Search

Background The study focused on the question of whether and – if so – to what direction and extent immunisations in the 1st year may be associated with the risk of being diagnosed with atopic diseases after the 1st year of life. Methods Data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, 2003–2006) were analysed. For analyses of potential associations between vaccination status and risk of hay fever, atopic dermatitis or asthma, sample sizes of 15254, 14297, and 15262, respectively, were available. Results Children with a sufficient TDPHiHeP vaccination at the end of the 1st year of life had a lower risk of being diagnosed with hay fever after the 1st year of life (adjusted prevalence ratio 0.85, 95% confidence interval 0.76–0.96). Analyses for associations between TDPHiHeP vaccination and risk of atopic dermatitis or asthma, or between age at onset of vaccination or of the number of antigens vaccinated in the 1st year of life and risk of atopic disease failed to yield statistical significance. Conclusions Our results provide no evidence that immunisations in the 1st year of life may increase the risk of atopic disease. If any association exists at all, our results may be interpreted as weakly supportive of the hypothesis that immunisations may slightly decrease the risk of atopy in later life.

Zusammenfassung: Kinder und Jugendliche mit beidseitigem Migrationshintergrund/MH weisen signifikant häufiger ungünstige Ernährungsmuster auf als jene ohne bzw. mit einseitigem MH, so die Ergebnisse einer Ernährungsmusteranalyse anhand von KiGGS-Daten. Der Sozialstatus erklärt nur einen Teil dieses Zusammenhangs. Die ungesünderen Ernährungsweisen nehmen mit der Verweildauer der zugewanderten Familien zu. Weiterhin beeinflussen Herkunftsland, Alter und Geschlecht (un-)günstigere Ernährungsmuster.

Die erste Folgebefragung der Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland (KiGGS Welle 1), die von 2009 bis 2012 als kombinierte Quer- und Langsschnitterhebung durchgefuhrt wurde, liefert u. a. aktuelle Daten zu allergischen Erkrankungen. Die Datenerhebung erfolgte mittels Telefoninterviews. Insgesamt nahmen 6093 Madchen und 6275 Jungen bzw. deren Eltern teil, darunter 4455 Ersteingeladene (0 bis 6 Jahre; Response 38,8 %) und 7913 Wiedereingeladene (7 bis 17 Jahre; Response 72,9 %). Laut Elternangaben war aktuell knapp ein Sechstel der Kinder und Jugendlichen von mindestens einer atopischen Erkrankung betroffen (15,6 %, 95 %-Konfidenzintervall 14,7–16,5). Die 12-Monats-Pravalenzen von Heuschnupfen, Neurodermitis und Asthma bronchiale betrugen 9,1 % (8,4–9,8), 6,0 % (5,4–6,6) bzw. 4,1 % (3,6–4,6). 2,2 % (1,9–2,6) der Kinder und Jugendlichen litten aktuell an einem allergischen Kontaktekzem. Im Vergleich zur KiGGS-Basiserhebung von 2003 bis 2006 hat in KiGGS Welle 1 ein hoherer Anteil von Eltern die Frage nach dem Auftreten von Asthma bronchiale in den letzten 12 Monaten bei ihren Kindern und Jugendlichen bejaht (4,1 vs. 3,2 %; p = 0,0034). Der Gesamtanstieg ist auf gestiegene Pravalenzen bei 0- bis 6-Jahrigen und hier vor allem bei Madchen zuruckzufuhren. Fur Heuschnupfen fallen hohere 12-Monats-Pravalenzen ebenfalls in den beiden unteren Altersgruppen und auch hier vor allem bei Madchen auf. Der Gesamtanstieg ist aber nicht statistisch signifikant (9,1 vs. 8,3 %; p = 0,08). Fur Neurodermitis war insgesamt ein rucklaufiger Trend in der aktuellen Betroffenheit zu beobachten [6,8 % (2003–2006) vs. 5,4 % (2009–2012); p = 0,0015].

Zusammenfassung In der Epidemiologie dienen Kriterien wie Prävalenz, Krankheitsschwere, Risikopotenzial für Folgekrankheiten im Erwachsenenalter und Chronifizierung, aber auch der individuelle und familiäre Leidensdruck der thematischen Schwerpunktsetzung in der Kinder- und Jugendgesundheitsforschung. Übergewicht und Adipositas, psychische Störungen, allergische Erkrankungen und Unfälle haben eine hohe Prävalenz im Kindes- und Jugendalter, bergen das Risiko für Folgekrankheiten und Chronifizierung (z.B. Übergewicht, Adipositas und Allergien), schränken die ungestörte Entwicklung der Kinder ein und belasten betroffene Familien (z.B. psychische Störungen, Allergien, Unfälle) und zählen deshalb in diesem Kontext zu den bedeutsamsten Themen. Nachfolgend wird ein kurzer Überblick hierzu gegeben (ausführlicher siehe Schwerpunkthefte zur KiGGS-Studie im Bundesgesundheitsblatt Heft 5/6 (2007) bzw. Heft 7 (2014)).

