Background The prevalence of allergy among Surabaya school children is currently unknown. Objective To identify the prevalence of the common allergic sensitization and allergic diseases among school children and undergraduate students in suburban of Surabaya by epidemiologic data collection. Methods A multistage simple random sampling was done to select 5 primary schools, 8 secondary schools (4 of junior high schools and senior high schools, respectively), and 1 university from 5 districts in Surabaya city. Out of 550 invited respondents, 499 (128 primary school, 221 secondary school, and 150 undergraduate) respondents gave their consent. A complete personal history, allergic symptoms, environmental exposure of common allergens was obtained from interview and the physical examinations were performed. Skin prick test (SPT) was done using 45 different allergen extracts. Total serum IgE and specific IgE radioallergosorbent test levels were measured for respondents with allergic manifestations. Results There was an increasing SPT positivity among study respondents, from primary school, secondary school, to undergraduate students (21.90%, 28.95%, to 45.30% respectively). Cockroach (42.85%) and fungi/mold spore (42.85%) were the most common allergens in primary school children. House dust mites was the most common allergen in secondary school (63.16%) and undergraduate students (58.82%). Urticaria and rhinitis were the commonest allergic diseases manifestation. History of atopy was positive in 60.79% of the allergic respondents. Conclusion The prevalence of allergic sensitization among school children and undergraduate students in Surabaya suburb areas were increased compared to previous estimates in 1998. While house dust mites are known as important allergens, surprisingly cockroach was the common allergen among the younger school children.

This case-control study was conducted to assess the relative role of genetic and environmental factors in determining the clinical manifestations of atopy allergy disease in school children, which is part of a large study of the prevalence of allergic diseases in school children in Surabaya. Using a simple multi-stage random sampling, 348 children from 5 elementary schools, 4 junior high schools, and 4 senior high schools in Surabaya were involved in the study. The subjects of the study along with her parents were guided to fill out the modified ISAAC questionnaire and underwent physical examination and skin prick test using 27 common allergen types found in the environment. For the analysis, 110 school children were randomly selected from the parent sample and included in the case group of 55 people (positive skin prick test against > 1 type of allergen), and the control group of 55 people (negative skin prick test). All genetic and environmental factors data were collected and analyzed. Most of the subjects had clinical manifestations of allergic rhinitis (66.36%), asthma (21.82%), food allergies (10.9%), and atopic dermatitis (6.36%). Complete models for multiple logistic regression analysis can only be performed for overall atopic disease and allergic rhinitis disease. The first birth order and exposure to home dust mites were the most significant clinical manifestations of atopy disease (OR 4.548, 95% CI: 1.813-11.410, p=0.01). Atopy status of the father was the only significant determinant factor for the manifestation of allergic rhinitis in the study subjects (OR 3.929; 95% CI: 1.143-13.052, p=0.03). Both genetic and environmental factors interacted and determined clinical manifestations of atopy allergy disease in school pupils. The father's genetic factors were more dominant than maternal genetic factors in determining the clinical manifestations of allergic rhinitis in offspring.

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