| 1. |
- Ballardini, Natalia, et al.
(author)
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Development and comorbidity of eczema, asthma and rhinitis to age 12 : data from the BAMSE birth cohort
- 2012
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In: Allergy. - Stockholm : Karolinska Institutet, Dept of Medical Epidemiology and Biostatistics. - 0105-4538 .- 1398-9995.
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Journal article (peer-reviewed)abstract
- BACKGROUND: Allergy-related diseases are a public health issue, but knowledge on development and comorbidity among children is scarce. The aim was to study the development of eczema, asthma and rhinitis in relation to sex and parental allergy, in a population-based cohort, during childhood. METHODS: At 1, 2, 4, 8 and 12 years, parental questionnaires were used to obtain data on allergy-related diseases. Complete data for all five follow-up occasions were available from 2916 children. Odds ratios for the risk of any allergy-related disease in relation to heredity and sex were calculated using generalized estimating equations. RESULTS: At 12 years, 58% of the children had had eczema, asthma and/or rhinitis at some time. Disease turnover was high for all three diseases throughout the study. Comorbidity increased with age, and at 12 years, 7.5% of all the children were affected by at least two allergy-related diseases. Parental allergy was associated with increased comorbidity and more persistent disease and increased the risk of having any allergy-related disease (adjusted OR 1.76; 95% CI 1.57-1.97) up to 12 years. Male sex was associated with an increased risk throughout childhood. Boys and girls did not differ in disease persistence, and for comorbidity, the differences were minor. CONCLUSIONS: Allergy-related diseases may affect a majority of children. Eczema, asthma and rhinitis develop dynamically throughout childhood, and allergic comorbidity is common. These findings indicate that allergy-related diseases should be neither seen nor studied as isolated entities.
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| 2. |
- Jansson, Sven-Arne, et al.
(author)
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Health-related quality of life, assessed with a disease-specific questionnaire, in Swedish adults suffering from well-diagnosed food allergy to staple foods
- 2013
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In: Clinical and Translational Allergy. - : Wiley. - 2045-7022. ; 3:21
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Journal article (peer-reviewed)abstract
- BackgroundOur aim was to investigate the factors that affect health related quality of life (HRQL) in adult Swedish food allergic patients objectively diagnosed with allergy to at least one of the staple foods cow’s milk, hen’s egg or wheat. The number of foods involved, the type and severity of symptoms, as well as concomitant allergic disorders were assessed.MethodsThe disease-specific food allergy quality of life questionnaire (FAQLQ-AF), developed within EuroPrevall, was utilized. The questionnaire had four domains: Allergen Avoidance and Dietary Restrictions (AADR), Emotional Impact (EI), Risk of Accidental Exposure (RAE) and Food Allergy related Health (FAH). Comparisons were made with the outcome of the generic questionnaire EuroQol Health Questionnaire, 5 Dimensions (EQ-5D). The patients were recruited at an outpatient allergy clinic, based on a convincing history of food allergy supplemented by analysis of specific IgE to the foods in question. Seventy-nine patients participated (28 males, 51 females, mean-age 41 years).ResultsThe domain with the most negative impact on HRQL was AADR, assessing the patients’ experience of dietary restrictions. The domain with the least negative impact on HRQL was FAH, relating to health concerns due to the food allergy. One third of the patients had four concomitant allergic disorders, which had a negative impact on HRQL. Furthermore, asthma in combination with food allergy had a strong impact. Anaphylaxis, and particularly prescription of an epinephrine auto-injector, was associated with low HRQL. These effects were not seen using EQ-5D. Analyses of the symptoms revealed that oral allergy syndrome and cardiovascular symptoms had the greatest impact on HRQL. In contrast, no significant effect on HRQL was seen by the number of food allergies.ConclusionsThe FAQLQ-AF is a valid instrument, and more accurate among patients with allergy to staple foods in comparison to the commonly used generic EQ-5D. It adds important information on HRQL in food allergic adults. We found that the restrictions imposed on the patients due to the diet had the largest negative impact on HRQL. Both severity of the food allergy and the presence of concomitant allergic disorders had a profound impact on HRQL.
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| 3. |
- Protudjer, Jennifer L. P., et al.
(author)
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Household Costs Associated with Objectively Diagnosed Allergy to Staple Foods in Children and Adolescents
- 2015
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In: Journal of Allergy and Clinical Immunology-In Practice. - : Elsevier BV. - 2213-2198 .- 2213-2201. ; 3:1, s. 68-75
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Journal article (peer-reviewed)abstract
- BACKGROUND: We previously reported that indirect and intangible costs burden households with a food allergic adult. We now extend our investigation to households with food allergic children and adolescents. OBJECTIVE: The objective of this study was to estimate direct, indirect, and intangible costs of food allergy in households with a child and/or adolescent with objectively diagnosed allergy to staple foods (cow's milk, hen's egg, and/or wheat), and to compare these costs with age-and sex-matched controls. METHODS: Direct and indirect cost parent-reported data collected via the Food Allergy Socio-Economic Questionnaire of 84 children (0-12 years) and 60 adolescents (13-17 years) with objectively diagnosed allergy to staple foods ("cases") and age- and sex-matched controls (n = 94 children; n = 56 adolescents) were compared. Annual household costs were calculated. Total household costs included direct plus indirect costs. Intangible costs included parent-reported health of their child and/or adolescent, standard of living, and perceptions of well-being. RESULTS: Amongst cases, total household costs were higher by (sic)3961 for children and (sic)4792 for adolescents versus controls (P < .05), and were driven by direct (eg, medications) and indirect (eg, time with health care professionals) costs. For children only, a history of anaphylaxis was associated with higher direct costs than no anaphylaxis ((sic)13,016 vs (sic)10,044, P < .05). Intangible costs (eg, parent-reported health of a child and/or adolescent) were significantly impacted amongst cases versus controls (P < .01). CONCLUSION: Households with a child and/or adolescent with objectively diagnosed allergy to staple foods have higher total household costs than controls. Direct and indirect costs were significantly higher for cases versus controls amongst children only. Amongst both age groups, such allergy adversely impacted intangible costs. (C) 2015 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology.
