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Eczema, asthma, and allergic rhinitis are the most prevalent paediatric allergic diseases observed in clinical settings. Characterized by persistent symptoms such as scratching, wheezing, and sneezing, allergic diseases may compromise the quality of life of affected children. Although diagnoses of allergic diseases are increasingly common, recent data regarding the severity and psychosocial impact of childhood allergic diseases is not available in Hong Kong. The present study referenced the research protocol proposed by the International Study of Asthma and Allergies in Childhood (ISAAC) to understand the disease profile and psychosocial impact of eczema, asthma, and allergic rhinitis on affected schoolchildren in Hong Kong.
Methods:
3,748 grade 1-2 and 5,771 grade 8-9 schoolchildren were recruited in this study from 44 schools in Hong Kong. The ISAAC questionnaire was used to determine the presence of allergic diseases and the following questionnaires were used to estimate the severity of three types of allergic diseases: Patient-oriented Eczema Measure (POEM), Childhood Asthma Control Test (CACT, for grade 1-2 schoolchildren) or Asthma Control Test (ACT, for grade 8-9 schoolchildren), and Visual Analogue Scale for Allergic Rhinitis Severity (VAS) . Paediatric Quality of Life Report Generic Score Scales (PedsQL) was used to measure health-related quality of life in four domains: physical, emotional, social, and school functioning. For grade 1-2 schoolchildren, caregivers filled out the questionnaires on their behalf. Data from 1,165 participants from grade 1-2 and 1,083 participants from grade 8-9 were analzyed.
Findings:
Based on reports from the ISAAC questionnaire, eczema was reported in 484 grade 1-2 and 286 grade 8-9 schoolchildren; asthma was reported in 63 grade 1-2 and 66 grade 8-9 schoolchildren; and allergic rhinitis was reported in 516 grade 1-2 and 500 grade 8-9 schoolchildren.
For grade 1-2 schoolchildren, POEM was significantly and negatively associated with physical (r(369)=-.19, p<.001), emotional (r(364)=-.19, p<.001), and social functioning (r(362)=-.14, p=.009). VAS was significantly and negatively associated with physical (r(469)=-.19, p<.001), emotional (r(465)=-.20, p<.001), social (r(464)=-.11, p=.022), and school functioning (r(469)=-.16, p<.001). No significant correlations were found for CACT. No significant regression models were found.
For grade 8-9 schoolchildren, POEM, ACT, and VAS were significantly associated with all dimensions of functioning. The more severe the condition, the lower the physical (POEM: r(131)=-.37, p<.001; ACT: r(61)=.66, p<.001); VAS: r(471)=-.34, p<.001), emotional (POEM: r(130)=-.31, p<.001; ACT: r(60)=.48, p<.001; VAS: r(470)=-.35, p<.001), social (POEM: r(130)=.-33, p<.001; ACT: r(60)=.52, p<.001; VAS: r(468)=-.26, p<.001), and school functioning (POEM: r(130)=-.33, p<.001; ACT: r(60)=.54, p<.001; VAS: r(468)=-.31, p<.001). ACT significantly predicted physical, social, and school functioning.
Conclusion and implications:
Allergic diseases are usually managed by symptom-based medical and pharmaceutical care. Current findings suggest that the psychosocial impact of childhood allergic diseases cannot be overlooked, and highlight the need for a holistic approach in managing allergic diseases such as the implementation of non-pharmaceutical psychosocial intervention. Given the increasing prevalence of childhood allergic diseases, understanding the disease profile and psychosocial characteristics of childhood allergic diseases can provide insights into the development of holistic healthcare and family-oriented policies.