ISAAC Story - The International Study of Asthma and Allergies in

420 Pages·2011·4.95 MB·English

The ISAAC Story
The International Study of Asthma and Allergies in Childhood
The ISAAC Story
ISBN: 978-0-473-20211-8
© November 2011
The International Study of Asthma and Allergies in Childhood Steering Committee
Department of Paediatrics: Child and Youth Health
The University of Auckland
Private Bag 92019
Auckland Mail Centre
Auckland 1142
New Zealand
http://isaac.auckland.ac.nz/story/

Suggested citation: Asher MI, Strachan DP, Pearce N, García-Marcos L (Eds). The ISAAC Story: The International Study of Asthma and
Allergies in Childhood. Auckland, New Zealand: The International Study of Asthma and Allergies in Childhood 2011.
The ISAAC Story
The International Study of Asthma and Allergies in Childhood

M. Innes Asher, David P. Strachan, Neil Pearce & Luis García-Marcos, Eds.
The International Study of Asthma and Allergies in Childhood
The ISAAC Story
Acknowledgements
Funding
Funding of ISAAC Phase One Organisations
ISAAC was open to any collaborator who agreed to adhere to the protocol. Countries in which
there was little existing information about asthma, rhinoconjunctivitis and eczema were
particularly encouraged to participate. Each centre was responsible for obtaining its own
funding. There were many field workers and funding agencies who supported data collection
and national, regional and international meetings, including the meetings of the ISAAC
Steering Committee. Unfortunately, these are too numerous to mention and are acknowledged
elsewhere in local publications.
The ISAAC International Data Centre was funded by:
The Health Research Council of New Zealand,
The Asthma and Respiratory Foundation of New Zealand,
The National Child Health Research Foundation,
The Hawke's Bay Medical Research Foundation,
The Waikato Medical Research Foundation,
Glaxo Wellcome New Zealand
Astra New Zealand.
Glaxo Wellcome International Medical Affairs funded the regional co-ordinating centres.
Funding of ISAAC Phase Two
The coordination and central laboratory analyses of the European centres were funded by the
Fifth Framework Programme of European Commission (QLK4-CT-1999-01288).
The following bodies funded the local studies.
Spain: (Almeria, Cartagena, Madrid, Valencia)
Fondo de Investigacion Sanitaria (grant code 00/1092E).
Turkey: (Ankara)
Scientific and Technical Research Council of Turkey (grant code SPAG-2237),
Treatment and Research Foundation of Turkey for Allergy, Asthma and Immunology,
The Research foundation of Hacettepe University, Faculty of Medicine.
Greece: (Athens, Thessaloniki)
The Thorax Foundation Research Center.
France: (Créteil)
French Institute of Health and Medical Research (Institut National de la Santé et de la
Recherche Médicale (INSERM), grant code IDS 337/4D001D and 737/69480),
Ministère de l'Emploi et de la Solidarité (grant code 227/7HL02D),
Mutuelle Générale de l'Education Nationale (grant code 257/8PL01F),
Agence de l’Environnement et de la Maitrise de l’Energie ADEME/PRIMEQUAL 96 (grant
code FJ012B).
Germany: (Dresden, Munich, Ulm)
German Ministry of Education and Research (grant code 01 EE 9411-3; Dresden, Munich),
Rudolf and Clothilde Eberhardt-Foundation (Ulm).
Italy: (Rome)
Lazio Regional Health Authority.
New Zealand: (Hastings)
Health Research Council of New Zealand,
Asthma and Respiratory Foundation of New Zealand,
Hawkes Bay Medical Research Foundation.
Sweden: (Linköping, Östersund)
The Swedish Foundation for Health Care Sciences and Allergy Research.
India: (Mumbai)
Jaslok Hospital & Research Centre.
West Bank: (Ramallah)
Al-Quds University, Directorate General for International Cooperation and Belgian
Technical Cooperation.
The Netherlands: (Utrecht)
Dutch Ministries of the Environment, of Health and of Transport.
UK: (West Sussex)
South Thames National Health Service Regional and Development project SPGS.
The centres in Mumbai, Ankara, Kintampo (Ghana), Riga (Latvia), Tallinn (Estonia), Tblisi
(Georgia) and Tirana (Albania) were supported, at least in part, by European members of the
ISAAC Steering Committee.
