TY - JOUR
T1 - Trends in eczema prevalence in children and adolescents
T2 - A Global Asthma Network Phase I Study
AU - the Global Asthma Network Phase I Study Group
AU - Langan, Sinéad Máire
AU - Mulick, Amy R.
AU - Rutter, Charlotte E.
AU - Silverwood, Richard J.
AU - Asher, Innes
AU - García-Marcos, Luis
AU - Ellwood, Eamon
AU - Bissell, Karen
AU - Chiang, Chen Yuan
AU - Sony, Asma El
AU - Ellwood, Philippa
AU - Marks, Guy B
AU - Mortimer, Kevin
AU - Martínez-Torres, A. Elena
AU - Morales, Eva
AU - Perez-Fernandez, Virginia
AU - Robertson, Steven
AU - Williams, Hywel C
AU - Strachan, David P.
AU - Pearce, Neil
AU - Bissell, Karen
AU - Chiang, Chen Yuan
AU - Marks,
AU - Mortimer, Kevin
AU - Masekela, R.
AU - Perez-Fernández, Virginia
AU - Martinez-Torres, A. Elena
AU - Robertson, Steven
AU - Rutter, Charlotte E.
AU - Silverwood, Richard J.
AU - Mallol, Javier
AU - Soto-Martinez, Manual E.
AU - Cabrera Aguilar, Angelita
AU - Douros, Konstantinos
AU - Mohammed, Samira
AU - Singh, Menu
AU - Singh, Virendra
AU - Sukumaran, Thevaruparambil Unny
AU - Awasthi, Shally
AU - Kabra, Sushil Kumar
AU - Salvi, Sundeep
AU - Mérida-Palacio, Juan Valente
AU - González-Díaz, Sandra Nora
AU - Navarrete-Rodriguez, Elsy Maureen
AU - Sánchez, José Félix
AU - Falade, Adegoke G.
AU - Zar, Heather J.
AU - López-Silvarrey Varela, Angel
AU - González Díaz, Carlos
AU - Nour, Madge
N1 - Funding Information:
This research was funded in whole or in part by the Wellcome Trust [205039/Z/16/Z]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript (AAM) version arising from this submission. We are grateful to the children, parents, adults who willingly participated with the help of schools and field workers in ISAAC Phases I and III and GAN Phase I. We thank the children and parents who participated in ISAAC Phases I and III and GAN Phase I; the school staff for their assistance and help with coordination; the principal investigators and their colleagues; the many funding bodies throughout the world that supported the individual ISAAC centres and collaborators and their meetings. The ISAAC International Data Centre was supported by the Health Research Council of New Zealand, the Asthma and Respiratory Foundation of New Zealand, the Child Health Research Foundation, the Hawke's Bay Medical Research Foundation, the Waikato Medical Research Foundation, Glaxo Wellcome New Zealand, the New Zealand Lottery Board, and Astra Zeneca New Zealand. Glaxo Wellcome International Medical Affairs supported the regional coordination and the ISAAC International Data Centre. The GAN Global Centre in Auckland was funded by The University of Auckland with additional funding from The Asthma and Respiratory Foundation of NZ, the Auckland Asthma Charitable Trust, The International Union Against Tuberculosis and Lung Disease, Boehringer Ingelheim NZ, Astra Zeneca Educational Grant. The London Data Centre was supported by a PhD studentship [to CR] from the UK Medical Research Council (grant number MR/N013638/1) and funding from the European Research Council under the European Union's Seventh Framework Programme (FP7/2007‐2013, ERC grant agreement number 668954). The Murcia Data Centre was supported by the University of Murcia and by Instituto de Salud Carlos III, fund PI17/0170. We thank the NIHR Global Health Research Unit on Lung Health and TB in Africa at Liverpool School of Tropical Medicine‐“IMPALA” for helping to make this work possible (grant number 16/136/35); IMPALA was commissioned by the National Institute for Health Research (NIHR) Global Health Research (GHR) using UK aid from the UK Government. The views expressed in this publication are those of the authors and not necessarily those of any of the funders. Individual centres involved in GAN Phase I data collection were funded by the following organizations: Costa Rica and Nicaragua partially funded by an unrestricted grant from Astra Zeneca for logistic purposes; India; Kottayam, New Delhi, Chandigarh, Bikaner, Jaipur, Lucknow, Pune, GAN Phase I was undertaken by Asthma Bhawan in India which was supported by Cipla Foundation; México, Puerto Vallarta Centro Universitario de la Costa, Universidad de Guadalajara; New Zealand, Auckland Asthma Charitable Trust; Nigeria, Ibadan, funded by NIHR (IMPALA grant Ref 16/136/35) using UK aid from the UK Government to support GHR; South Africa, Cape Town, SA Medical Research Council, Allergy Society of South Africa; Syria; Lattakia: The Medical National Syndicate.
