Zusammenfassung
Im Kinder- und Jugendgesundheitssurvey (KiGGS) wurden von 2003–2006 an einer bevölkerungsbezogenen Stichprobe von 17.641 0- bis 17-Jährigen Daten zu allergischen Erkrankungen (Asthma, atopisches Ekzem, Heuschnupfen, allergisches Kontaktekzem) erhoben und Blutproben auf spezifische IgE-Antikörper gegen 20 verbreitete Allergene untersucht. Die Lebenszeitprävalenz (LZP) mindestens einer atopischen Erkrankung betrug 22,9 % (95 %- KI 22,0–23,7 %), die 12-Monats-Prävalenz (12MP) 16,1 % (15,4–16,8 %); Jungen (17,3; 16,3–18,2 %) waren häufiger betroffen als Mädchen (14,9; 14,0–15,8 %). Kinder mit Migrationshintergrund waren aktuell seltener von einer atopischen Erkrankung betroffen, ebenso Kinder aus Familien mit niedrigem Sozialstatus. Die LZP des allergischen Kontaktekzems lag nach Elternangaben bei 9,9 % (9,4–10,5 %); Mädchen (13,8; 12,9–14,8 %) waren häufiger betroffen als Jungen (6,2; 5,6–6,9 %). 40,8 % (39,6–42,0 %) der 3- bis 17-Jährigen waren gegenüber mindestens einem der getesteten Allergene sensibilisiert; Jungen (45,0; 43,5–46,5 %) häufiger als Mädchen (36,4; 35,0–37,9 %). In den alten Bundesländern war die LZP des allergischen Kontaktekzems höher (10,2; 9,6–10,9 %) als in den neuen Bundesländern (8,4; 7,4–9,6 %); ansonsten zeigten sich keine Ost-West-Unterschiede. Die KiGGS-Daten liefern erstmals bundesweit repräsentative Daten über allergische Erkrankungen und Sensibilisierungen. Die beobachteten Prävalenzunterschiede stehen in weitgehender Übereinstimmung mit bisherigen Studien und können die Hygienehypothese stützen. Die Prävalenzen zwischen Ost- und Westdeutschland scheinen sich inzwischen vollständig angenähert zu haben.
Abstract
In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) from 2003–2006 information was collected on allergic diseases (asthma, atopic dermatitis, hay fever, allergic contact eczema) from a population-based sample of 17,641 0–to 17-year-olds, and blood samples were studied for specific IgE antibodies to 20 common allergens. The lifetime prevalence (LTP) of at least one atopic disease was 22.9 % (95 % CI: 22.0–23.7 %), the 12-month prevalence (12MP) was 16.1 % (15.4–16.8 %); boys (17.3; 16.3–18.2 %) were more frequently affected than girls (14.9; 14.0–15.8 %). Children with a background of migration were less often currently affected by an atopic disease, as were children from families of low social status. According to parents' accounts, the LTP of allergic contact eczema was 9.9 % (9.4–10.5 %); girls (13.8;12.9–14.8) were more frequently affected than boys (6.2; 5.6–6.9 %). Of the 3- to 17-year-olds, 40.8 % (39.6–42.0 %) were sensitised to at least one of the allergens tested; boys (45.0; 43.5–46.5 %) more frequently so than girls (36.4; 35.0–37.9 %). In the states of the former FRG, the LTP of allergic contact eczema was higher (10.2; 9.6–10.9 %) than those in the former GDR (8.4 % 7.4–9.6 %); otherwise there were no East-West differences. The KiGGS data provide the first nationally representative data on allergic diseases and sensitisation. The differences in prevalence observed correspond to a great extent with previous studies and may support the hygiene hypothesis. The prevalences in East and West Germany now seem to have equalised.
