Increase in atopic sensitization rate among Dutch children with symptoms of allergic disease between 1994 and 2014

Background: The prevalence of symptoms of allergic diseases has increased significantly during the last decades. However, studies into time trends of atopic sensitization among children are limited and have focused on aeroallergen sensitization. We aimed to investigate time trends in the prevalence and degree of atopic sensitization to inhalant and food allergens among children (0-17 years) with symptoms of allergic disease. Methods: Sensitization data of all children tested in our clinical laboratory during 1994-2014 were analyzed. Sensitization was detected using the ImmunoCAP system and defined as a specific IgE level of = 0.35 kU/L. Trends in sensitization rates to 5 food and 5 aeroallergens for different age categories were investigated with logistic regression, adjusted for age and sex. Results: Sensitization data of 18 199 children were analyzed. Between 1994 and 2014, a steady and statistically significant increase in overall sensitization rate was found (from 40.5% in 1994 to 48.9% in 2014, adjusted odds ratio [aOR] 1.01 per year, 95% confidence interval [CI] 1.00 to 1.01, P = .003). This increase in sensitization rate was mainly explained by increasing aeroallergen sensitization among 4- to 11-year-old children (aOR 1.02, 95% CI 1.01 to 1.02, P .15). Conclusion: We observed a statistically significant increase in sensitization rate between 1994 and 2014 among children with symptoms of allergic disease. This was mainly explained by increasing aeroallergen sensitization among 4-to 11-year-olds

Anxiety problems in children and adolescents: a population-based cohort study on incidence and management in Dutch primary care

Koet LBM, de Schepper EIT, Bohnen AM, Bindels PJE, Gerger H. Anxiety problems in children and adolescents: a population-based cohort study on incidence and management in Dutch primary care. British Journal of General Practice. 2022.Background Due to a large strain on youth mental health care, general practice is suggested as an alternative treatment setting for children and adolescents with anxiety problems. However, research on the current management of these children and adolescents within general practice is scarce. Aim To investigate the incidence of coded anxiety in general practice using the International Classification of Primary Care (ICPC), and GPs' management of children and adolescents presenting with anxiety problems. Design and setting Population-based cohort study using electronic medical records of 51 212 children (aged 0-17 years) in primary care in the Rotterdam region between 1 January 2012 and 31 December 2018. Method Incidence of ICPC codes for anxiety were calculated, then the characteristics of children and adolescents consulting their GP with anxiety and the GPs' management were assessed qualitatively using quantitative content analysis. Results Incidence of ICPC codes for anxiety in children and adolescents was 5.36 (95% confidence interval [CI] = 5.02 to 5.71) per 1000 person- years. Adolescent females had the highest incidence with 14.01 (95% CI = 12.55 to 15.58) per 1000 person-years. Of the 381 children and adolescents consulting their GP with an initial anxiety problem (median age 13.3 years, 40.4% male), GPs referred 59.3% to mental health care in the first year while 26.5% of children and adolescents were managed by a specialised practice nurse within general practice. Of the 381 children and adolescents, 10.5% received psychiatric medication during the first year, with the trend being for increased prescriptions during adolescence. Conclusion In general practice children and adolescents frequently received one of two ICPC codes for anxiety, especially adolescent females. Most presenting to their GP with anxiety problems are referred externally or seen by a specialised practice nurse within general practice