Temporal changes in the prevalence of childhood asthma and allergies in urban and rural areas of Cyprus: results from two cross sectional studies

Abstract

BackgroundThe prevalence of childhood asthma and allergies in Cyprus was significantly higher in urban compared to rural areas back in the year 2000, against a background of an overall low prevalence (e.g. current wheeze 6.9%) by comparison to northern European countries. In this study we aimed to assess temporal changes in the prevalence of asthma and allergies in Cyprus after an 8-year interval and to examine whether any differential changes have occurred in urban and rural parts of the island.MethodsDuring the academic years 1999-2000 and 2007-2008, the parents of 7-8 year old children residing in the same set of urban and rural areas completed the ISAAC core questionnaire. In addition to providing prevalence estimates of allergic diseases in 2000 and 2008, changes between the two periods were expressed as odds ratios estimated in multiple logistic regression models adjusting for survey participants' characteristics.ResultsThe prevalence of current wheeze was higher in 2008 (8.7%, 95% confidence interval 7.5%-9.9%, n = 2216) than the previously recorded figure in 2000 (6.9%, 95% CI 6.2%-7.6%, OR = 1.25, 95% CI: 1.02-1.53, n = 4944). Significant increases were also seen in the prevalence of lifetime asthma (11.3% vs. 17.4%, OR = 1.59, CI: 1.36-1.86), eczema (6.8% vs. 13.5%, OR = 1.91, CI: 1.59-2.29) and allergic rhinoconjuctivitis (2.6% vs. 5.2%, OR = 1.82, CI: 1.39-2.41). The prevalence of current wheeze nearly doubled between 2000 and 2008 in rural areas (5.4% vs. 9.7%, OR 1.81, CI: 1.24-2.64) while no significant change was observed in urban areas (7.5% vs. 8.4%, OR 1.08, CI: 0.84-1.37); p value for effect modification = 0.04. Rises in asthma and rhinitis prevalence, but not eczema were also more pronounced in rural compared to urban areas.ConclusionsThe prevalence of allergic diseases in Cyprus is still on the rise; recent increases appear more pronounced among children living in rural areas possibly indicating recent environmental and lifestyle changes in these communities

Prevalence of asthma and allergies in children from the Greek-Cypriot and Turkish-Cypriot communities in Cyprus: a bi-communal cross-sectional study

“…The response rate among the G/C community was lower than the one in the T/C community, possibly as a result of the steady rise in the number of surveys performed in G/C schools in the last decade. Nevertheless, we do not think that this has compromised the representativeness of the G/C sample since the socio-demographic characteristics of the participants compare very favorably with the profile recorded in other epidemiological studies performed at a similar time in this population with much higher response rates; details of this, and other sensitivity analyses performed to assess the possible magnitude of selection bias in the G/C sample were published in a previous report [12]. Even though the socio-demographic composition of the G/C sample supports its representativeness, we cannot entirely rule out that the findings are not affected by the lower participation among G/C children.…”

“…In the G/C community, prevalence of current wheeze in 7–8 year-old children assessed with the use of ISAAC questionnaire was 8.7% in 2008, demonstrating a rising trend from the previous recorded estimate of 6.9% in 2000–01 [12]. In the T/C community, there is currently no evidence regarding the temporal prevalence trends of allergic conditions in childhood.…”

“…In order to retain comparability with previous studies in the G/C community, schools in two out of the four districts controlled by the Republic of Cyprus (i.e. Nicosia and Limassol) were invited to participate (n = 124, 98% of those contacted) [12]. In the T/C community, schools from the whole geographical area north of the division line were invited to participate (n = 105, 100% of those contacted).…”

“…In the G/C community, childhood allergic diseases were recently reported to be rising [12]. Data from the T/C community are limited to a single epidemiological study published more than 10 years ago [13].…”

Eczema in Early Childhood, Sociodemographic Factors and Lifestyle Habits Are Associated with Food Allergy: A Nested Case-Control Study

“…Since the prevalence of eczema is increasing [20][21][22] , and eczema is highly associated with food allergy [20][21][22] , it may explain the increasing prevalence of food allergy. Understanding the role of the skin barrier is of particular interest as this represents a potentially modifiable risk factor.…”