Aufgrund der Zunahme von Allergien in Deutschland sind aktuelle Daten zur Pravalenz allergischer Sensibilisierungen von grosem Interesse. Im Rahmen der „Studie zur Gesundheit Erwachsener in Deutschland (DEGS1)“ (2008–2011) wurden an einer bevolkerungsbezogenen Stichprobe von 7025 18- bis 79-Jahrigen Blutproben auf spezifische IgE-Antikorper gegen 50 verbreitete Einzelallergene untersucht sowie 2 Tests mit jeweils einer Mischung aus Inhalationsallergenen (SX1) und Graserpollen (GX1) durchgefuhrt. 48,6% der Teilnehmer wiesen mindestens eine Sensibilisierung auf. Mehr Manner als Frauen waren gegen mindestens ein Allergen sensibilisiert. Zudem waren mehr jungere als altere Teilnehmer und mehr Personen mit hoherem Sozialstatus von mindestens einer Sensibilisierung betroffen. Gegen Inhalationsallergene waren 33,6% der Teilnehmer sensibilisiert, gegen Nahrungsmittelallergene 25,5% und gegen Insektengifte 22,5%. Im Vergleich zum Bundes-Gesundheitssurvey 1998 (BGS98) hat die Pravalenz einer Sensibilisierung gegen Inhalationsallergene von 29,8% auf 33,6% zugenommen. Dieser Trend war nur bei Frauen signifikant. Die Ergebnisse des DEGS1 zeigen eine nach wie vor hohe Pravalenz allergischer Sensibilisierungen.

In industrialized countries atopic diseases have been reported to be less likely in children and adolescents with a migrant background compared to non-migrants. This paper aimed at both examining and comparing prevalence of asthma, allergic rhinoconjunctivitis and atopic dermatitis and allergic sensitization to specific IgE antibodies in children and adolescents with and without a migrant background. Using data of the population-based German Health Interview and Examination Survey for children and adolescents (KiGGS; n = 17,450; 0–17 years), lifetime and 12-month prevalence of atopic diseases and point prevalence of 20 common allergic sensitizations were investigated among migrants compared to non-migrants. Multiple regression models were used to estimate the association of atopic disease and allergic sensitization with migrant background. In multivariate analyses with substantial adjustment we found atopic dermatitis about one-third less often (OR 0.73, 0.57–0.93) in participants with a two-sided migrant background. Statistically significant associations between allergic sensitizations and a two-sided migrant background remained for birch (OR 0.73, 0.58–0.90), soybean (OR 0.72, 0.54–0.96), peanut (OR 0.69, 0.53–0.90), rice (OR 0.64, 0.48–0.87), potato (OR 0.64, 0.48–0.85), and horse dander (OR 0.58, 0.40–0.85). Environmental factors and living conditions might be responsible for the observed differences.

To cite this artcle: Schmitz R, Atzpodien K, Schlaud M. Prevalence and risk factors of atopic diseases in German children and adolescents – findings from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Pediatr Allergy Immunol 2012: 23: 716–723. Abstract Background: Atopic diseases became an important health problem in affluent Western societies. Methods: To study the prevalence and factors associated with the risk of atopic diseases in Germany, data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) were analysed (n = 17,450). Standardized, computer-assisted personal interviews with parents and parent-administered questionnaires provided physician diagnoses of allergic rhinoconjunctivitis, atopic dermatitis and asthma as well as data on demographic characteristics, migration background, birth order, age at the beginning of nursery, atopic diseases of parents, parents’ smoking status, parents’ occupation, breastfeeding and living environment. Results: The life-time prevalence of atopic dermatitis was 13.2% (95% confidence limit: 12.5–13.9%), 10.7% (10.1–11.3%) for allergic rhinoconjunctivitis and 4.7% (4.3–5.1%) for asthma. At least one atopic disease in parents was the strongest factor associated with atopic diseases in the offspring, with a prevalence ratio of up to 2.6. High and middle socio-economic status (prevalence ratio, 95% confidence limit: 1.28, 1.12–1.46; 1.15, 1.01–1.32) were associated with the risk of atopic dermatitis, whereas a two-sided background of migration reduced the risk (0.76, 0.65–0.88). Factors that reduced the risk of allergic rhinoconjunctivitis were parents working as self-employed farmers (0.48, 0.30–0.76) and older siblings (0.80, 0.71–0.89), whereas the beginning of nursery school at older age was associated with an increased risk in children who were cared for outside the family before school age (1.05, 1.00–1.10). Living in mould-infested rooms (1.64, 1.23–2.19), an urban living environment (1.20, 1.02–1.42) and a smoking mother and/or father (1.20, 1.02–1.40) were associated with the risk of asthma. Conclusions: Our results are in line with the so-called ‘hygiene hypothesis’, which emphasizes the role of environmental factors in addition to a genetic predisposition in the development of atopic diseases. Research on factors associated with atopic diseases can facilitate decisions on preventive strategies. Further studies are needed to explore trends in prevalence and risk factors for atopic diseases.

