Prevalence and classification of rhinitis in preschool children in Portugal: a nationwide study

• Published in: Allergy (Copenhagen) 2013-10, Vol.68 (10), p.1278-1288
• Main Authors: Morais‐Almeida, M., Santos, N., Pereira, A. M., Branco‐Ferreira, M., Nunes, C., Bousquet, J., Fonseca, J. A.
• Format: Article
• Language: English
• Subjects: Age; Allergies; Asthma; Child, Preschool; classification; Comorbidity; Cross-Sectional Studies; Epidemiology; Female; Humans; Male; Nose; Population Surveillance; Portugal - epidemiology; Preschool children; Prevalence; rhinitis; Rhinitis - diagnosis; Rhinitis - epidemiology; Risk Factors; severity; Severity of Illness Index
• ISSN: 0105-4538; 1398-9995
• DOI: 10.1111/all.12221

Background Information on rhinitis epidemiology in preschool children is scarce. Objectives To estimate, in children with 3–5 years of age, current rhinitis prevalence, to describe rhinitis symptoms and associated sociodemographic characteristics, and to report allergic rhinitis and its impact on asthma (ARIA) classification. Methods Cross‐sectional, nationwide, population‐based study including children aged 3–5 years. A multistep selection strategy was used to obtain a representative sample. Data were collected at kindergartens and parish centers by face‐to‐face interview to caregivers, using an adapted ISAAC questionnaire. ‘Current rhinitis’ (CR) was defined as the presence of ≥1 rhinitis symptom (repeated sneezing and/or itchy nose, blocked nose for >1 h, or runny nose without having a cold/flu) in the last year. Rhinitis lasting ≥4 days/week and ≥4 consecutive weeks was classified as persistent. Moderate–severe disease interfered ‘a moderate amount’ or ‘a lot’ in daily activities. Results Five thousand and eighteen children were included. CR prevalence was 43.4% [95% CI (42.0–44.8%); n = 2179] and that of physician‐diagnosed rhinitis was 11.7% [95% CI (10.8–12.6%); n = 588]. Of children with CR, 67% reported blocked nose, 48% rhinorrhea, and 46% sneezing/itchy nose. Considering ARIA classification, 30% of the population had mild intermittent, 3% mild persistent, 7% moderate–severe intermittent, and 3% moderate–severe persistent rhinitis. Children with CR had more current wheezing, physician‐diagnosed asthma, self‐reported food allergy, and family history of allergic disease. These characteristics were also associated with persistent and moderate–severe rhinitis. Conclusions This is the first nationwide population‐based study reporting rhinitis prevalence and ARIA classification in preschool children. In this age‐group, rhinitis is frequent and underdiagnosed. About 25% children with rhinitis presented moderate–severe disease.