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| 4. |
- Uwe, Nicolay, et al.
(author)
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Validation of a Disease-Specific Questionnaire for Measuring Parent-Reported Health-Related Quality of Life in Children with Allergies
- 2012
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In: Scandinavian Journal of Caring Sciences. - Oxford : Wiley. - 0283-9318 .- 1471-6712. ; 26:4, s. 679-687
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Journal article (peer-reviewed)abstract
- Purpose: To evaluate the properties and suitability of a disease-specific questionnaire to assess parent-reported health-related quality of life (HRQL) of children and parents of children suffering from food hypersensitivity (FHS) or allergy to furred pets (AFP). Methods: The parents of 202 children with FHS and of 131 children with AFP filled in questionnaires comprising the CHQ-PF28 and the Food-Pet-Allergy in Children (FPAC) Questionnaire. Psychometric properties of the FPAC questionnaire were evaluated separately for FHS and AFP. Results: Analyses resulted in five proposed scales: Limitations of Family/Child Activities (I), Parents Distress (II), Childs Emotions (III), Child in School (IV) and Family Conflicts (V). Convergent/discriminant validity for scales I, II and III of both questionnaires was high; for scale IV it was moderate. All five FHS and four AFP scales were able to distinguish significantly between children with and without clinical allergy symptoms (known-group validity). Internal consistency reliability was good for scales I, II and III, but poor for scale IV. Conclusion: Three valid scales were determined for both FHS and AFP (Limitations of Family/Child Activities, Parents Distress and Childs Emotions) and can be used in clinical research.
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| 5. |
- Östblom, Eva
(author)
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Symptoms of food hypersensitivity in relation to sensitization to food and health-related quality of life in children
- 2008
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Doctoral thesis (other academic/artistic)abstract
- Intensive research in the field of food hypersensitivity (FHS) and food allergy has resulted in determination of serum levels of IgE antibodies to food above which the probability of demonstrating symptoms is ≥ 95%. However, data concerning clinical phenotypes of FHS and the relationship between sensitization to food and symptoms are presently scarce. Moreover, research on the impact of FHS on health-related quality of life (HRQL) is still in its infancy. Accordingly, the general aim of this thesis was to characterize children reported by their parents to have FHS with regards to symptoms, sensitization, different phenotypes and the impact on HRQL, employing a population-based study design. A prospective birth cohort (BAMSE) of 4,089 children was followed up to the age of 8-9 years by having their parents fill in questionnaires concerning the children s exposures and health outcomes at various time-points. Blood samples were collected at 4 and 8 years of age for analysis of IgE antibodies to food. At 9 years of age, a separate questionnaire concerning HRQL was filled out by the parents of a subgroup of 1,376 children. Paper I describes different phenotypes of FHS observed in children during their first 8 years of life. An increased risk of having asthma, rhinitis and/or atopic eczema at 8 years of age was seen for children reported to have FHS at an early age. Children who demonstrated only a single symptom of FHS and/or little or no sensitization to food had the most favourable prognosis for later remission of their food-related symptoms. Paper II characterizes different aspects of sensitization and reported FHS in 4-year-old children. Half of all the children with gastrointestinal symptoms or atopic dermatitis exhibited only a single symptom and less than 50% of these same children were sensitized to food. Among the children with reported urticaria, facial oedema or wheeze related to food, a majority had multiple symptoms and where sensitized to food as well. Paper III documents a positive association between reported FHS and elevated levels of IgE antibodies to milk, eggs or fish. For peanuts, this association was also significant, although not as pronounced as expected; whereas for soy beans and wheat the association was very weak. The final investigation reveals that as reported by their parents, the HRQL of children with FHS is lower than that of both children with no allergic disease and children suffering from other allergic disorders. This impairment in HRQL was most pronounced for children with food-related symptoms originating from the airways. High levels of IgE antibodies to food were also associated with a reduced HRQL. In conclusion, children demonstrating only a single symptom of FHS and/or no sensitization to food seem to recover from this disease. Increasing levels of IgE antibodies to milk, egg or fish are associated with an enhanced risk of having FHS elicited by these items of food, but this is not seen to the same extent particularly for soy bean, but also for wheat and peanuts. FHS leads to a negatively affected HRQL for both children and their families. This is especially true if the disease is pronounced or associated with high levels of IgE antibodies to food.
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