Worldwide trends in the prevalence of asthma symptoms: phase III of the International Study of Asthma and Allergies in Childhood (ISAAC) (original) (raw)
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The Lancet, 2021
Background Asthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of asthma symptoms is changing. Methods This updated cross-sectional study used the same methods as the International Study of Asthma and Allergies in Childhood (ISAAC) Phase III. Asthma symptoms were assessed from centres that completed GAN Phase I and ISAAC Phase I (1993-95), ISAAC Phase III (2001-03), or both. We included individuals from two age groups (children aged 6-7 years and adolescents aged 13-14 years) who self-completed written questionnaires at school. We estimated the 10-year rate of change in prevalence of current wheeze, severe asthma symptoms, ever having asthma, exercise wheeze, and night cough (defined by core questions in the questionnaire) for each centre, and we estimated trends across world regions and income levels using mixed-effects linear regression models with region and country income level as confounders. Findings Overall, 119 795 participants from 27 centres in 14 countries were included: 74 361 adolescents (response rate 90%) and 45 434 children (response rate 79%). About one in ten individuals of both age groups had wheeze in the preceding year, of whom almost half had severe symptoms. Most centres showed a change in prevalence of 2 SE or more between ISAAC Phase III to GAN Phase I. Over the 27-year period (1993-2020), adolescents showed a significant decrease in percentage point prevalence per decade in severe asthma symptoms (-0•37, 95% CI-0•69 to-0•04) and an increase in ever having asthma (1•25, 0•67 to 1•83) and night cough (4•25, 3•06 to 5•44), which was also found in children (3•21, 1•80 to 4•62). The prevalence of current wheeze decreased in low-income countries (-1•37,-2•47 to-0•27), in children and-1•67,-2•70 to-0•64, in adolescents) and increased in lower-middle-income countries (1•99, 0•33 to 3•66, in children and 1•69, 0•13 to 3•25, in adolescents), but it was stable in upper-middleincome and high-income countries. Interpretation Trends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma.
International patterns of the prevalence of pediatric asthma
Pediatric Clinics of North America, 2003
Just as the occurrence of asthma and allergies can be studied at many different levels including populations, individuals, organs, tissues, or cells, the causes of asthma can be studied at these different levels. All of these approaches are potentially useful, and individual researchers will focus on different levels of analysis depending on their training, areas of interest, and availability of funding . In the past the major contribution of epidemiology to the study of chronic diseases has been on the population level, including analyses of patterns of disease prevalence and incidence across demographic, geographic, and temporal factors (''person, place, and time''). In particular, many of the epidemiologic hypotheses concerning the causes of cancer and chronic diseases such as coronary disease have stemmed, at least in part, from geographic comparisons .
Allergologia et Immunopathologia, 2020
Introduction and Objectives: There have been differences in temporal trends of asthma prevalence by geographic region and economic prosperity. The aim of this study was to assess temporal trends in asthma prevalence among young adolescents in Skopje, Republic of North Macedonia as a developing country with a low asthma prevalence. Subjects and Methods: Data was obtained from three cross-sectional surveys (2002, 2006, and 2016) of adolescents (12-15 years) from randomly selected schools in Skopje. Trends in the prevalence of asthma and asthma-like symptoms were investigated descriptively and using multiple logistic regression to adjust for potential confounding factors. Results: The prevalence of asthma increased, although the changes were not statistically significant (2002: 1.7%; 2006: 2.0%; 2016: 2.8%; p = 0.075). Statistically significant (p < 0.05) reductions in wheeze prevalence over time (2002, 2006, 2016) were observed for current wheeze (8.8%, 7.2%, 5.5%), exercise-induced wheeze (14.2%, 7.9%, 1.9%), and night dry cough (16.5%, 13.5%, 9.6%). After adjustment for potential confounding factors, there was an increase in asthma likelihood by year compared to 2002 (2006: OR = 1.22, 95%CI = 0.67−2.22; 2016: OR = 2.45, 95%CI = 1.24−4.84). In the adjusted analyses, associations between year and the asthma-like symptoms confirmed the descriptive results, except for current wheeze, where statistical significance disappeared.
