دانلود رایگان مقاله عوامل مرتبط با شدت بیماری ترکیبی رینیت و التهاب ملتحمه دوران کودکی

abstract

Background: Allergic rhinitis is one of the most common chronic diseases in children. Although it has a large impact on the patient's quality of life, little is known about the factors associated with its severity. The aim of this study was to assess the factors associated with the severity of rhinoconjunctivitis among children in the general population. Methods: A survey was conducted using an online research panel in 2012. Parents were asked to answer an International Study of Asthma and Allergies in Childhood-based questionnaire to identify children with current rhinoconjunctivitis and evaluate factors associated with the severity of its symptoms. Severity was rated according to the degree of impairment caused by the symptoms in the patient's daily life. Results: Among 26,725 children aged 6e12 years old, rhinoconjunctivitis was defined in 5175 (19.4%), and of these, 688 children (13.3% of children with current rhinoconjunctivitis) presented severe symptoms. Living in areas with a high cedar and cypress pollen count and having concurrent eczema were associated with severe rhinoconjunctivitis [adjusted OR (95% CI): 1.21 (1.00e1.46) and 1.45 (1.20e1.75), respectively]. Further, a maternal history of asthma and allergic rhinitis was a significant risk factor for severe rhinoconjunctivitis [1.34 (1.04e1.74) and 1.30 (1.10e1.53), respectively]. However, living with furbearing animals (pets) before 1 year of age proved to be a protective factor against severe rhinoconjunctivitis [0.70 (0.52e0.94)]. Conclusions: Environmental factors such as pets and pollen, together with comorbidities and a maternal history of allergic diseases, play an important role in determining the severity of rhinoconjunctivitis.

Discussion

Our study demonstrated that several factors were associated with the severity of childhood rhinoconjunctivitis in the general population, a finding corroborated by other reports. A Spanish study demonstrated that children with severe rhinitis were more likely to suffer from conjunctivitis, asthma, and atopic dermatitis.14 An Italian study of children recruited at a clinic showed that the severity of pollen-induced allergic rhinitis was associated with paternal smoking, having older siblings, asthma, and oral allergy syndrome, but not with a familial history of allergic diseases.15 Our study discovered that environmental factors such as exposure to furry pets in infancy and the pollen count in the area of residence were associated with the severity of childhood rhinoconjunctivitis. Pollen is one of the major environmental factors influencing allergic diseases. Japanese cedar and Japanese cypress are major causes of pollinosis in Japan, where more than 90% of pollinosis patients experience moderate to severe rhinitis according to Allergic Rhinitis and its Impact on Asthma.19 We have reported that cedar and cypress pollen counts were positively associated with the prevalence of current rhinoconjunctivitis among Japanese school children.18 In this study we showed that 89.1% children with severe rhinoconjunctivitis had a history of pollinosis. Although generally, not much data are available regarding the association of pollen exposure with the severity of rhinitis and/or conjunctivitis, the present study has shown that cedar and cypress pollen counts were associated with the severity of rhinoconjunctivitis among children in Japan. An Italian study of children with pollen-induced allergic rhinitis showed that children in Central and Southern Italy experienced a higher frequency of moderate to severe rhinitis and were more frequently sensitized to olive, cypress, and pellitory pollens than those in Northern Italy.15 Pollens might affect the severity of rhinitis and/or conjunctivitis in many regions of the world.