25 points 20 to 24 points 19 points and less Asthma Control Test

10. Comparison of allergy disease prevalence in the period 1996 - 2001 17%  Number of allergy patients in 1996 17% 25% in 2001* 25% 32 % in 2006* 32 %  In 2006, statistically significantly higher numbers of allergy patients  in all age groups  in all monitored diagnoses *including 17-year

11. Age of allergy disease onset in 5-year-old allergy patients 25,9 18,24,9 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 199620012006 Pre-school age (4 - 5) Infant age (2 - 3) Nursing age (0 - 1)

12. Indoor environment risk factors - comparison of the years 2001 and 2006  Animal in a household: Compared to the 2001 survey, the number of households with an animal decreased in 2006, as well as the number of households of allergy patients with an animal. The number of households with an asthma patient and with a pet remained the same (10% asthma patients have a cat, 20% asthma patients have a dog).  Smoker in a household: The number of households with smokers decreased significantly both for the whole group and for allergy and asthma patients.  Molds in a household: The number of children exposed to molds has changed neither in the whole study group, nor in allergy or asthma patients.

13. Conclusions of the prevalence study in 2006  In 2006, prevalence of allergy diseases in selected monitored cities was 32%, for asthma and pollinosis significantly higher in boys  The number of allergy patients has increased statistically significantly by 15 % compared to 1996  There is an earlier onset of allergy diseases (as compared with 1996 and 2001)  For allergic children, we may observe a positive trend in the decrease of households with a smoker and households with an animal

14. Conclusions of the prevalence study in 2006, cont.  Although the life-long prevalence of allergy diseases is high, not all children have symptoms of disease. This we regard as the marker of successful treatment.  The asthma control test revealed that 44 % asthma patients have their disease under full control.

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