Health-related quality of life in food hypersensitive schoolchildren and their families: parents' perceptions

BACKGROUND: About 20% of schoolchildren and adolescents in Sweden suffer from perceived food hypersensitivity (e.g. allergy or intolerance). Our knowledge of how child food hypersensitivity affects parents HRQL and what aspects of the hypersensitivity condition relate to HRQL deterioration in the family is limited. Thus the aim of this study was to investigate the parent-reported HRQL in families with a schoolchild considered to be food hypersensitive. The allergy-associated parameters we operated with were number of offending food items, adverse food reactions, additional hypersensitivity, allergic diseases and additional family members with food hypersensitivity. These parameters, along with age and gender were assessed in relation to child, parent and family HRQL. METHODS: In May 2004, a postal questionnaire was distributed to parents of 220 schoolchildren with parent-reported food hypersensitivity (response rate 74%). Two questionnaires were used: CHQ-PF28 and a study-specific questionnaire including questions on allergy-associated parameters. In order to find factors that predict impact on HRQL, stepwise multiple linear regression analyses were carried out. RESULTS: An important predictor of low HRQL was allergic disease (i.e. asthma, eczema, rhino conjunctivitis) in addition to food hypersensitivity. The higher the number of allergic diseases, the lower the physical HRQL for the child, the lower the parental HRQL and the more disruption in family activities. Male gender predicted lower physical HRQL than female gender. If the child had sibling(s) with food hypersensitivity this predicted lower psychosocial HRQL for the child and lower parental HRQL. Food-induced gastro-intestinal symptoms predicted lower parental HRQL while food-induced breathing difficulties predicted higher psychosocial HRQL for the child and enhanced HRQL with regards to the family's ability to get along. CONCLUSION: The variance in the child's physical HRQL was to a considerable extent explained by the presence of allergic disease. However, food hypersensitivity by itself was associated with deterioration of child's psychosocial HRQL, regardless of additional allergic disease. The results suggest that it is rather the risk of food reactions and measures to avoid them that are associated with lower HRQL than the clinical reactivity induced by food intake. Therefore, food hypersensitivity must be considered to have a strong psychosocial impact

Vaccinaties in het eerste levensjaar en gerapporteerde allergische aandoeningen bij kinderen van 8-12 jaar

Evidence for the relationship between the diphtheria tetanus pertussis (DTP) vaccination and allergic disorders is inconclusive, because the available studies that constitute the evidence are liable to confounding by indication. Further the Haemophilus influenzae type b (Hib) vaccination was added recently to most existing vaccination programmes and therefore no conclusive data on the relationship with allergic disorders are yet available. Objective of the study was to assess the relationship between vaccinations in the first year of life and reported allergic disorders at primary school age. We conducted a cross sectional study in 1875 children attending Orthodox Reformed (Protestant) primary schools in the Netherlands. The parents returned questionnaires with data on vaccination status, allergic symptoms and lifetime allergic disorders (asthma, hay fever, eczema and food allergy), and possible confounders. In the diphtheria tetanus pertussis (inactivated) poliomyelitis (DTP-IPV) vaccinated group Hib vaccinated and Hib unvaccinated children were compared as to allergic disorders. No clinically or statistically significant differences in the prevalence of asthma, hay fever, eczema and food allergy appeared between vaccinated and unvaccinated groups. The DTP-IPV vaccination and the Hib-vaccination, administered in the first year of life, do not increase the risk of allergic disorders in 8-12 years-old, Dutch children