Funding Information:
International Union Against Tuberculosis and Lung Disease, Boehringer Ingelheim New Zealand, Astra Zeneca Educational Grant, UK National Institute of Health Research, UK Medical Research Council (PhD studentship for Charlotte E. Rutter, UKMRC grant number MR/N013638/1), European Research Council, Instituto de Salud Carlos III, Wellcome Trust (Wellcome Trust Senior Clinical fellowship to Professor Sinéad Langan, grant number 205039/Z/16/Z).
Funding Information:
This research was funded in whole or in part by the Wellcome Trust [205039/Z/16/Z]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript (AAM) version arising from this submission. We are grateful to the children, parents, adults who willingly participated with the help of schools and field workers in ISAAC Phases I and III and GAN Phase I. We thank the children and parents who participated in ISAAC Phases I and III and GAN Phase I; the school staff for their assistance and help with coordination; the principal investigators and their colleagues; the many funding bodies throughout the world that supported the individual ISAAC centres and collaborators and their meetings. The ISAAC International Data Centre was supported by the Health Research Council of New Zealand, the Asthma and Respiratory Foundation of New Zealand, the Child Health Research Foundation, the Hawke's Bay Medical Research Foundation, the Waikato Medical Research Foundation, Glaxo Wellcome New Zealand, the New Zealand Lottery Board, and Astra Zeneca New Zealand. Glaxo Wellcome International Medical Affairs supported the regional coordination and the ISAAC International Data Centre. The GAN Global Centre in Auckland was funded by The University of Auckland with additional funding from The Asthma and Respiratory Foundation of NZ, the Auckland Asthma Charitable Trust, The International Union Against Tuberculosis and Lung Disease, Boehringer Ingelheim NZ, Astra Zeneca Educational Grant. The London Data Centre was supported by a PhD studentship [to CR] from the UK Medical Research Council (grant number MR/N013638/1) and funding from the European Research Council under the European Union's Seventh Framework Programme (FP7/2007-2013, ERC grant agreement number 668954). The Murcia Data Centre was supported by the University of Murcia and by Instituto de Salud Carlos III, fund PI17/0170. We thank the NIHR Global Health Research Unit on Lung Health and TB in Africa at Liverpool School of Tropical Medicine-“IMPALA” for helping to make this work possible (grant number 16/136/35); IMPALA was commissioned by the National Institute for Health Research (NIHR) Global Health Research (GHR) using UK aid from the UK Government. The views expressed in this publication are those of the authors and not necessarily those of any of the funders. Individual centres involved in GAN Phase I data collection were funded by the following organizations: Costa Rica and Nicaragua partially funded by an unrestricted grant from Astra Zeneca for logistic purposes; India; Kottayam, New Delhi, Chandigarh, Bikaner, Jaipur, Lucknow, Pune, GAN Phase I was undertaken by Asthma Bhawan in India which was supported by Cipla Foundation; México, Puerto Vallarta Centro Universitario de la Costa, Universidad de Guadalajara; New Zealand, Auckland Asthma Charitable Trust; Nigeria, Ibadan, funded by NIHR (IMPALA grant Ref 16/136/35) using UK aid from the UK Government to support GHR; South Africa, Cape Town, SA Medical Research Council, Allergy Society of South Africa; Syria; Lattakia: The Medical National Syndicate.
Publisher Copyright:
© 2023 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.
PY - 2023/3
Y1 - 2023/3
N2 - 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.
AB - 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.
KW - atopic dermatitis
KW - eczema
KW - flexural rash
KW - global estimates
KW - prevalence
UR - http://www.scopus.com/inward/record.url?scp=85147574596&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85147574596&partnerID=8YFLogxK
U2 - 10.1111/cea.14276
DO - 10.1111/cea.14276
M3 - Article
AN - SCOPUS:85147574596
SN - 0954-7894
VL - 53
SP - 337
EP - 352
JO - Clinical and Experimental Allergy
JF - Clinical and Experimental Allergy
IS - 3
ER -
