Allergic rhinitis in children: Incidence and treatment in Dutch general practice in 1987 and 2001

Abstract

Allergic rhinitis is a common chronic disorder in children, mostly diagnosed in primary health care. This study investigated the national incidence and treatment of allergic rhinitis among children aged 0-17 yr in Dutch general practice in 1987 and 2001 to establish whether changes have occurred. A comparison was made with data from the first (1987) and second (2001) Dutch national surveys of general practice on children aged 0-17 yr. Incidence rates were compared by age, sex, level of urbanization and season. The management of the general practitioner was assessed regarding drug prescriptions and referrals to medical specialists, and compared with the clinical guideline issued in 1996. The incidence rate of allergic rhinitis increased from 6.6 (1987) to 9.2 (2001) per 1000 person-years. We found a male predominance with a switch in adolescence to a female predominance at both time points. The increase in incidence was the highest in rural (<30,000 inhabitants) and suburban areas (30,000-50,000 inhabitants). Compared to 1987, there was a significant increase in incidence in the central part of the Netherlands in 2001. In both years, the incidence was higher in spring compared with the other seasons. In 2001, children of natives and western immigrants visited the general practitioner more often with complaints of allergic rhinitis compared to 1987. In 1987, prescribed medication consisted mainly of nasal corticosteroids (36%) and in 2001 of oral antihistamines (45%). Although a clinical guideline was not issued until 1996, overall, the treatment of allergic rhinitis by general practitioners was in both years in accordance with the current clinical guideline, but with a stronger adherence in 2001. The results show an increased incidence in the past decades of allergic rhinitis in children in Dutch general practice. The shift to a smaller spectrum of prescriptions in 2001 may be a result of the 1996 clinical guideline.

Clinical profile, outcomes and improvement in symptoms and productivity in rhinitic patients in Karachi, Pakistan

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Prediction of the incidence and persistence of allergic rhinitis in adolescence: A prospective cohort study

“…This is consistent with former findings of a ''switch'' during puberty: boys were reported to have a higher prevalence of asthma and rhinitis in childhood yet a lower one than girls after puberty. 36,40 Underlying causes explaining this convergence are unknown. Possible explanations are hormonal status or a difference in behavior and thus exposure.…”

Early-life risk factors and incidence of rhinitis: Results from the European Community Respiratory Health Study—an international population-based cohort study

“…In subjects without atopy in adult life, females have a consistently increased risk of rhinitis compared with males throughout life. Studies of pediatric cohorts have observed an increased incidence of allergic rhinitis 17,18 and aero-allergen sensitization 19 in boys than in girls. One previous study of Finnish adolescents reported the incidence of rhinitis between follow-up surveys conducted at 16, 22, and 32 years of age.…”