Background: Behavioural prevention and counselling programmes for lifestyle-related cardiovascular risk factors are widely offered. However, their population-wide use is largely unexplored, particularly in high-risk persons with known CVD or diabetes. Methods: Data were collected within GEDA 2009, a national health survey covering a representative sample of 21,262 adults in Germany. Standardised structured computer-assisted telephone interviews included self-reported physician-diagnosed coronary heart disease, myocardial infarction, heart failure, stroke, diabetes as well as height, weight, usual diet, physical activity, and the use of programmes for weight reduction, healthy diet and improvement of fitness or mobility in the last twelve months. Results: The use of prevention measures was lowest for weight reduction (men 2.1%, women 3.5%), somewhat higher for healthy diet (men 3.2%, women 4.7%), and highest for improvement of fitness or mobility (men 8.6%, women 16.1%). Among individuals with the respective risk factor, programme participation was still low: 5.5% in obese men (women 7.2%) for weight reduction, 2.8% in men (women 3.7%) who did not eat fruit or vegetables daily for healthy diet, and 7.9% in physically inactive men (women 15.7%) for improvement of fitness or mobility. In the presence of known CVD or diabetes, participation increased inconsistently and only moderately. Conclusion: Our results show low participation in behavioural prevention measures for lifestyle-related risk factors even in individuals with known CVD or diabetes. Further studies should investigate knowledge about potential programme benefit, availability and reimbursement in both patients and health care providers.

Die Studiendesigns und Instrumente zur Uberwachung der Impfstoffsicherheit haben alle Starken und Schwachen, sodass zu diesem Zweck Daten aus mehreren Quellen genutzt werden sollten. Grundlage fur entsprechende Datensammlungen sind unter anderem Selbstangaben von Patienten uber mogliche Nebenwirkungen. Bisher ist aber wenig uber die Faktoren bekannt, die beeinflussen, ob Personen Impfnebenwirkungen angeben beziehungsweise berichten. Von 2003 bis 2006 wurden im reprasentativen Kinder- und Jugendgesundheitssurvey (KiGGS) von insgesamt 17.641 Probanden im Alter bis zu 17 Jahren Daten zu soziodemografischen Merkmalen, verabreichten Impfstoffen, zum Impfzeitpunkt und zu schlecht vertragenen Impfungen erhoben und Pradiktoren fur elternberichtete Impfnebenwirkungen durch uni- und multivariate Analysen ermittelt. Leben in den alten Bundeslandern (OR 1,61; 95%-KI 1,08–2,39), ein positiver CSHCN (Cildren with Special Health Care Needs)-Screener (OR 1,49; 95%-KI 1,08–2,04) und eine kritische elterliche Impfeinstellung (OR 3,29; 95%-KI 2,28–4,75) waren unabhangig voneinander mit einer hoheren Wahrscheinlichkeit verbunden, dass Eltern Impfnebenwirkungen in der Befragung berichteten. Die Ergebnisse deuten darauf hin, dass die elterliche Wahrnehmung und Bewertung von Impfnebenwirkungen sowie ihre allgemeine Einstellung zu Impfungen die Angaben zu moglichen Nebenwirkungen beeinflussen konnte.

Each method to monitor vaccine safety has strengths and limitations. Therefore, vaccine safety monitoring should rely on different types of data sources. Methods commonly rely on patient-reported adverse reactions. Little is, however, known about factors that may affect the probability with which patients report adverse reactions to vaccines. From 2003-2006, the representative National Health Interview and Examination Survey for Children and Adolescents ("Kinder- und Jugendgesundheitssurvey", KiGGS) retrospectively collected information about vaccines, vaccination dates, and suspected vaccine related adverse reactions from a total of 17,641 participants (