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The International Study of Asthma and Allergies in Childhood
The ISAAC Story
Funding of ISAAC Phase Three
As with ISAAC Phase One, ISAAC Phase Three was open to any collaborator who agreed to
adhere to the protocol and each centre was requested to provide it's own funding .The
programme was funded by the many funding bodies throughout the world that supported the
individual ISAAC centres and collaborators and their meetings. In New Zealand ISAAC was
funded by:
The Health Research Council of New Zealand,
The Asthma and Respiratory Foundation of New Zealand,
The Child Health Research Foundation,
The Hawke’s Bay Medical Research Foundation,
The Waikato Medical Research Foundation,
Glaxo Wellcome New Zealand,
The NZ Lottery Board
Astra Zeneca New Zealand.
Travel grants were awarded by the Auckland Medical Research Foundation and the Maurice &
Phyllis Paykel Trust.
Glaxo Wellcome International Medical Affairs supported the regional coordination and the
ISAAC International Data Centre.
The ISAAC International Data Centre is currently funded grants from the BUPA Foundation,
The Auckland Medical Research Foundation and The New Zealand Lotteries Commission.
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The International Study of Asthma and Allergies in Childhood
The ISAAC Story
Contents
Acknowledgements 3
Contents 5
Editors Introduction - David Strachan and Innes Asher 10
Contributors 11
Tribute to Stephan Weiland 22
Background
Rationale for ISAAC 23
Aims of ISAAC 24
Origins of ISAAC 25
Asthma epidemiology in the 1980s Michael Burr 25
The origins of ISAAC: a German perspective Ulrich Keil 26
The origins of ISAAC: a New Zealand perspective Innes Asher 27
The origins of ISAAC: a United Kingdom perspective Ross Anderson 28
The origins of Phase Two surveys in Germany Erika von Mutius 29
The ISAAC Toolbox 30
The written questionnaire for asthma and wheezing David Strachan 31
The video questionnaire for asthma and wheezing Julian Crane 31
Asthma alone, or asthma and allergies? David Strachan 32
Development of the rhinitis questionnaire David Strachan and Bonnie Sibbald 32
Development of the eczema questionnaireDavid Strachan and Hywel Williams 33
Bronchial responsiveness (link to report?)Innes Asher 34
Measuring eczema by questionnaire and examinationHywel Williams 34
Development of Phase Two modules David Strachan 35
The Phase Three risk factor questionnaire Ed Mitchell 35
Development of ISAAC 35
The globalization of ISAACNeil Pearce 36
The recruitment of Phase One regional co-ordinators David Strachan 36
The globalization of ISAAC Phase Two David Strachan 37
ISAAC in the context of other European initiatives Bert Brunekreef 37
ISAAC in the 21st century Carsten Flohr, Gary Wong 38
The global context of ISAAC in the 21st century 38
ISAAC Data Centres 39
The Auckland Data Centre Tadd Clayton 39
The Ulm Data Centre Gudrun Weinmayr 40
Communications within ISAACPhilippa Ellwood 40
ISAAC Diary (Time Line) 41
ISAAC Steering Committee Time Line 45
Methods
Study Design 46
Phase One 46
Phase Two 47
Phase Three 47
Quality Assurance Philippa Ellwood 48
Consent and Confidentiality Philippa Ellwood 49
Data ManagementTadd Clayton 50
Statistical Analyses David Strachan, Alistair Stewart and Tadd Clayton 51
Statistical methods used in ISAAC: Phase One 51
Statistical methods used in ISAAC: Phase Two 51
Statistical methods used in ISAAC: Phase Three prevalence maps and time trend analyses 52
Statistical methods used in ISAAC: Phase Three risk factor analyses 52
Statistical methods used in ISAAC: Centre-level differences adjusted for individual-level risk factors 53
Statistical methods used in ISAAC: Ecological analyses at the centre level 53
Graphs and Maps Tadd Clayton 54
Findings
Introduction 55
Overview of Global Findings 55
Worldwide Publications 59
Phase One Prevalence 63
Phase One Ecological 64
Phase Two 65
Phase Three Time Trends 67
Phase Three World Maps 68
Phase Three Risk Factors 69
Methodological Studies 70
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The International Study of Asthma and Allergies in Childhood
The ISAAC Story
Centres
Regions 72-88
Countries Cont.
