Objectives-To determine the prevalence rates of the various causes of severe headache in schoolchildren, with special emphasis on migraine and its impact on school attendance.Design-Population based study in two stages, comprising an initial screening questionnaire followed by clinical interviews and examination of children with symptoms and a control group of asymptomatic children matched for age and sex.Setting-67 primary and secondary schools in the city ofAberdeen.Subjects-2165 children, representing a random sample of 10/o of schoolchildren in Aberdeen aged 5-15 years.Main outcome measures-(a) the prevalence of migraine (International Headache Society criteria) and of other types of headache; (b) the impact of migraine on school attendance.Results-The estimated prevalence rates of migraine and tension headache were 10X60%o (95% confidence interval 9 1 to 12.3) and 0 9%'/o (0*5 to 1.5) respectively. The estimated prevalence rates for migraine without aura and migraine with aura were 7-80/ (95% confidence interval 6*5 to 9.3) and 2-80/ (2-0 to 3.8) respectively. In addition, 10 children (0 70/6) had headaches which, though lasting less than two hours, also fulfilled the International Headache Society criteria for migraine, 14 (0 9%/) had tension headaches, and 20 (13%/) had non-specific recurrent headache. The prevalence of migraine increased with age, with male preponderance in children under 12 and female preponderance thereafter. Children with migraine lost a mean of [7][8]
Objective-To estimate changes in the prevalence of respiratory symptoms and the reported diagnoses of asthma, eczema, and hay fever in primary school children in Aberdeen between 1964 and 1989.Design-Determination of incidence prevalence and prevalence from survey data.Setting-Aberdeen, Scotland. Participants-2743 primary school children (aged 8-13) from 1964 and 3942 from 1989.Main outcome measures -Survey data on whether, according to the parent or guardian, the child wheezed or was troubled with shortness of breath; the number of episodes of breathlessness in the past year; and whether asthma, eczema, or hay fever had ever been diagnosed.Results-Questionnaires were completed by the parents of 2510 children in 1964 and 3403 children in 1989. The prevalence of wheeze rose from 10-4% in 1964 to 19-8% in 1989, and the prevalence of episodes of shortness of breath increased from 5-4% to 10-0%. In both surveys wheeze and shortness of breath were more prevalent in boys than in girls. The reported diagnosis of asthma rose from 4-1% to 10-2%, hay fever from 3-2% to 11-9%, and eczema from 5.3% to 12%. The proportion of boys suffering from eczema rose from 47-7% to 60-0%. Hay fever showed a similar increase, from 49-4% to 60-1%, in boys over the 25 year period. Though the parents of a higher proportion ofchildren with wheeze were aware of the diagnosis of asthma in 1989, because ofthe increased prevalence ofwheeze the absolute number ofparents ofwheezy children who were not aware of a diagnosis of asthma increased from 7-4% to 9-6% of the population studied.Conclusion-The higher diagnosis rate for asthma is due not simply to changes in diagnostic fashion but reflects an increase over the past 25 years in the prevalence of respiratory symptoms, which in turn may reflect a more general change in the prevalence of atopy, the increase in which was particularly noticeable in boys. This increase explains some of the increase in hospital admission rates for children with asthma.
Two thousand women were recruited for a prospective investigation of the influence of maternal antioxidant intake in pregnancy on the development of asthma and eczema in children. A food frequency questionnaire was used to characterize diet during pregnancy and blood antioxidant levels were measured. Postal questionnaires were used to follow up the 1,924 singleton children born to the cohort at 6, 12, and 24 months of age. There were no associations between maternal antioxidant intake and wheezing symptoms and eczema in the children's first year. In the children's second year, maternal vitamin E intake during pregnancy was negatively associated with wheeze in the absence of a "cold" (p for trend 0.010) and, in children whose mothers were atopic, there was a negative association between maternal vitamin E intake and childhood eczema (p for trend 0.024). Maternal vitamin C intake during pregnancy was positively associated with "ever wheeze" and eczema during the children's second year. This study suggests that maternal dietary antioxidant intakes during pregnancy may modify the risks of developing wheeze and eczema during early childhood. Further follow up of the cohort will determine whether maternal diet during pregnancy is associated with asthma and atopic disease in later childhood.
The UK Cystic Fibrosis Survey holds data on all people resident in the UK who were diagnosed as having cystic fibrosis and born either since 1968 or before 1968 and alive in 1977. Thus, incidence may be reported from 1968 and prevalence from 1977.The previous estimates are updated to the end of 1995 from data held in the database on 23 August 1996.The incidence is now calculated as one in 2415 live births. The 1992 mid-year population was 6500 people with 65% aged under 16 years. Births outnumber deaths by 160 per year, which suggests a population of 7750 by the year 2000, with all the increase being in the adult age range.The survival of successive cohorts continues to be better than earlier cohorts, the linear descent of the curves is still evident. The infant mortality rate for cystic fibrosis is now under 20 per thousand per year and early childhood mortality is under five per thousand per year.The crude mortality rate for 1995 was 21 per thousand per year, but the standardised mortality ratio was about 3300.
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