Celiac disease is an immune-mediated systemic disorder triggered by gluten-containing grains in genetically predisposed individuals (1– 3). Its defining characteristics are enteropathy and evidence of celiac disease–specific autoantibodies to tissue transglutaminase (3). Celiac disease is usually lifelong but with a gluten-free diet it is very treatable: the mucosa of the small intestine return to their normal condition and subsequent tests for celiac disease–specific autoantibodies are negative. Celiac disease can develop at any age. Symptoms range from the classic signs of malabsorption syndrome—diarrhea, weight loss, growth failure, osteoporosis, and anemia—to nonspecific symptoms such as chronic constipation or abdominal pain (1, 2). Screening examinations in children have revealed that 50 to 70% of those affected are asymptomatic (4, 5). Celiac disease cannot develop without a genetic predisposition to HLA markers DQ2 or DQ8. Approximately one-third of the Caucasian population is DQ2-positive or DQ8-positive. If celiac disease is suspected, the first step should be to determine serum levels of IgA autoantibodies to tissue transglutaminase IgA (tTG-IgA) or to endomysium (EmA-IgA), in addition to determining total IgA to rule out IgA deficiency (2, 3). The highly sensitive and specific autoantibody tests identify patients with celiac disease and make it possible to document its prevalence and incidence, regardless of whether patients suffer any clinical complaints. The frequency of classic celiac disease with malabsorption is approximately 1 in 1000 children (6, 7). The prevalence of celiac disease that has been established using antibody screening in various European countries and North America is estimated at approximately 1% (8, 9). Incidence seems to have increased in recent decades (10). There are no current figures on the prevalence of celiac disease in children in Germany. A cross-sectional study conducted 20 years ago, involving 3004 children, found celiac disease confirmed by biopsy in one in 500 (0.2%) of the children (6). In the southern German KORA/MONICA population cohort, 63 of 4633 (1.4%) and 18 of 4173 (0.43%) of adults respectively were found to have tTG-IgA levels above the cut-off value in two cross-sectional studies (9, 11). When compared to seronegative individuals of the same ages, there was an approximately twofold increase in the risk of dying within nine years for seropositive men (217/2289 versus 11/44) and an approximately fourfold increase in risk for seropositive women (91/2281 versus 4/19) (11). Even when clinical symptoms are absent, celiac disease that remains untreated in the long term entails numerous health risks including lymphoproliferative diseases (12– 19). In children identified via screening there is increasing evidence that growth and bone quality can be adversely affected (15, 19). Because the complaints of celiac disease are so nonspecific, it often takes years before symptomatic patients are diagnosed (20). By then, symptoms and organic complications of celiac disease that has remained untreated for many years, such as pancreatic failure or atrophy of the spleen, are often no longer reversible (20– 22). We used retained samples from KiGGS study participants. The KiGGS study was a study conducted by the Robert Koch Institute in Berlin as part of German nationwide health monitoring of child and adolescent health. The retained samples were used to establish the prevalence of celiac disease–specific autoantibodies in children and adolescents in Germany and to compare the anthropometric and various laboratory parameters of seropositive and seronegative individuals.

Background: To assess the prevalence of allergic sensitization and to analyze patterns of sensitization to common inhalant and food allergens in a nationwide representative sample of children and adolescents in Germany. Methods: Data were collected from 2003 to 2006 within the KiGGS, the national Health Interview and Examination Survey covering a representative sample of 17,641 children and adolescents in Germany. Immunoglobulin E (IgE) antibodies to 20 specific allergens (11 inhalant and 9 food allergens) were quantitatively measured in a subsample of 12,988 KiGGS participants aged 3-17 years using the ImmunoCAP system. Serum concentrations ≥0.35 kU/l indicate sensitized participants. An exploratory factor analysis was performed in order to identify sensitization patterns. Results: Sensitization to at least 1 of the 20 tested allergens was detected in 40.2% [95% confidence interval (CI) 39.0-41.4] of the participants. The highest sensitization prevalences were found for pollen from Timothy grass (22.7%; 21.5-23.9) and rye (21.2%; 20.0-22.4). Sensitization was more prevalent in boys than in girls and prevalence increased generally with increasing age. We identified seven sensitization groups, namely (in descending order of magnitude) ‘Timothy grass/rye', ‘house-dust mites', ‘food/mugwort', ‘birch/apple', ‘animals', ‘cow's milk/egg white' and ‘moulds'. Conclusions: Allergic sensitization is common in German children and adolescents. The fact that sensitization potentially leads to clinically relevant allergic diseases stresses the public health relevance of this topic. Whether the grouping reflects the propensity for persons to be sensitized to multiple allergens within a group, or whether it is due to IgE cross-reactivity between different allergens of similar structure is still being discussed.

Background Whether unvaccinated children and adolescents differ from those vaccinated in terms of health is subject to some discussion.