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Background\ud 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.\ud Methods\ud 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.\ud Findings\ud 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-middle-income and high-income countries.\ud Interpretation\ud 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.\ud Funding\ud International Union Against Tuberculosis and Lung Disease, Boehringer Ingelheim New Zealand, AstraZeneca Educational Grant, National Institute for Health Research, UK Medical Research Council, European Research Council, and Instituto de Salud Carlos III.

SummaryObjective To analyze the knowledge of asthma and its management in Spanish school teachers using the Newcastle Asthma Questionnaire (NAKQ). Design Descriptive, observational prevalence study, using a self-report questionnaire on knowledge about childhood asthma and its management by teachers in pre-school, primary, and secondary schools in nine Spanish cities. Age, sex, academic training, teaching experience, courses in which they taught, and personal and family history of asthma, were collected from each teacher. For knowledge determination, the validated Spanish version of the NAKQ was used. Results A total of 208 centers participated, including 7,494 teachers. The questionnaire was completed by 4,679 teachers (62.4%). The mean score of correct responses was 16.0 ± 4.8 points out of 31 (median = 17, range: 0–30). Only 6.8% of teachers were capable of pointing out the three main symptoms of the disease; 1.5% knew the triggering factors of an asthma attack; 8.6% knew two medicines useful during an asthma attack; 32.7% knew that inhaled medications had less side effects than pills, and only 3.8% knew of ways to prevent asthma attacks during exercise. In the multivariate analysis, variables significantly associated with a higher questionnaire score were a “lower age” (Beta coefficient = −0.09), “male gender” (Beta = 0.77), “being asthmatic” (Beta = 2.10), or “having close relatives with asthma” (Beta = 1.36) and “teaching in a private school” (Beta = 0.66) or in “compulsory secondary education” (Beta = 0.59). Conclusions Teachers have a low level of knowledge about asthma, with an important limitation in some aspects of the disease. They should be trained to recognize the main symptoms of the disease, on how to act in the event of symptoms, and the early identification of situations in which the pupils require health care assistance. Pediatr Pulmonol. 2016;51:678–687. © 2015 Wiley Periodicals, Inc.

Resumen Objetivo Evaluar la fiabilidad y la validez de la version en castellano del cuestionario NewCastle Asthma Knowledge Questionnaire (NAKQ) para la determinacion de conocimientos sobre asma en profesores. Metodos Diseno y muestra: estudio observacional, transversal, en centros educativos de A Coruna con segundo ciclo de educacion infantil, primaria y/o secundaria obligatoria. Los centros se seleccionaron mediante muestreo aleatorizado, estratificado segun titularidad y nivel educativo (24 centros, 864 profesores). Contestaron 537 (62,1%) docentes (precision, ± 4%, seguridad, 95%). Mediciones Edad, sexo, formacion academica, experiencia docente, antecedentes personales/familiares de asma, cuestionario NAKQ. Analisis Evaluacion de consistencia interna (alfa de Cronbach). La validez concurrente se determino comparando la puntuacion en docentes asmaticos o con familiares asmaticos y docentes sin contacto con el asma. Se evaluo la fiabilidad test-retest en 2 centros seleccionados aleatoriamente, mediante indice Kappa, metodologia de Bland-Altman y el coeficiente de correlacion intraclase. Resultados La puntuacion media del cuestionario NAKQ fue 15,7 ± 5,3 (mediana 17), contestando correctamente el 50,6% de items. El coeficiente alfa de Cronbach fue 0,824 (IC 95%: 0,802-0,845). La puntuacion NAKQ fue mayor en asmaticos o con familiares proximos asmaticos (17,7 ± 3,3) que en docentes con familiares lejanos asmaticos (16,1 ± 5,4) y docentes sin contacto proximo con el asma (15,1 ± 5,6; p En el analisis test-retest (Kappa 0,33 a 1) no hubo diferencias entre la puntuacion NAKQ en la primera y la segunda cumplimentacion (diferencia media, 0,3 ± 2,3; coeficiente de correlacion intraclase, 0,863). Conclusiones Las puntuaciones obtenidas con la version espanola del NAKQ en profesores de centros escolares espanoles son fiables y validas para medir su grado de conocimiento de asma.