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Literatur
Bergmann K, Kamtsiuris P, Kahm H et al. (1998) Prävalenz von Krankheiten im Kindesalter. Monatsschr Kinderheilkd 146
Koch K (1998) Weltatlas der Allergien. Dtsch Ärztebl 95:1032–1034
von Mutius E (1998) The rising trends in asthma and allergic disease. Clin Exp Allergy 28 [Suppl 5]:45–49; discussion 50–41
Kolip P, Nordlohne E, Hurrelmann K (1995) Der Jugendgesundheitssurvey 1993. In: Kolip P, Hurrelmann K, Schnabel P (Hrsg) Jugend und Gesundheit. Juwenta, Weinheim München, S 25–48
Wjst M (1996) Epidemiologie von Asthma im Kindes alter im internationalen Vergleich. Allergologie 19:234–243
Newacheck PW, Halfon N (2000) Prevalence, impact, and trends in childhood disability due to asthma. Arch Pediatr Adolesc Med 154:287–293
Wahn U, Wichmann HE (2000) Spezialbericht Allergien. Gesundheitsberichterstattung des Bundes. Statistisches Bundesamt (Hrsg). Metzer und Poeschel, Stuttgart
Krämer U, Möllemann AHB (2001) Epidemiologie allergischer Erkrankungen bei Kindern. Zeitliche Trends in Deutschland und Diskussion möglicher Ursachen und Trends. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 44:633–642
Nikolai T, Bellach B, von Mutius E et al. (1997) Increased prevalence of sensitization against aeroallergens in adults in West compared to East Germany. Clin Exp Allergy 27:886–892
Weiland SK, von Mutius E, Hirsch T et al. (1999) Prevalence of respiratory and atopic disorders among children in the East and West of Germany five years after unification. Eur Respir J 14:862–870
Schuster A, Reinhard D (1999) Asthma bronchiale. In: Wahn U, Seger R, Wahn V (Hrsg) Pädiatrische Allergologie und Immunologie. Urban und Fischer, München Jena, S 284–303
NN (1997) Guidelines for the diagnosis and management of asthma. National Institutes of Health (National Heart, Lung, and Blood Institute)
Kamtsiuris P, Lange M, Schaffrath Rosario A (2007) Der Kinder- und Jugendgesundheitssurvey (KiGGS): Stichprobendesign, Response und Nonresponse-Analyse. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 50:547–556
Hölling H, Kamtsiuris P, Lange M et al. (2007) Der Kinder- und Jugendgesundheitssurvey (KiGGS): Studienmanagement und Durchführung der Feldarbeit. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 50:557–566
Dölle R, Schaffrath Rosario A, Stolzenberg HR (2007) Der Kinder- und Jugendgesundheitssurvey (KiGGS): Datenmanagement. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 50:567–572
Filipiak-Pittroff B, Wölke G (2007) Externe Qualitätssicherung im Kinder- und Jugendgesundheitssurvey (KiGGS). Vorgehensweise und Ergebnisse. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 50:573–577
Lange M, Kamtsiuris P, Lange C et al. (2007) Messung soziodemographischer Merkmale im Kinder- und Jugendgesundheitssurvey (KiGGS) und ihre Bedeutung am Beispiel der Einschätzung des allgemeinen Gesundheitszustandes. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 50:578–589
Schenk L, Ellert U, Neuhauser H (2007) Kinder und Jugendliche mit Migrationshintergrund in Deutschland. Methodische Aspekte im Kinder- und Jugendgesundheitssurvey (KiGGS). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 50:590–599
Hermann-Kunz E, Thierfelder W (2001) Allergische Rhinitis und Sensibilisierungsraten – Nimmt die Prävalenz wirklich zu? Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 44:643–653
Rohling I (2002) Gesundheit und Entwicklungsstand der Osnabrücker Schulanfänger. Stadt Osnabrück, Fachbereich Soziales und Gesundheit, Gesundheitsamt, Osnabrück
NN (2000) Saarbrücker Kinder – gesunde Kinder? Stadtverband Saarbrücken
Zöllner IK, Weiland SK, Piechotowski I et al. (2005) No increase in the prevalence of asthma, allergies, and atopic sensitisation among children in Germany: 1992–2001. Thorax 60:545–548
Maziak W, Behrens T, Brasky TM et al. (2003) Are asthma and allergies in children and adolescents increasing? Results from ISAAC phase I and phase III surveys in Munster, Germany. Allergy 58:572–579
Backlund AB, Perzanowski MS, Platts-Mills T et al. (2006) Asthma during the primary school ages – prevalence, remission and the impact of allergic sensitization. Allergy 61:549–555
Buser K, von Bohlen F, Werner P et al. (1993) The prevalence of neurodermatitis among school children in the Hannover administrative district. Dtsch Med Wochenschr 118:1141–1145
Werner S, Buser K, Kapp A, Werfel T (2002) The incidence of atopic dermatitis in school entrants is associated with individual life-style factors but not with local environmental factors in Hannover, Germany. Br J Dermatol 147:95–104
Schäfer T, Kramer U, Vieluf D et al. (2000) The excess of atopic eczema in East Germany is related to the intrinsic type. Br J Dermatol 143:992–998
Mortz CG, Lauritsen JM, Bindslev-Jensen C, Andersen KE (2001) Prevalence of atopic dermatitis, asthma, allergic rhinitis, and hand and contact dermatitis in adolescents. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis. Br J Dermatol 144:523–532
Heine G, Schnuch A, Uter W, Worm M (2004) Frequency of contact allergy in German children and adolescents patch tested between 1995 and 2002: results from the Information Network of Departments of Dermatology and the German Contact Dermatitis Research Group. Contact Dermatitis 51:111–117
Clayton TH, Wilkinson SM, Rawcliffe C et al. (2006) Allergic contact dermatitis in children: should pattern of dermatitis determine referral? A retrospective study of 500 children tested between 1995 and 2004 in one U.K. centre. Br J Dermatol 154:114–117
Uekert SJ, Akan G, Evans MD et al. (2006) Sex-related differences in immune development and the expression of atopy in early childhood. J Allergy Clin Immunol 118:1375–1381
Mohrenschlager M, Schafer T, Huss-Marp J et al. (2006) The course of eczema in children aged 5–7 years and its relation to atopy: differences between boys and girls. Br J Dermatol 154:505–513
Nicolai T, Pereszlenyiova-Bliznakova L, Illi S et al. (2003) Longitudinal follow-up of the changing gender ratio in asthma from childhood to adulthood: role of delayed manifestation in girls. Pediatr Allergy Immunol 14:280–283
Heinrich J, Popescu MA, Wjst M et al. (1998) Atopy in children and parental social class. Am J Public Health 88:1319–1324
du Prel X, Kraemer U, Behrendt H et al. (2006) Preschool childrens' health and its association with parental education and individual living conditions in East and West Germany. BMC Public Health 6:312
Schaub B, Lauener R, von Mutius E (2006) The many faces of the hygiene hypothesis. J Allergy Clin Immunol 117:969–977; quiz 978
Vercelli D (2006) Mechanisms of the hygiene hypothesis – molecular and otherwise. Curr Opin Immunol 18:733–737
Zaccone P, Fehervari Z, Phillips JM et al. (2006) Parasitic worms and inflammatory diseases. Parasite Immunol 28:515–523
Flohr C (2003) Dirt, worms and atopic dermatitis. Br J Dermatol 148:871–877
van Schayck CP, Knottnerus JA (2004) No clinical evidence base to support the hygiene hypothesis. Prim Care Respir J 13:76–79
Gibbs S, Surridge H, Adamson R et al. (2004) Atopic dermatitis and the hygiene hypothesis: a case-control study. Int J Epidemiol 33:199–207
Flohr C, Johansson SG, Wahlgren CF, Williams H (2004) How atopic is atopic dermatitis? J Allergy Clin Immunol 114:150–158
Zutavern A, Hirsch T, Leupold W et al. (2005) Atopic dermatitis, extrinsic atopic dermatitis and the hygiene hypothesis: results from a cross-sectional study. Clin Exp Allergy 35:1301–1308
Braun-Fahrlander C, Riedler J, Herz U et al. (2002) Environmental exposure to endotoxin and its relation to asthma in school-age children. N Engl J Med 347:869–877
Grüber C, Meinlschmidt G, Bergmann R et al. (2002) Is early BCG vaccination associated with less atopic disease? An epidemiological study in German preschool children with different ethnic backgrounds. Pediatr Allergy Immunol 13:177–181
Kabesch M, Schaal W, Nicolai T, von Mutius E (1999) Lower prevalence of asthma and atopy in Turkish children living in Germany. Eur Respir J 13:577–582
Hjern A, Haglund B, Hedlin G (2000) Ethnicity, childhood environment and atopic disorder. Clin Exp Allergy 30:521–528
Grüber C, Illi S, Plieth A et al. (2002) Cultural adaptation is associated with atopy and wheezing among children of Turkish origin living in Germany. Clin Exp Allergy 32:526–531
Ones U, Akcay A, Tamay Z et al. (2006) Rising trend of asthma prevalence among Turkish school-children (ISAAC phases I and III). Allergy 61:1448–1453
von Mutius E, Fritzsch C, Weiland SK et al. (1992) Prevalence of asthma and allergic disorders among children in united Germany: a descriptive comparison. BMJ 305:1395–1399
von Mutius E, Martinez FD, Fritzsch C et al. (1994) Prevalence of asthma and atopy in two areas of West and East Germany. Am J Respir Crit Care Med 149:358–364
Schäfer T, Kramer U, Dockery D et al. (1999) What makes a child allergic? Analysis of risk factors for allergic sensitization in preschool children from East and West Germany. Allergy Asthma Proc 20:23–27
Heinrich J, Hoelscher B, Frye C et al. (2002) Trends in prevalence of atopic diseases and allergic sensitization in children in Eastern Germany. Eur Respir J 19:1040–1046
Krämer U, Link E, Oppermann H et al. (2002) Die Schulanfängerstudie in West- und Ostdeutschland (SAWO): Trends von Allergien und Sensibilisierungen 1991–2000. Gesundheitswesen 64:657–663
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Schlaud, M., Atzpodien, K. & Thierfelder, W. Allergische Erkrankungen. Bundesgesundheitsbl. 50, 701–710 (2007). https://doi.org/10.1007/s00103-007-0231-9
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DOI: https://doi.org/10.1007/s00103-007-0231-9
Schlüsselwörter
- Gesundheitssurvey
- Kinder
- Jugendliche
- Allergien
- Atopien
- Sensibilisierung
- Asthma
- Atopisches Ekzem
- Heuschnupfen
- Allergisches Kontaktekzem