Africa
Asia-Pacific Nicaragua
Eastern Mediterranean Nigeria
Indian Sub-Continent Niue
Latin America Norway
North America Nouvelle Caledonie
Northern and Eastern Europe Pakistan
Oceania Palestine
Western Europe Panamá
Paraguay
Countries 89-164 Peru
Philippines
Albania
Poland
Algeria
French Polynesia
Argentina
Portugal
Australia
Republic of Ireland
Austria
Republic of Macedonia
Barbados
République de Guinée
Belgium
Republique Democratique du Congo
Bolivia
Reunion Island
Brasil
Romania
Bulgaria
Russia
Cameroon
Samoa
Canada
SAR China
Channel Islands
Serbia and Montenegro
Chile
Singapore
China
South Africa
Colombia
South Korea
Congo
Spain
Cook Islands
Sri Lanka
Costa Rica
Sudan
Cote d'Ivoire
Sultanate Of Oman
Croatia
Sweden
Cuba
Syria
Ecuador
Taiwan
Egypt
Thailand
El Salvador
Togo
Estonia
Tokelau
Ethiopia
Tonga
Fiji
Trinidad and Tobago
Finland
Tunisia
France
Turkey
Gabon
Ukraine
Georgia
United Kingdom
Germany
Uruguay
Ghana
USA
Greece
Uzbekistan
Honduras
Venezuela
Hungary
Vietnam
Iceland
India Centres 165-352
Indonesia
Iran A Coruña, Spain
Isle of Man Addis Ababa, Ethiopia
Italy Adelaide, Australia
Japan Akola, India
Jordan Aleppo, Syria
Kenya Algiers, Algeria
Kuwait Al-Khod, Sultanate Of Oman
Kyrgyzstan Almeria, Spain
Latvia Alor Setar, Malaysia
Lebanon Amman, Jordon
Lithuania Anglia and Oxford, United Kingdom
Malaysia Ankara, Turkey
Malta Antwerp, Belgium
Mexico Apia, Samoa
Morocco Aracaju, Brasil
Netherlands Ascoli Piceno, Italy
New Zealand Asturias, Spain 6
The International Study of Asthma and Allergies in Childhood
The ISAAC Story
Centres Cont.
David-Panamá, Panamá
Asunción, Paraguay
Dresden, Germany
Athens, Greece
Eldoret, Kenya
Auckland, New Zealand
Emilia-Romagna, Italy
Bali, Indonesia
Empoli, Italy
Balykchi, Kyrgyzstan
Feira de Santana, Brasil
Bandung, Indonesia
Firenze, Italy
Bangalore, India
Frosinone, Italy
Bangkok, Thailand
Fukuoka, Japan
Barbados, Barbados
Funchal, Portugal
Barcelona, Spain
Grand Tunis, Tunisia
Bari, Italy
Greifswald, Germany
Barranquilla, Colombia
Guangzhou, China
Bay of Plenty, New Zealand
Guayaquil, Ecuador
Beijing, China
Guernsey, Channel Islands
Beirut, Lebanon
Hamilton, Canada
Belgrade, Serbia And Montenegro
Hawkes Bay, New Zealand
Belo Horizonte, Brasil
Helsinki, Finland
Benslimane, Morocco
Ho Chi Minh City, Vietnam
Bikaner, India
Hong Kong 13-14, Sar China
Bilbao, Spain
Hong Kong 6-7, Sar China
Birjand, Iran
Ibadan, Nigeria
Bishkek, Kyrgyzstan
Ipoh, Malaysia
Bogotá, Colombia
Islamabad, Pakistan
Bombay (17), India
Isle of Man, Isle Of Man
Bombay (16), India
Itajaí, Brasil
Bombay (18), India
Jaipur, India
Bombay (29), India
Jalalabat, Kyrgyzstan
Borivali, India
Jersey, Channel Islands
Boulmene, Morocco
Jima, Ethiopia
Brasília, Brasil
Jodhpur, India
Brazzaville, Congo
Karachi, Pakistan
Buenos Aires, Argentina
Kärnten, Austria
Cádiz, Spain
Kaunas, Lithuania
Cairo, Egypt
Kharkiv, Ukraine
Calama, Chile
Khartoum, Sudan
Cali, Colombia
Khon Kaen, Thailand
Cape Town, South Africa
Kinshasa, Republique Democratique Du
Caracas, Venezuela
Congo
Cartagena, Spain
Kintampo , Ghana
Caruaru, