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Decreasing prevalence of atopic dermatitis in Swedish schoolchildren: three repeated population-based surveys
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.ORCID iD: 0000-0002-9976-5702
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.ORCID iD: 0000-0001-7222-6402
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.ORCID iD: 0000-0002-2358-8754
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2024 (English)In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 190, no 2, p. 191-198Article in journal (Refereed) Published
Abstract [en]

Background: The prevalence of atopic dermatitis (AD) has increased over several decades and now affects about one-fifth of all children in high-income countries (HICs). While the increase continues in lower-income countries, the prevalence of AD might have reached a plateau in HICs.

Objectives: To investigate trends in the prevalence of AD and atopic comorbidity in schoolchildren in Sweden.

Methods: The study population consisted of three cohorts of children (median age 8 years) in Norrbotten, Sweden, for 1996 (n = 3430), 2006 (n = 2585) and 2017 (n = 2785). An identical questionnaire that included questions from the International Study of Asthma and Allergies in Childhood (ISAAC) protocol was used in all three cohorts. Trends in AD prevalence were estimated, as well as trends in atopic comorbidity. AD prevalence was estimated both according to the ISAAC definition of AD and by adding the reported diagnosis by a physician (D-AD).

Results: The prevalence of AD decreased in the last decade, from 22.8% (1996) and 21.3% (2006) to 16.3% (2017; P < 0.001). The prevalence of D-AD was lower, but the same pattern of decrease was seen, from 9.3% (1996) and 9.4% (2006) to 5.7% (2017; P < 0.001). In all three cohorts, AD was more common among girls than boys (18.9% vs. 13.8% in 2017; P < 0.001). Children from the mountain inlands had a higher prevalence of AD than children from coastal cities (22.0% vs. 15.1% in 2017; P < 0.001). In comparing D-AD, there were no significant differences between the sexes or between inland or coastal living. Concomitant asthma increased over the years from 12.2% (1996) to 15.8% (2006) to 23.0% (2017; P < 0.001). Concomitant allergic rhinitis and allergic sensitization increased from 1996 (15.0% and 27.5%) to 2006 (24.7% and 49.5%) but then levelled off until 2017 (21.0% and 46.7%).

Conclusions: The prevalence of AD among schoolchildren in Sweden decreased over the study period, whereas atopic comorbidity among children with AD increased. Although a decrease was seen, AD is still common and the increase in atopic comorbidity among children with AD, especially the increase in asthma, is concerning.

Place, publisher, year, edition, pages
Oxford University Press, 2024. Vol. 190, no 2, p. 191-198
National Category
Dermatology and Venereal Diseases Respiratory Medicine and Allergy Pediatrics
Identifiers
URN: urn:nbn:se:umu:diva-220461DOI: 10.1093/bjd/ljad370ISI: 001109170600001PubMedID: 37776301Scopus ID: 2-s2.0-85183507098OAI: oai:DiVA.org:umu-220461DiVA, id: diva2:1836601
Funder
Swedish Heart Lung FoundationSwedish Asthma and Allergy AssociationSwedish Research CouncilVårdal FoundationNorrbotten County CouncilVisare NorrRegion VästerbottenAvailable from: 2024-02-09 Created: 2024-02-09 Last updated: 2024-04-05Bibliographically approved

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af Klinteberg, MajaWinberg, AnnaAndersson, MartinRönmark, EvaHedman, Linnea

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