Prevalence of allergic rhinitis, related comorbidities and risk factors in schoolchildren

BackgroundThe study aimed to determine the prevalence and risk factors of allergic rhinitis and related comorbidities in school-age children in Budapest, capital of Hungary. Data and epidemiological studies on this disease are still limited.MethodsA cross sectional study was conducted in 21 representative and randomly selected primary schools in 2019. International Study of Asthma and Allergies in Childhood-based questionnaires (n=6869) inquiring about prevalence and related risk factors of allergic rhinitis were distributed to all parents. The data were characterised with standard descriptive statistics: frequencies (percentages) and means for categorical and quantitative data, respectively.Results3836 of the questionnaires (1857 M/1979F) were completed. The prevalence of current allergic rhinitis was 29.3% (1043), physician-diagnosed allergic rhinitis was 9.7% (373), cumulative allergic rhinitis was 36.2% (1289) and current allergic rhinoconjunctivitis was 16.2% (577). The presence of physician diagnosed atopic disease-asthma (p<0.0001, OR=4.398, 95% CI 3.356-5.807), food allergy (p<0.0001, OR=2.594, 95% CI1.995-3.378), and eczema (p<0.0001, OR=1.899, 95% CI1.568-2.300)-were significantly related to an increased risk of cumulative allergic rhinitis. Significant factors associated with allergic rhinitis include male gender (p<0.0001), family history of atopy (p<0.0001), frequent upper respiratory tract infections (p<0.0001), tonsillectomy (p=0.0054), antibiotics given in the first year of life (p<0.0001), paracetamol given in the first year of life (p=0.0038), long-lasting common infections caused by viruses and/or bacteria before the appearance of the allergy (p<0.0001), consumption of drinks containing preservatives or colourants (p=0.0023), duration of living in Budapest (p=0.0386), smoking at home (p=0.0218), smoking at home in the first year of life (p=0.0048), birds at home (p=0.0119), birds at home in the first year of life (p=0.0052), visible mould in the bedroom (p=0.0139), featherbedding (p=0.0126), frequent or constant heavy-vehicle traffic (p=0.0039), living in a weedy area (p<0.0001) and living in the vicinity of an air-polluting factory or mine (p=0.0128).ConclusionsThe prevalence of allergic rhinoconjunctivitis in 6-12-year-old children in Budapest is higher than reported for most of the surrounding European countries. While asthma (OR=4.398) is the most significant comorbidity, environmental factors such as birds at home in the first year of life (OR=2.394) and living in a weedy area (OR=1.640) seem to be the most important factors associated with AR. Strategies for preventive measures should be implemented.Trial registration number: KUT-19/2019. The study was approved by the Ethics Committee at Heim Pal National Pediatric Institute,