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Trends in eczema prevalence in children and adolescents: A Global Asthma Network Phase I Study

Langan, SM; Mulick, AR; Rutter, CE; Silverwood, RJ; Asher, MI; García-Marcos, L; Ellwood, E; Bissell, K; Chiang, C-Y; El Sony, A; et al. Langan, SM; Mulick, AR; Rutter, CE; Silverwood, RJ; Asher, MI; García-Marcos, L; Ellwood, E; Bissell, K; Chiang, C-Y; El Sony, A; Ellwood, P; Marks, GB; Mortimer, K; Martínez-Torres, AE; Morales, E; Perez-Fernandez, V; Robertson, S; Williams, HC; Strachan, DP; Pearce, N; Global Asthma Network Phase I Study Group (2023) Trends in eczema prevalence in children and adolescents: A Global Asthma Network Phase I Study. Clinical and Experimental Allergy, 53 (3). pp. 337-352. ISSN 0954-7894 https://doi.org/10.1111/cea.14276
SGUL Authors: Strachan, David Peter

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Abstract

Background Eczema (atopic dermatitis) is a major global public health issue with high prevalence and morbidity. Our goal was to evaluate eczema prevalence over time, using standardized methodology. Methods The Global Asthma Network (GAN) Phase I study is an international collaborative study arising from the International Study of Asthma and Allergies in Children (ISAAC). Using surveys, we assessed eczema prevalence, severity, and lifetime prevalence, in global centres participating in GAN Phase I (2015–2020) and one/ both of ISAAC Phase I (1993–1995) and Phase III (2001–2003). We fitted linear mixed models to estimate 10-yearly prevalence trends, by age group, income, and region. Results We analysed GAN Phase I data from 27 centres in 14 countries involving 74,361 adolescents aged 13–14 and 47,907 children aged 6–7 (response rate 90%, 79%). A median of 6% of children and adolescents had symptoms of current eczema, with 1.1% and 0.6% in adolescents and children, respectively, reporting symptoms of severe eczema. Over 27 years, after adjusting for world region and income, we estimated small overall 10-year increases in current eczema prevalence (adolescents: 0.98%, 95% CI 0.04%–1.92%; children: 1.21%, 95% CI 0.18%–2.24%), and severe eczema (adolescents: 0.26%, 95% CI 0.06%–0.46%; children: 0.23%, 95% CI 0.02%–0.45%) with larger increases in lifetime prevalence (adolescents: 2.71%, 95% CI 1.10%–4.32%; children: 3.91%, 95% CI 2.07%–5.75%). There was substantial heterogeneity in 10-year change between centres (standard deviations 2.40%, 0.58%, and 3.04%), and strong evidence that some of this heterogeneity was explained by region and income level, with increases in some outcomes in high-income children and middle-income adolescents. Conclusions There is substantial variation in changes in eczema prevalence over time by income and region. Understanding reasons for increases in some regions and decreases in others will help inform prevention strategies.

Item Type: Article
Additional Information: © 2023 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: 1107 Immunology, 1111 Nutrition and Dietetics, 1117 Public Health and Health Services, Allergy
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Clinical and Experimental Allergy
ISSN: 0954-7894
Dates:
DateEvent
12 March 2023Published
8 February 2023Published Online
30 November 2022Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
205039/Z/16/ZWellcome Trusthttp://dx.doi.org/10.13039/100004440
MR/N013638/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
668954European Research Councilhttp://dx.doi.org/10.13039/501100000781
PI17/0170Instituto de Salud Carlos IIIhttp://dx.doi.org/10.13039/501100004587
16/136/35National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
URI: https://openaccess.sgul.ac.uk/id/eprint/115027
Publisher's version: https://doi.org/10.1111/cea.14276

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