Delivered by Ingenta to: State University New York At Buffalo IP: 46.161.58.84 On: Thu, 16 Jun 2016 05:59:23 Copyright (c) Oceanside Publications, Inc. All rights reserved. For permission to copy go to https://www.oceansidepubl.com/permission.htm Special Focus: Pediatric Asthma ISAAC The determination of asthma, rhinitis, eczema, and atopy prevalence in 9- to 11-year-old children in the city of Izmir Ozkan Karaman, M.D., Canan Sule Turgut, M.D., Nevin Uzuner, M.D., Duygu Olmez, M.D., Arzu Babayigit, M.D., Suna Kose, M.D., and Dilek Tezcan, M.Sc. (Turkey) ABSTRACT The International Study of Asthma and Allergies in Childhood (ISAAC) phase II was designed to allow comparisons between populations in different countries and to investigate possible etiologic factors. This study was conducted to better delineate the prevalence and etiologic factors of asthma, rhinitis, and eczema in Izmir (Turkey) and to be included in the international comparisons by using a standard methodology of ISAAC phase II. The questionnaire was distributed to 2112 students in the 3rd, 4th, and 5th grades of 12 selected primary schools in urban and rural boroughs of Izmir. One thousand two hundred seventeen of these questionnaires were evaluated and physical examinations and skin-prick tests were performed on 1098 of these children. The prevalence values were 15.9% for recent wheezing and 4.8% for physician-diagnosed asthma. The prevalence of sneezing or runny or blocked nose in the past 12 months when the child did not have a cold or flu was 30%. The prevalence of physician-diagnosed allergic rhinitis was 17%. The prevalence of an itchy rash that was coming and going for at least 6 months was 7.2% and the prevalence of physician-diagnosed eczema was 4.9%. Atopic sensitization prevalence in the population was 8.8% with house-dust mite sensitization being the most frequent one. Secretion rales and sibilant wheezing rhoncus were detected in 2.7% of children by chest auscultation. In 1.1% of children flexural dermatitis was detected. Objective tests are necessary for epidemiologic studies of the aforementioned diseases. (Allergy Asthma Proc 27:319 –324, 2006; doi: 10.2500/aap.2006.27.2877) R ecently, the frequency of asthma and allergic dis- eases has been increasing, especially in western and developed countries. 1,2 Globally, the incidence of childhood asthma varies between 1 and 30% in various communities. 3 This increase depends on both environ- mental and individual factors. Individual factors in- clude genetic predisposition, geometry of airways and airway hyperreactivity, sex, and race. Environmental factors include viral and bacterial infections, diet, pas- sive smoking, numbers of persons in family and social and economic state. 4 The etiology of asthma and other allergic diseases still could not be clarified completely despite many studies. A study group—the “International Childhood Asthma and Allergic Diseases” (ISAAC)— has been formed to standardize and raise the value of epidemi- ologic research and to maintain international commu- nication. The first phase of the study aimed at deter- mining the prevalences of asthma and allergic diseases by the use of standardized methods in 721,601 children from 156 centers. 1,4 ISAAC phase II has been organized to search the causes of variation in prevalences in ISAAC phase I. Using the questionnaire of the ISAAC phase II study, epidermal prick test, and physical ex- amination in Izmir, which is the third largest city of Turkey, aimed to investigate the frequency and etiol- ogy of asthma, allergic rhinitis, and eczema and to compare these with the results of other regions in Turkey and other countries. METHODS Selection of Samples This study was done in accordance with the studies of ISAAC phase II by using the same questionnaire in Izmir between September 2002 and October 2002. The number of children living in Izmir between the ages of 9 and 11 years was 161,391. To reach 97% confidence with 1% error, a sample size of at least 851 children was determined necessary; therefore, 1000 children partic- ipated into this study. There are 28 districts in Izmir, 7 of which are situated in the center and 21 in the pe- riphery. The study included children from primary schools, four from central and eight from peripheral districts, to reflect the whole city. These districts were From the Dokuz Eylu ¨ l University Faculty of Medicine, Division of Pediatric Allergy, Inciraltı, Izmir, Turkey Address correspondence and reprint requests to Duygu Olmez, Dokuz Eylu ¨ l Univer- sity Faculty of Medicine, Division of Pediatric Allergy, Inciraltı, Izmir 35340, Turkey E-mail address: duyguolmez@hotmail.com Copyright © 2006, OceanSide Publications, Inc., U.S.A. Allergy and Asthma Proceedings 319