The association between early exposure to paracetamol or to antibiotics and eczema is conflicting. This study aims to know whether the early exposure to those drugs is associated with eczema at school age, and whether the strength of the association is modified by the presence of asthma or rhinoconjunctivitis. Children aged 6-7 (n = 13908) from the International Study of Asthma and Allergies in Childhood in Spain provided data about current asthma, rhinoconjunctivitis and eczema. Parent-reported information was also obtained on paracetamol and antibiotic consumption during the first year of life. Logistic regression analysis with eczema as outcome and including exposure to paracetamol or to antibiotics, together with possible confounders, was carried out in the whole sample of children and in five different strata: no respiratory symptom and any respiratory symptom further subdivided into: asthma with rhinoconjunctivitis, asthma without rhinoconjunctivitis and rhinoconjunctivitis without asthma. In the whole sample, exposure to paracetamol was associated with eczema (aOR 1.56 [1.36-1.80]) as was antibiotic consumption (aOR 1.66 [1.43-1.92]). These associations did not substantially change after additionally adjusting for the other drug. A similar pattern was found among children without respiratory symptoms. In children with symptoms, adjusting for the other drug modified the association with paracetamol (aOR from 1.32 [1.03-1.71] to 1.09 [0.83-1.43]) but did not change that with antibiotics (aOR from 1.80 [1.38-2.35] to 1.81 [1.37-2.39]). Early exposure to paracetamol or to antibiotics is associated with an increased prevalence of eczema at school age. Asthma and/or rhinoconjunctivitis substantially modifies this association.

The objective of this study was to estimate the relationship between the prevalence of asthma in schoolchildren aged 6-7 years and 13-14 years and the mean annual sunny hours (MASH) in Spain, and to explore predictive models for asthma prevalence. The prevalence of asthma was obtained from the International Study of Asthma and Allergies (ISAAC) Phase III 2002-2003, and climate and socio-economic variables from official sources. Nine centres were studied and a further four centres, two of which are in ISAAC, to test the predictive models. Logistic regression was used to estimate adjusted prevalence rates of asthma for each centre, and multiple regression models to study the effects of MASH and other meteorological and socio-economic variables. The adjusted prevalence rate of asthma decreased 0.6% [95% confidence interval (CI) 0.4-0.8%] for the 6-7 years group and 1.1% (95% CI 0.8-1.3%) for the 13-14 years group with an increase in the MASH of 100 h. Relative humidity was negatively associated with asthma in the older age group, and gross province product per capita (GPP) was positively associated with asthma in the younger age group. The predictive models, which included MASH, gender, relative humidity, and GPP, anticipated prevalence rates of asthma without significant differences between the levels observed and those expected in 9 of the 11 measurements carried out. The results indicate that sunny hours have a protective effect on the prevalence of asthma in schoolchildren.

Resumen Introduccion El objetivo del estudio ha sido analizar la relacion entre contaminantes del aire y la prevalencia de sintomas recientes de asma, rinitis alergica y eccema atopico, en escolares de 6 y 7 anos. Pacientes y metodos La prevalencia de sintomas de enfermedades alergicas recientes (ultimos 12 meses) se obtuvo mediante el cuestionario del estudio ISAAC (International Study of Asthma and Allergies in Childhood) Espana, con la participacion de 7 centros (Asturias, Barcelona, Bilbao, Cartagena, La Coruna, Madrid y Valencia) y 20.455 escolares de 6 y 7 anos, durante 2002–2003. De los sistemas de deteccion de contaminantes de los centros citados se obtuvieron datos de las concentraciones anuales medias de dioxido de azufre (SO2), dioxido de nitrogeno (NO2), monoxido de carbono (CO) y total de particulas en suspension. Resultados La concentracion media anual (CMA) de SO2 se asocio significativamente con una mayor prevalencia de asma grave reciente (odds ratio ajustada [ORa], nivel 3 sobre nivel 1 de contaminacion=1,32; intervalo de confianza [IC] del 95%, 1,01–1,73), rinitis (ORa=1,56; IC del 95%, 1,39–1,75) y rinoconjuntivitis (ORa=1,70; IC del 95%, 1,45–2,00). La CMA de CO se asocio con una prevalencia mas alta de rinitis (ORa=1,65; IC del 95%, 1,34–2,04), rinoconjuntivitis (ORa=1,76; IC del 95%, 1,31–2,37) y eccema atopico (ORa=1,55; IC del 95%, 1,17–2,04). Las CMA de NO2 y de total de particulas en suspension presentaron asociaciones inversas con la prevalencia de tos seca nocturna. Conclusiones Se indica que contaminantes del aire, como SO2 y CO, incrementan el riesgo de sintomas recientes de asma y rinitis alergica en escolares de 6 y 7 anos de nuestro medio.

