Increasing prevalence of asthma, allergic rhinitis but not eczema in 5- to 8-yr-old Maltese children (ISAAC)

Abstract

The International Study of Asthma and Allergies in Childhood (ISAAC) was the first worldwide study carried out with standardized questionnaires in order to create a reliable global map of childhood allergy. Phase 1 of the study was carried out in the Maltese Islands in 1994/95 while a similar study (phase 3) was repeated 7 yr later (2001/02). In this paper, the data obtained from 3816 5- to 8-yr-olds (80% response rate) in phase 3 were compared to that obtained from 3509 5- to 8-yr-olds (78.5% response rate) in phase 1 of the study in order to evaluate whether the problem of allergic conditions in Maltese schoolchildren was indeed changing. About 30.2% (phase 3) vs. 19.1% (phase 1) (p < 0.0001) of the participants were wheezers ‘ever’ while 14.8% vs. 8.8% (p < 0.0001) were current wheezers and 14.8% vs. 7.5% (p < 0.0001) were labelled as asthmatics. Of these wheezing children, 13.3% vs. 6.2% (p = 0.0002) had a wheezing episode severe enough to limit speech. Nasal problems were present in 28.8% of Maltese children in 2001 and in 23.4% in 1994 (p < 0.0001) and 24.4% vs. 20.7% (p < 0.0001) of all respondents persisted with these symptoms up to the year of answering the questionnaire. Hayfever had been diagnosed in 22.2% vs. 14.7% (p < 0.0001) of all the children. About 6.7% vs. 7.0% (p = 0.61) of respondents had an recurring itchy rash suggestive of eczema for at least 6 months of their lives and 5.4.% vs. 5.5% had it currently. In 1994, the prevalence of wheezing and eczema were slightly lower than the global mean, unlike the case of rhinitis, which in Malta was commoner than the world average, while in 2001 wheezing together with rhinitis surpassed the global mean as well. These results indicate a rising prevalence of wheezing and rhinitis but not eczema in Maltese children. Asthma seemed to be better controlled and all three allergic conditions more likely to be diagnosed.