BRONCHIAL ASTHMA AND ATOPY IN CHILDHOOD IN RETHYMNO, KRETA GREECE.

Pouliasi Anna. Bagaki Alena, Lariou Mary-Stella, Pateraki Irene, Giannousi Elisabeth, Varakis Nikolaos.

Paediatric Clinic of General Hospital of Rethymno. Rethymno,Crete,Greece.

Objective: The purpose of this study is to determine the prevalence of Br. Asthma and Atopy in childhood in the region of Rethymno to evaluate their correlation and to detect other possible risk factors.

Methods: We contacted a cohort study among 5350 children (0-11 years old, which were examined at our Clinic from 1987 till 1997). Our records indicated that they formed the 85% of the children born in Rethymno during this period. 1734 children out of the total were manifesting sings of allergic disease and were included in this study.

Results: Our data indicated that the prevalence of active atopy was 32.4%. A positive family history was found in 62.5% while 60% of the studied children were male.

WHEEZING	UP.RES. SYST	BR. STHMA	URTICARIA	FOOD ALLERGY	DRUG ALL.	ATOPIC DERM.
8,6%	10.1%	8,6%	2,2%	0,65%	0,7%	1,3%

The respiratory allergic manifestations dominated our sample with an 85% percentage, from which 26.8% was Bronchial Asthma. The admission rate for Bronchial Asthma during the same period (1987-1997) was:

Percentage of admissions per age

0-2YS	3-4 YS	5-6 YS	7-8 YS	9-10 YS	11-12YS
49,3%	17.9%	10,7%	7,3%	6,4%	4,9%

Percentage of admissions per month

JAN	FEB	MAR	APR	MAY	JUN	JUL	AUG	SEP	OCT	NOV	DEC
26	29,9	25,4	22.6	25.1	18.9	13	16,4	20.7	27.9	27.5	30.3

The prevalence of moderate Bronchial Asthma was 5% while that of mild B.A. 3,6%. We focused our study on moderate Bronchial Asthma and we noticed that the risk factors include a positive family history in 87% with the mothers manifesting atopy in 46,5%. Once more the male predominance was 60%, while of great importance seems to be the age of appearance of the first episode.

Age of appearance of the first episode

0-6 MONTHS	6-12 MONTHS	1-2 YEARS	2-5 YEARS	5-8 YEARS
44.6%	21%	15.1%	13.9%	5.4%

Finally moderate B.A. coexisted with other allergic manifestations at the 70% of the children, 48% of which were from the upper respiratory system while as much as 38.9% was atopic dermatitis (note that the prevalence of atopic dermatitis in the total is only 1.3%). As far as the environmental factors for moderate B.A. are concerned, we accused mainly: viral infections, humidity, passive smoking, domestic animals and aeroalergens. We recorded an increase in admissions from October till February (average rate 28.3%) a fact that was correlated with the increased humidity of the atmosphere (-70%) and the exacerbation of viral infections. A peak during March and May was explained by the elevation of aeroallergens (flower blooming season).

Conclusions: The prevalence of Atopy was 32.3%. The percentage concerns mainly the documented respiratory manifestations of allergic disease. The prevalence of Bronchial Asthma was 8.6%. Variables like family atopy. sex, age and environmental factors seem to play major role in influencing the prevalence of Atopy. Asthma and other allergic diseases constitute a major health problem for the children in Rethymno. It is obvious the great importance of comprehending and controlling both symptoms and precipitating factors.