International Journal of Epidemiology, 2008
Background There are extensive data on the prevalence of childhood asthma worldwide but the relationships between asthma symptom prevalence, mortality and hospital admissions have not been investigated. Methods The International Study of Asthma and Allergies in Childhood (ISAAC) used a standard questionnaire to measure the 12-month period prevalence of asthma symptoms by parental report in 6-7 year olds in 40 countries, and by self-report in 13-14 year olds in 60 countries. The initial survey was in the mid 1990s (Phase One) and this was repeated in the early 2000s (Phase Three). We correlated the prevalence values of any wheeze and severe wheeze with national data on mortality and hospital admissions for asthma in 5-14 year olds. Results All correlations with prevalence were positive. In 13-14 year olds, the correlations between severe wheeze in Phase One and contemporaneous mortality and hospital admission rates were r ¼ 0.32 (P ¼ 0.047) and r ¼ 0.73 (P ¼ 0.003), respectively. In 6-7 year olds in Phase One, the correlation with severe wheeze and mortality was r ¼ 0.42 (P ¼ 0.024). In 14 countries the correlation between admission and mortality rates in the 5-14 year age group was r ¼ 0.53 (P ¼ 0.054). Conclusions There are consistently positive associations between asthma symptom prevalence, admissions and mortality. The prevalence of asthma symptoms in children obtained from local questionnaire studies may provide a guide to estimate the incidence of severe episodes of asthma in countries with incomplete data on hospital admissions or mortality, or vice versa.
IDENTIFYING INTERNATIONAL DIFFERENCES IN ASTHMA SEVERITY, CONTROL, AND TREATMENT IN KIDS AND ADULTS
Aim: The Global Initiative for Asthma recommendations set asthma treatment targets in 2020, that were modified in 2021. Unfortunately, there have been no significant international surveys on asthma control. The Asthma Insights Also Realities studies remain primary large-scale studies to look at global differences in asthma harshness, controller, in addition treatment in kids and grownups. Methods: A cross-section of homes in 27 regions such As South America, Australia, and Asia being polled to detect asthmatic individuals having signs during previous year but which remained using present asthma medication among the overall population. A standardized survey was applied to 7796 individuals and, by proxy, 3157 asthmatic adolescents. The relative and absolute patient perceptions of asthma symptoms and intensity, comprising medical care, health care usage, missed work-school, also medicine utilization, have been evaluated. Results: Considering regional differences, asthma had a significant effect on individuals' life, with significant loss of school as well as workdays. The present global equal of asthma controller falls very short of lengthy treatment targets outlined in global standards. The considerable number of individuals endure to have signs also lifestyle constraints, necessitating emergency care. Adolescent asthmatic individuals were likewise overrepresented among current smokers. Nonetheless, even now in individuals with symptomatic chronic asthma, the use of anti-inflammatory preventive therapy remained small, ranging from 28 percent in Western Europe to 10% in China, as did usage of objective lung purpose tests. In all locations, the association among self-perceived harshness of asthma also neutral analysis of intensity using GINA parameters remained abnormally low.Conclusion: Researchers suggest that, complementary alternative medicines, many patients globally have inadequate patient outcomes, with lengthy care dropping far short of GINA criteria. Keywords: Global Initiative, Asthma recommendations, asthma treatment.
The European respiratory journal, 2017
The Global Asthma Network (GAN), established in 2012, followed the International Study of Asthma and Allergies in Childhood (ISAAC). ISAAC Phase One involved over 700 000 adolescents and children from 156 centres in 56 countries; it found marked worldwide variation in symptom prevalence of asthma, rhinitis and eczema that was not explained by the current understanding of these diseases; ISAAC Phase Three involved over 1 187 496 adolescents and children (237 centres in 98 countries). It found that asthma symptom prevalence was increasing in many locations especially in low- and middle-income countries where severity was also high, and identified several environmental factors that required further investigation.GAN Phase I, described in this article, builds on the ISAAC findings by collecting further information on asthma, rhinitis and eczema prevalence, severity, diagnoses, asthma emergency room visits, hospital admissions, management and use of asthma essential medicines. The subjec...
The Journal of Allergy and Clinical Immunology: In Practice, 2015
What is already known about this topic? Prior asthma surveys, conducted from 1998 to 2004 in various countries, reported levels of symptoms, activity limitations, and urgent treatment (eg, hospitalization) in patients with asthma, as well as the level of overall asthma control. What does this article add to our knowledge? This examination of results from surveys conducted from 2009 to 2011 on patients with asthma in 20 countries provides new insight into regional differences and similarities in patients' asthma characteristics, and it reveals numerous unmet needs with regard to the current state of asthma care and overall patient expectations. How does this study impact current management guidelines? The global Asthma Insight and Management surveys found patient-exhibited lack of conviction on asthma treatment recommendations and management guidelines and revealed an ongoing need for improvements in asthma care.