Objective The objective of the study was to analyze the relationship between air pollutants and the prevalence of recent symptoms of asthma, allergic rhinitis, and atopic eczema in schoolchildren aged between 6 and 7 years. Patients and Methods The prevalence of recent (previous 12 months) symptoms of allergic diseases was obtained by means of the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC), Spain, with the participation of 7 centers (Asturias, Barcelona, Bilbao, Cartagena, La Coruna, Madrid, and Valencia) and 20 455 schoolchildren aged between 6 and 7 years, from 2002 to 2003. The pollutant detection systems of the aforementioned centers provided the mean annual concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and total suspended particulate matter. Results The annual average concentration of SO2 showed a significant association with a higher prevalence of recent severe asthma (adjusted odds ratio [aOR] between level-1 and level-3 pollution, 1.32; 95% confidence interval [CI], 1.01–1.73), rhinitis (aOR, 1.56; 95% CI, 1.39–1.75), and rhinoconjunctivitis (aOR, 1.70; 95% CI, 1.45–2.00). The annual average concentration of CO was associated with a higher prevalence of rhinitis (aOR, 1.65; 95% CI, 1.34-2.04), rhinoconjunctivitis (aOR, 1.76; 95% CI, 1.31–2.37), and eczema (aOR, 1.55; 95% CI, 1.17–2.04). The annual average concentration for NO2 and total suspended particulate matter showed inverse associations with the prevalence of nocturnal dry cough. Conclusions Findings suggest that air pollutants such as SO2 and CO increase the risk of recent symptoms of asthma and allergic rhinitis in schoolchildren aged between 6 and 7 years in Spain.

ObjetivoDescribir la prevalencia de dermatitis atópica (DA) y conocer las características de la dieta en niños con DA.DiseñoEstudio descriptivo, transversal.EmplazamientoCentros escolares de educación primaria.Mediciones principalesSe realizó un estudio mediante la utilización del cuestionario validado y estandarizado del estudio ISAAC de fase III, que permite conocer la prevalencia de DA en niños y compararla entre centros. Se acompañó de una encuesta sobre consumo de alimentos. Se calcularon la razón de prevalencia (RP) de DA en relación con el consumo de alimentos y los intervalos de confianza del 95%.ResultadosSe incluyó en el estudio a un total de 28.448 niños de 6-7 años. La prevalencia de DA clínicamente diagnosticada fue del 15,35% en niños y del 15,24% en niñas. Los alimentos más consumidos fueron la leche y los cereales, seguidos del arroz, la pasta y los huevos. Los alimentos menos consumidos fueron la mantequilla, la margarina y la comida rápida.Se observó una razón de prevalencia de DA en los niños que consumían pasta (RP=1,35), pescado (RP=1,28), cereales (RP=1,26), huevos (RP=1,13) y carne (RP=1,09).ConclusionesLa prevalencia de DA en España fue del 15,3% asociada con el consumo de alimentos. El consumo de lácteos, cereales y aceite de oliva es adecuado. La ingesta de fruta, verdura, pescado y legumbres es inferior a la aconsejada. Sería necesario realizar futuros estudios sobre el tema.ObjectivesTo describe the prevalence of atopic eczema (AE) and to find the characteristics of the diet of children with AE.DesignDescriptive, transversal study.SettingPrimary schools.Main measurementsThe study used the standardized and validated questionnaire of the ISAAC phase III study, which finds the prevalence of AE in children and enables inter-centre comparison to be conducted. A questionnaire about food consumption was included. The prevalence ratio (PR) of AE and food consumption (95% confidence intervals) was calculated.ResultsA total of 28 448 children aged 6-7 were included in the study. The prevalence of clinically diagnosed AE was 15.35% in boys and 15.24% in girls. The foods most often consumed were: dairy and cereals, followed by rice, pasta, and eggs. The least consumed were: butter, margarine, and fast food. The PR for children who consumed pasta was (PR=1.35), seafood (PR=1.28), cereals (PR=1.26), eggs (PR=1.13), and meat (PR=1.09).ConclusionsThe prevalence of AE in Spain was 15.3%, and was associated with food consumption. The consumption of dairy products, cereals, and olive oil was appropriate. The intake of fruit, vegetables, seafood, and legumes was below the recommended amounts. Future studies on the question are needed.

Background: Although several studies have investigated the influence of diet on asthma in schoolchildren, none of them has evaluated how obesity can modify this effect. A study was undertaken to evaluate the association of various foods and a Mediterranean diet with the prevalence of asthma and rhinoconjunctivitis, adjusting for obesity and exercise. Methods: A cross-sectional study was performed in 20 106 schoolchildren aged 6–7 years from eight Spanish cities. Using the ISAAC phase III questionnaire, parents reported chest and nose symptoms, food intake, weight, height and other factors, including exercise. A Mediterranean diet score was developed. A distinction was made between current occasional asthma (COA) and current severe asthma (CSA). Results: Independent of the amount of exercise, each Mediterranean score unit had a small but protective effect on CSA in girls (adjusted OR 0.90, 95% CI 0.82 to 0.98). Exercise was a protective factor for COA and rhinoconjunctivitis in girls and boys (the more exercise, the more protection). Obesity was a risk factor for CSA in girls (adjusted OR 2.35, 95% CI 1.51 to 3.64). Individually, a more frequent intake (1–2 times/week and ⩾3 times/week vs never/occasionally) of seafood (adjusted ORs 0.63 (95% CI 0.44 to 0.91) and 0.53 (95% CI 0.35 to 0.80)) and cereals (adjusted OR 0.56 (95% CI 0.30 to 1.02) and 0.39 (95% CI 0.23 to 0.68)) were protective factors for CSA, while fast food was a risk factor (adjusted ORs 1.64 (95% CI 1.28 to 2.10) and 2.26 (95% CI 1.09 to 4.68)). Seafood (adjusted ORs 0.74 (95% CI 0.60 to 0.92) and 0.67 (95% CI 0.53 to 0.85)) and fruit (adjusted ORs 0.76 (95% CI 0.60 to 0.97) and 0.71 (95% CI 0.57 to 0.88)) were protective factors for rhinoconjunctivitis. Conclusions: A Mediterranean diet has a potentially protective effect in girls aged 6–7 years with CSA. Obesity is a risk factor for this type of asthma only in girls.

To analyze the knowledge of asthma and its management in Spanish school teachers using the Newcastle Asthma Questionnaire (NAKQ).Descriptive, observational prevalence study, using a self-report questionnaire on knowledge about childhood asthma and its management by teachers in pre-school, primary, and secondary schools in nine Spanish cities. Age, sex, academic training, teaching experience, courses in which they taught, and personal and family history of asthma, were collected from each teacher. For knowledge determination, the validated Spanish version of the NAKQ was used.A total of 208 centers participated, including 7,494 teachers. The questionnaire was completed by 4,679 teachers (62.4%). The mean score of correct responses was 16.0 ± 4.8 points out of 31 (median = 17, range: 0-30). Only 6.8% of teachers were capable of pointing out the three main symptoms of the disease; 1.5% knew the triggering factors of an asthma attack; 8.6% knew two medicines useful during an asthma attack; 32.7% knew that inhaled medications had less side effects than pills, and only 3.8% knew of ways to prevent asthma attacks during exercise. In the multivariate analysis, variables significantly associated with a higher questionnaire score were a "lower age" (Beta coefficient = -0.09), "male gender" (Beta = 0.77), "being asthmatic" (Beta = 2.10), or "having close relatives with asthma" (Beta = 1.36) and "teaching in a private school" (Beta = 0.66) or in "compulsory secondary education" (Beta = 0.59).Teachers have a low level of knowledge about asthma, with an important limitation in some aspects of the disease. They should be trained to recognize the main symptoms of the disease, on how to act in the event of symptoms, and the early identification of situations in which the pupils require health care assistance. Pediatr Pulmonol. 2016;51:678-687. © 2015 Wiley Periodicals, Inc.

Fundamento y objetivo Estimar la evolucion temporal de la prevalencia de sintomas de rinitis alergica y sus variaciones geograficas. Pacientes y metodo Durante 2001-2002 se efectuo la tercera fase del estudio ISAAC, cuyos resultados se compararon con los de la primera fase (1993-1994). Este estudio transversal incluyo a 30.046 escolares de 13-14 anos en 9 centros (Asturias, Barcelona, Bilbao, Cartagena, Castellon, Madrid, Pamplona, Valencia y Valladolid). Se empleo un cuestionario sobre sintomas de rinitis cumplimentado por los escolares en colegios e institutos con una participacion entre el 100 y el 75,8%. Se emplearon modelos de regresion de Poisson para estudiar la evolucion. Resultados Se aprecio una evolucion dispar de la prevalencia de sintomas de rinitis alergicas con disminucion en Barcelona y Bilbao, estabilizacion en Cartagena, Pamplona y Valencia, e incremento en Castellon, Madrid y Valladolid, aunque el aumento de la alergia nasal fue general. Ajustando por sexo, centro y cambio estacional, las prevalencias de rinoconjuntivitis en los ultimos 12 meses (razon de prevalencia = 1,13; intervalo de confianza del 95%, 1,07-1,19) y de alergia nasal alguna vez (razon de prevalencia = 1,22; intervalo de confianza del 95%, 1,15-1,30) crecieron. La prevalencia de sintomas de rinitis alguna vez descendio y la de rinitis en los ultimos 12 meses no experimento variacion. Las prevalencias de rinoconjuntivitis y alergia nasal variaron por centros, correspondiendo a Madrid, Asturias, Cartagena y Bilbao las mas elevadas. En conjunto, los datos indican una situacion intermedia al comparar con otros paises segun el metodo ISAAC. Conclusiones Se han identificado dos patrones en la evolucion de los sintomas de rinitis alergica y el estudio de factores de riesgo en el ambito local seria de importancia para su prevencion.

a b s t r a c t Objective: To evaluate the reliability and validity of the Spanish version of the Newcastle Asthma Knowl- edge Questionnaire (NAKQ) for determining asthma knowledge in teachers. Methods: Design and sample: A cross-sectional observational study in educational centers of A Coru ˜ na providing preschool, primary school and/or compulsory secondary education. Centers were selected by random sampling, stratified by ownership and educational level (24 centers, 864 teachers). A total of 537 (62.1%) teachers responded (precision, ±4%, confidence, 95%). Measurements: Age, sex, academic training, teaching experience, personal/family history of asthma, NAKQ. Analysis: Evaluation of internal consistency (Cronbach's alpha). Concurrent validity was determined by comparing scores of asthmatic teachers or with asthmatic relatives with teachers with no contact with asthma. Test-retest reliability was evaluated in 2 randomly selected centers by the kappa index, Bland-Altman method and intraclass correlation coefficient. Results: Mean score on the NAKQ was 15.7 ± 5.3 (median 17), correctly answering 50.6% of items. Cronbach's alpha coefficient was 0.824 (95% CI: 0.802-0.845). NAKQ score was higher in asthmatic teachers or with close asthmatic relatives (17.7 ± 3.3) than in teachers with distant asthmatic relatives (16.1 ± 5.4) and teachers without close contact with asthma (15.1 ± 5.6; P

Atopic Eczema (AE) is a chronic inflammatory skin disease that affects children and adults, and alters quality of life with a high morbidity rate and severe economic burden. The objective of the present work was to analyse specific atmospheric pollutants (O3, NO, PM10 and SO2) affecting the prevalence of diagnosed AE and its symptoms among 6-7-year-old schoolchildren.The participants included 21311 schoolchildren aged 6-7 years from 8 Spanish regions, whose parents completed the ISAAC Phase III questionnaire to ascertain AE diagnosis and symptoms. The mean levels (µg/m3) of O3, NO, PM10 (particles 10 micrometers or less in diameter) and SO2 were determined in each geographical area. Participating in this study.According to these mean levels, three levels of exposure to each pollutant were considered: level 1 (percentiles 0-25); level 2 (percentiles 26-74); level 3 (percentiles 75-100). Exposure to O3 was associated with increased prevalence of rashes (exposure level 2, Odds Ratio (OR): 1.22, 95% Confidence Interval (95%CI): 1.02-1.45; level 3 OR: 1.33, 95%CI: 1.10-1.61) and diagnosed AE (level 2, OR: 1.27, 95%CI: 1.17-1.39; level 3 OR: 1.27, 95%CI: 1.15-1.41). An association was found between the level of NO and a drop in the prevalence of diagnosed AE (exposure level 2, OR: 0.88, 95%CI: 0.81-0.95; level 3 OR: 0.85, 95%CI: 0.74-0.97). There was also an association between the highest exposure level to PM10 and a reduced prevalence of rashes (level 3 OR: 0.42, 95%CI: 0.22-0.81) and diagnosed AE (level 3 OR: 0.53, 95%CI: 0.38-0.75). Future studies into exposure to O3 and its relationship with allergic diseases may be conducted in order to prevent this association.

[Resumen] Objetivos. Determinar la prevalencia y variaciones geográficas de síntomas relacionados con asma en niños y adolescentes gallegos. Población y métodos. Estudio transversal según la metodología ISAAC (Internacional Study of Asthma and Allergies in Childhood) mediante cuestionario escrito distribuido en el medio escolar. Se incluyeron 10.371 niños de 6-7 años y 10.372 adolescentes de 13-14 años de todas las Áreas Sanitarias de Galicia. Se analizaron las variaciones geográficas mediante un modelo de regresión logística. Resultados. Las sibilancias en los últimos 12 meses oscilaron en los pequeños, del 11,4 (Santiago) al 15,7% (Vigo) y en los adolescentes del 8,8 (Ourense) al 18,8% (Vigo). Según el género se observó una mayor frecuencia en varones de 6-7 años (p < 0,001) y con tendencia a la significación estadística en las chicas de 13-14 años (p = 0,08). El riesgo (Odds ratio [OR]) de sibilancias en los últimos 12 meses, en el área de mayor prevalencia con respecto a la de menor, fue 1,45 (intervalo de confianza [IC] del 95%: 1,12-1,88) en niños y 2,39 (IC 95%: 1,82-3,13) en adolescentes. La prevalencia de asma estimada para Galicia fue de 13,6% en niños y 12,2% en adolescentes. Conclusiones. La prevalencia de sibilancias en los últimos 12 meses en las diferentes áreas gallegas es sensiblemente superior al resto de ciudades españolas participantes en el ISAAC en los pequeños, siendo muy similar en los adolescentes, salvo en Vigo donde es sensiblemente superior. Encontramos un patrón geográfico muy definido en los adolescentes, siendo mayores las prevalencias en la costa que en el interior. [Abstract] Objectives. To determine the prevalence and geographic variations of the symptoms associated with asthma in Galician children and adolescents. Population and methods. A cross-sectional epidemiological study following ISAAC (International Study of Asthma and Allergies in Childhood) methodology, and using a written questionnaire distributed in schools. The study sample included 10,371 6-7 year-old children and 10,372 13-14 year-old adolescents, all of them from Galician Health Areas. A logistic regression model was used to analyse geographic variations. Results. In the 6-7 year-old group, wheezing in the last 12 months varied from 11.4% (Santiago) to 15.7% (Vigo) and in the adolescents varied from 8.8% (Ourense) to 18.8% (Vigo). The distribution by gender showed a predominant significance in 6-7 year-old males (P < .001), and near to be statistically significant in 13-14 year-old females (P = .08). The risk (odds ratio [OR]) of wheezing in the last 12 months in the area with highest prevalence in comparison with the area of lowest prevalence was 1.45 (95% Confidence Interval [CI], 1.12-1.88) for children and 2.39 (95% CI, 1.82-3.13) for adolescents. The estimated prevalence of asthma in the Autonomous Community of Galicia was 13.6% in younger children and 12.2% in adolescents. Conclusions. The prevalence of wheezing in the last 12 months in the different areas of Galicia is considerably higher than the rest of Spanish ISAAC cities in the 6-7 years group and very similar in the 13-14 years group, except in Vigo where it is considerably higher. We found a clearly defined geographic pattern in the adolescent group, with higher prevalences in coastal areas than in the interior.

