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Cilj rada: procjena učestalosti simptoma astme, alergijskog rinitisa/rinokonjunktivitisa i atopijskog dermatitisa na području Međimurske županije u Sjeverozapadnoj Hrvatskoj. Metode i ispitanici: ispitivanje je provedeno od siječnja do travnja 2005. godine među djecom mlađe školske dobi u 27 osnovnih škola izabranih metodom slučajnog odabira. Podaci su prikupljeni standardiziranim pisanim upitnikom ISAAC faze I. Rezultati: u ispitivanje je uključeno 3106-ero djece mlađe dobne skupine (7 – 9 godina), s odazivom od 96,94%. 712-ero (22,9%) djece imalo je do tada simptome alergijskih bolesti. Učestalost simptoma tijekom života iznosila je: piskanje 14,91%, simptomi alergijskog rinitisa 8,88% i simptomi atopijskog dermatitisa 10,66%. Učestalost simptoma unatrag 12 mjeseci iznosila je: piskanje 6,92%, simptomi alergijskog rinitisa 8,40%, simptomi alergijskog rinokonjunktivitisa 4,67%, simptomi atopijskog dermatitisa 5,76%. Zaključak: rezultati pokazuju da je Međimurska županija područje s umjerenim stupnjem prevalencije simptoma alergijskih bolesti među djecom mlađe školske dobi., Objective: To estimate the prevalence of symptoms of asthma, allergic rhinitis/rhinoconjuctivitis and atopic eczema symptoms in the Međimurje County in Northwest Croatia. Subjects and methods: The study was undertaken between January and April 2005 among school children in 27 randomly selected elementary schools. Data were collected using standardized ISAAC written questionnaire Phase I. Results: A total of 3106 children participated in the study (7–9 yrs) with response rate 96.94%. 712 (22.9%) children had symptoms of allergic diseases at some time in their life. Estimated lifetime (ever) prevalence rates of symptoms were: wheezing 14.91%, allergic rhinitis symptoms 8.88% and atopic dermatitis symptoms 10.66%. Estimated 12-month prevalence rates were: wheezing 6.92%, allergic rhinitis symptoms 8.40%, allergic rhinoconjunctivitis 4.67%, and atopic dermatitis symptoms 5.76%. Conclusions: The results of this study show that Međimurje County is an area with moderate prevalence of atopic disease symptoms among the pediatric population.

The authors are indebted to the collaborators in the participating centres and all parents, children, teachers and other school staff who participated in the surveys. There are many field workers and funding agencies who supported data collection and national, regional and international meetings, including the meetings of the ISAAC Steering Committee. Unfortunately, these are too numerous to mention (they are acknowledged elsewhere) but the authors particularly wish to thank the funders who supported the ISAAC International Data Centre including the Health Research Council of New Zealand, the Asthma and Respiratory Foundation of New Zealand, the National Child Health Research Foundation, the Hawke’s Bay Medical Research Foundation, the Waikato Medical Research Foundation, Glaxo Wellcome New Zealand and Astra New Zealand, as well as Glaxo Wellcome International Medical Affairs for finding the regional coordinating centres. The International Data Centre is now supported by a grant from the BUPA Foundation., The International Study of Asthma and Allergies in Childhood (ISAAC) Phase One showed large worldwide variations in the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema, up to 10 to 20 fold between countries. Ecological analyses were undertaken with ISAAC Phase One data to explore factors that may have contributed to these variations, and are summarised and reviewed here. In ISAAC Phase One the prevalence of symptoms in the past 12 months of asthma, rhinoconjunctivitis and eczema were estimated from studies in 463,801 children aged 13 - 14 years in 155 centres in 56 countries, and in 257,800 children aged 6-7 years in 91 centres in 38 countries. Ecological analyses were undertaken between symptom prevalence and the following: Gross National Product per capita (GNP), food intake, immunisation rates, tuberculosis notifications, climatic factors, tobacco consumption, pollen, antibiotic sales, paracetamol sales, and outdoor air pollution. Symptom prevalence of all three conditions was positively associated with GNP, trans fatty acids, paracetamol, and women smoking, and inversely associated with food of plant origin, pollen, immunisations, tuberculosis notifications, air pollution, and men smoking. The magnitude of these associations was small, but consistent in direction between conditions. There were mixed associations of climate and antibiotic sales with symptom prevalence. The potential causality of these associations warrant further investigation. Factors which prevent the development of these conditions, or where there is an absence of a positive correlation at a population level may be as important from the policy viewpoint as a focus on the positive risk factors. Interventions based on small associations may have the potential for a large public health benefit., peer-reviewed

Alergijske bolesti i astma postale su najčešće kronične bolesti dječje dobi u razvijenim zemljama, sa stalnim porastom prevalencije u posljednjih nekoliko desetljeća. Astma kao kronična bolest uvelike ograničava fizički, emocionalni i socijalni aspekt bolesnikova života te utječe na obitelj, školovanje i karijeru. Kronična upala promjenjivog intenziteta u astmi je trajno prisutna i izaziva pojačanu reaktivnost dišnih putova, koja dovodi do ponavljajućih epizoda piskanja, zaduhe, napetosti u prsnom košu i kašlja. Akutna pogoršanja mogu nastati naglo, a prigodno mogu biti i opasna za život. Na pojavu i klinički tijek astme utječu brojni čimbenici vezani za bolesnika i okoliš. Kao posljedica neprepoznate ili neodgovarajuće liječene upale u astmi, dolazi do procesa remodeliranja dišnih putova i ireverzibilnog slabljenja plućne funkcije u većine bolesnika., Allergic diseases and asthma have become the most common chronic diseases of childhood in developed countries, with increasing prevalence in the last few decades. Asthma is a chronic illness with a strong impact on the patient’s physical, emotional and social aspects of life and it affects the child's family, education and career. The chronic inflammation of the airways in asthma is variable but constant and causes increase in airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing. Acute exacerbations of asthma can be rapid in onset, severe and even life threatening in the absence of effective treatment. Risk factors involved in the development of asthma and the clinical expression of the disease may be classified as host factors and environmental factors. Unrecognised or inadequately treated chronic inflammation in asthma leads to airway wall remodelling and progressive irreversible loss of lung function in most patients.

The prevalence of allergic rhinitis and related diseases varies from country to country and even within particular countries. The prevalence is difficult to precisely estimate. There is ample evidence showing the rate of allergic rhinitis to be on an increase worldwide over the last decades, especially so in industrialized countries. The increasing prevalence remains largely unexplained merely by lifestyle changes and environmental pollution. Great effort has therefore been invested to identify the possible impacts, which may hopefully help control this "allergic march"., Učestalost alergijskog rinitisa i s njim povezanih bolesti znatno se razlikuje među pojedinim zemljama, pa čak i među pojedinim regijama unutar iste zemlje. Nije jednostavno točno procijeniti rasprostranjenost alergijskog rinitisa. Postoje čvrsti dokazi o porastu učestalosti alergijskog rinitisa u svijetu posljednjih desetljeća, poglavito u razvijenim zemljama. Tendencija rasta ove učestalosti još uvijek nije dovoljno razjašnjena uz dva trenutno najizraženija čimbenika tog porasta, a to su zapadnjački način života i onečišćenje okoliša. Ulažu se znatna sredstva i napori u istraživanje porasta alergija u svijetu, pa postoji nada da će ti napori pomoći u zaustavljanju "epidemije" alergija.