DISAGREEMENT OF DIFFERENT ESTIMATES OF RHINITIS PREVALENCE IN PRESCHOOL CHILDREN

Ana Margarida Pereira (1,2,3), Natacha Santos (1,2), Manuel Branco-Ferreira (4,5), Carlos Nunes (4,6), João Almeida Fonseca (2,3,4,7,8), Jean Bousquet (9), Mário Morais-Almeida (1,4)

(1) Hospital CUF-Descobertas, Immunoallergy Department, Lisbon, Portugal; (2) Hospital S. João EPE, Allergy and Clinical Immunology Department, Porto, Portugal; (3) Faculdade de Medicina da Universidade do Porto, Health Information and Decision Sciences Department, Porto, Portugal; (4) Sociedade Portuguesa de Alergologia e Imunologia Clínica (SPAIC); (5) Centro Hospitalar Lisboa Norte, Immunoallergy Department, Lisboa, Portugal; (6) Centro de Imunoalergologia do Algarve, Portimão, Portugal;

(7) Hospital and Instituto CUF, Allergy Unit, Porto, Portugal; (8) CINTESIS – Center for Research in Health Technologies and Information Systems, Porto, Portugal; (9) Department of Allergy and Respiratory Diseases, University Hospital and INSERM, Montpellier, France

There is not a single, universally accepted and validated definition to assess rhinitis prevalence

1)  to compare the prevalence of current rhinitis in preschool children using two different definitions 2)  to evaluate the agreement between these definitions and between them and patient-reported physician-diagnosed rhinitis

(PR-PDR) and medication use in the previous 12 months

AIMS

METHODS AND RESULTS

CONCLUSIONS

ISAAC definition Alternative definition “In the past 12 months, has your child had a problem with the following symptoms when he/she did not have a cold or he “flu”:

a)   Sneezing repeatedly and itching in the nose? (yes/no) b)   Blocked nose for at least a straight hour? (yes/no) c)   Runny nose when he/she did not have a cold or the “flu”? (yes/no)”

(questionnaire excerpt)  At least one symptom At least two symptoms

CURRENT RHINITIS

In the same study sample, the use of different definitions was associated with widely different estimates of rhinitis prevalence. The diagnostic accuracy of these definitions needs to be evaluated against clinical examination.

Prevalence

Agreement with:

Rhinitis medication use (n=582/11.7%)

43.5% [95%CI(42.1-44.9)]

20.4% [95%CI(19.3-21.5)]

PR-PDR and medication (n=544/10.9%)

Physician-diagnosed rhinitis (PR-PDR) (n=588/11.7%) 67.7

67.6

67.1

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Proportion of agreement Proportion of disagreement

82.5

82.9

82.7

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Proportion of agreement Proportion of disagreement

Agreement between definitions

Κ= 0.282

Κ=0.279

Κ=0.263

Κ= 0.361

Κ= 0.371

Κ= 0.351

Κ= 0.501

Study design: Cross-sectional, nationwide, population-based study; Target population: 3 to 5 years old Portuguese children; Data collection: questionnaire primarily adapted from the ISAAC questionnaire; applied by face-to-face interview to caregivers

5018 children included

77.0%

In relation to this presentation, I declare that there are no conflicts of interest

Κ= 0.501