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Tadd Clayton,1 M Innes Asher, 1 Julian Crane,2 Philippa Ellwood,1 Richard Mackay,3 Edwin A Mitchell,1Chris D Moyes,4 Philip Pattemore,5 Neil Pearce,6 and Alistair W Stewart7 |
| 1Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland 1142, New Zealand. |
| 2Wellington Asthma Research Group, Wellington School of Medicine, University of Otago, Wellington 6242, New Zealand. |
| 3Canterbury Health Laboratories, Christchurch 8140, New Zealand. |
| 4Bay of Plenty District Health Board, Whakatane 3158, New Zealand. |
| 5Department of Paediatrics, Christchurch School of Medicine, University of Otago, Christchurch 8140, New Zealand. |
| 6Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom. |
| 7School of Population Health, The University of Auckland, Auckland 1142, New Zealand. |
Correspondence: M Innes Asher. Department of Paediatrics: Child and Youth Health, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. Tel: +64-9-923-6454, Fax: +64-9-373-7602,Email: i.asher@auckland.ac.nz
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Received April 10, 2013; Accepted June 30, 2013.
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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
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Background
Eczema is a common chronic disease which has significant morbidity and costs for children and their families. Phase One (1993) of the International Study of Asthma and Allergies in Childhood (ISAAC) found a high prevalence of symptoms of eczema in New Zealand.
Objective
In Phase Three (2001-3) we aimed to answer these three questions: Is the prevalence of eczema changing over time?; Are there ethnic differences in prevalence?; and What are the risk factors for eczema?
Methods
Five New Zealand centres participated in ISAAC Phases One and Three using the same methodology. Questionnaires about ethnicity, symptoms of eczema and environmental factors were completed by parents of 6-7 year olds (children) and self-completed by 13-14 year olds (adolescents). Prevalence and change per year were calculated by centre, ethnicity and gender. Prevalence differences between centres and associations with environmental factors were examined using logistic regression.
Results
There was little change in prevalence over time for the children, and a decrease in prevalence for the adolescents. Prevalence was higher among Māori and even higher among Pacific participants than among European children. Positive associations with current eczema symptoms were found for both age groups for truck traffic in the street of residence, and current paracetamol consumption, and for children only, antibiotics or paracetamol in the 1st year of life. Inverse associations were found with residence in New Zealand less than 5 years, consumption of milk, seafood, and eggs, and presence of a dog in the home.
Conclusion
Eczema remains a significant problem, particularly for young Māori and Pacific New Zealanders in whom less recognition of eczema and poorer access to effective, sustained eczema management may be contributing factors. Reverse causation may explain all the environmental findings apart from truck traffic which is increasing in New Zealand.
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Keywords: Eczema, Children, Adolescents, Ethnicity, New Zealand, Environment.
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Open Access
Abstract
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