Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: The International Study of Asthma and Allergies in Childhood (ISAAC)

David Strachan, Bonnie Sibbald, Stephan Weiland, Nadia Aït-Khaled, Gabriel Anabwani, H. Ross Anderson, M. Innes Asher, Richard Beasley, Bengt Björkstén, Michael Burr, Tadd Clayton, Julian Crane, Philippa Ellwood, Ulrich Keil, Christopher Lai, Javier Mallol, Fernando Martinez, Edwin Mitchell, Stephen Montefort, Neil PearceColin Robertson, Jayant Shah, Alistair Stewart, Erika Von Mutius, Hywel Williams

Research output: Contribution to journalArticlepeer-review

577 Scopus citations


Background: As part of the International Study of Asthma and Allergies in Childhood (ISAAC), prevalence surveys were conducted among representative samples of school children from locations in Europe, Asia, Africa, Australasia, North and South America. Subjects: 257,800 children aged 6-7 years from 91 centres in 38 countries, and 463,801 children aged 13-14 years from 155 centres in 56 countries. Methods: Written symptom questionnaires were translated from English into the local language for self-completion by the 13-14-year-olds and completion by the parents of the 6-7-year-olds. Rhinitis was described as a problem with sneezing, or a runny, or blocked nose when you (your child) DID NOT have a cold or the 'flu. Additional questions were asked about rhinitis associated with itchy-watery eyes, interference with activities and a history of hay fever ever. Results: The prevalence of rhinitis with itchy-watery eyes ('rhinoconjunctivitis') in the past year varied across centres from 0.8% to 14.9% in the 6-7-year-olds and from 1.4% to 39.7% in the 13-14-year-olds. Within each age group, the global pattern was broadly consistent across each of the symptom categories. In centres of higher prevalence there was great variability in the proportion of rhinoconjunctivitis labelled as hay fever. The lowest prevalences of rhinoconjunctivitis were found in parts of eastern Europe, south and central Asia. High prevalences were reported from centres in several regions. Conclusion: These results suggest substantial worldwide variations in the prevalence and labelling of symptoms of allergic rhinoconjunctivitis which require further study. These differences, if real, may offer important clues to environmental influences on allergy.

Original languageEnglish (US)
Pages (from-to)161-168
Number of pages8
JournalPediatric Allergy and Immunology
Issue number4
StatePublished - Nov 1997


  • Allergic rhinitis
  • Conjunctivitis
  • Epidemiology
  • Global
  • Hay fever
  • Rhinitis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Immunology


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