Objectives: To determine the prevalence and geographic variations of the symptoms associated with asthma in Galician children and adolescents. Population and methods: A cross-sectional epidemiological study following ISAAC (International Study of Asthma and Allergies in Childhood) methodology, and using a written questionnaire distributed in schools. The study sample included 10,371 6-7 year-old children and 10,372 13-14 year-old adolescents, all of them from Galician Health Areas. A logistic regression model was used to analyse geographic variations. Results: In the 6-7 year-old group, wheezing in the last 12 months varied from 11.4% (Santiago) to 15.7% (Vigo) and in the adolescents varied from 8.8% (Ourense) to 18.8% (Vigo). The distribution by gender showed a predominant significance in 6-7 year-old males (P

Atopic eczema (AE) is a chronic skin disease. Recent reports indicate that the worldwide prevalence of AE is increasing and that various environmental factors are implicated in its aetiology. Climatic conditions have been related with AE prevalence, and Spain has varying climatic conditions. The aim of this study is to document the possible climatic influence on the prevalence of AE in schoolchildren aged 6-7 years in three different climatic regions in Spain. We conducted a cross-sectional population-based survey of 28,394 schoolchildren aged 6-7 years from 10 Spanish centres in three different climatic regions. The mean participation rate was 76.5%. AE prevalence was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and the Spanish Academy of Dermatology criteria used in Spain to diagnose AE. The data, including annual temperature, precipitation, relative humidity and the annual number of sunny hours per climatic region, were obtained from the Spanish National Institute of Meteorology. Different AE prevalences were found in all three climatic regions studied: Atlantic, 32.9; Mediterranean 28.3; and Continental 31.2 per 100 children studied (p < 0.005). AE was positively associated with precipitation and humidity, and was negatively associated with temperature and the number of sunny hours. The results show that AE is significantly dependent on meteorological conditions.

OBJECTIVES: To describe the prevalence of atopic eczema (AE) and to find the characteristics of the diet of children with AE. DESIGN: Descriptive, transversal study. SETTING: Primary schools. MAIN MEASUREMENTS: The study used the standardized and validated questionnaire of the ISAAC phase III study, which finds the prevalence of AE in children and enables inter-centre comparison to be conducted. A questionnaire about food consumption was included. The prevalence ratio (PR) of AE and food consumption (95% confidence intervals) was calculated. RESULTS: A total of 28 448 children aged 6-7 were included in the study. The prevalence of clinically diagnosed AE was 15.35% in boys and 15.24% in girls. The foods most often consumed were: dairy and cereals, followed by rice, pasta, and eggs. The least consumed were: butter, margarine, and fast food. The PR for children who consumed pasta was (PR=1.35), seafood (PR=1.28), cereals (PR=1.26), eggs (PR=1.13), and meat (PR=1.09). CONCLUSIONS: The prevalence of AE in Spain was 15.3%, and was associated with food consumption. The consumption of dairy products, cereals, and olive oil was appropriate. The intake of fruit, vegetables, seafood, and legumes was below the recommended amounts. Future studies on the question are needed.

Our goal was to estimate the time trends in the prevalence of symptoms of allergic rhinitis (AR) and its geographic variations.During 2001-2002, the phase 3 of ISAAC study was carried out, and a comparison with the phase 1 (1993-1994) was done. This cross sectional study included 30,046 schoolchildren 13-14 years-old from 9 centers (Asturias, Barcelona, Bilbao, Cartagena, Castellon, Madrid, Pamplona, Valencia, and Valladolid). A questionnaire about rhinitis symptoms self-administered to schoolchildren was used at schools and institutes with a participation rate of 100% to 75.8%.A divergent time trend of AR prevalence symptoms was observed with a decrease in Barcelona and Bilbao, a stabilization in Cartagena, Pamplona, and Valencia, and an increase in Castellon; Madrid and Valladolid; however, there was an overall increase in nasal allergy. The prevalence of rhinoconjunctivitis in the past year (Prevalence Ratio [PR] = 1,13; 95% Confidence Interval [CI], 1.07-1.19) and nasal allergy ever (PR = 1.22; 95% CI, 1.15-1.30) increased after adjusting for gender, center and season change. The prevalence of rhinoconjunctivitis and nasal allergy varied according to centres, Madrid, Asturias, Cartagena and Bilbao exhibiting the higher prevalence. Taken as a whole, these data indicate a middle prevalence of AR when compared with other countries following an ISAAC methodology.Two patterns of time trend of prevalence of symptoms of AR were observed. The investigation of risk factors at local level could be important in order to undertake preventive measures.