背景:关于儿童时期过敏状况的人群患病率的纵向数据有限,很少有研究纳入参考标准口服食物挑战来确认食物过敏。
目的:描述IgE介导的食物过敏的人群患病率,湿疹,哮喘,墨尔本6岁和10岁的鼻炎,澳大利亚。
方法:HealthNuts研究在墨尔本招募了5,276名1岁婴儿,澳大利亚,在6岁和10岁时重复评估。在6岁和10岁时,护理人员填写了一份关于过敏性疾病症状和医生诊断的问卷(儿童哮喘和过敏的国际研究).儿童被邀请参加临床评估,包括皮肤点刺测试,肺功能检查,和口服食物挑战。为了最小化减员偏差的影响,对6岁和10岁参与者的患病率估计值进行加权,以反映招募时整个队列的特征.
结果:总计,4,455和4,065个家庭在6岁和10岁时参加了会议,分别(原始队列的84%和77%)。其中,73%和55%的参与者年龄在6岁和10岁,分别,完成临床评估。总的来说,36.5%(95%CI,34.8-38.2)和38.2%(95%CI,36.5-40.1%)的6岁和10岁儿童患有至少一种当前过敏性疾病,大约三分之一的人患有两种或两种以上的过敏性疾病。6岁儿童中6.4%(95%CI,5.6-7.2)发生食物过敏,10岁儿童中6.3%(95%CI,5.5-7.2)发生食物过敏。在婴儿期有挑战性确认食物过敏的婴儿中,45%的人在10岁时患有持续性疾病。目前诊断为6岁和10岁哮喘的患病率分别为12.1%(95%CI,10.9-13.3)和13.1%(95%CI,11.9-14.4),分别,目前的湿疹略有下降,从6岁时的15.3%(95%CI,14.1-19.7)下降到10岁时的12.9%(95%CI,11.7-14.2),当前的鼻炎从6岁时的15.1%(95%CI,13.9-16.5)增加到10岁时的25.0%(95%CI,23.4-26.7).
结论:40%的小学学龄儿童患有过敏性疾病;三分之一有多种过敏性诊断。挑战确认的食物过敏患病率仍然很高,45%的食物过敏婴儿在10岁以下有持续性疾病。
BACKGROUND: There are limited longitudinal data on the population prevalence of allergic conditions during childhood, and few studies have incorporated the reference standard oral food challenge to confirm food allergy.
OBJECTIVE: To describe the population prevalence of IgE-mediated food allergy, eczema, asthma, and rhinitis at ages 6 and 10 years in Melbourne, Australia.
METHODS: The HealthNuts
study recruited 5,276 1-year-old infants in Melbourne, Australia, with repeat assessments at ages 6 and 10 years. At ages 6 and 10 years, carers completed a questionnaire on symptoms and doctor diagnosis of allergic conditions (International
Study of Asthma and Allergies in Children). Children were invited to attend a clinic assessment including skin prick test, lung function tests, and oral food challenges when indicated. To minimize the impact of attrition bias, prevalence estimates among participants at ages 6 and 10 years were weighted to reflect characteristics of the whole cohort at recruitment.
RESULTS: In total, 4,455 and 4,065 families participated at ages 6 and 10 years, respectively (84% and 77% of the original cohort). Of those, 73% and 55% of participants ages 6 and 10 years, respectively, completed clinical assessments. Overall, 36.5% (95% CI, 34.8-38.2) and 38.2% (95% CI, 36.5-40.1%) of 6- and 10-year-olds had at least one current allergic disease, and around one third of those had two or more allergic diseases. Food allergy occurred in 6.4% (95% CI, 5.6-7.2) of 6-year olds and 6.3% (95% CI, 5.5-7.2) of 10-year-olds. Among infants with challenge-confirmed food allergy in infancy, 45% had persistent disease at age 10 years. The prevalence of current diagnosed asthma at ages 6 and 10 years were 12.1% (95% CI, 10.9-13.3) and 13.1% (95% CI, 11.9-14.4), respectively, current eczema decreased slightly from 15.3% (95% CI, 14.1-19.7) at age 6 years to 12.9% (95% CI, 11.7-14.2) at age 10 years, and current rhinitis increased from 15.1% (95% CI, 13.9-16.5) at age 6 years to 25.0% (95% CI, 23.4-26.7) at age 10 years.
CONCLUSIONS: Allergic diseases affect 40% of primary school-age children; one third have multiple allergic diagnoses. Challenge-confirmed food allergy prevalence remains high, and 45% of infants with food allergy have persistent disease to age 10 years.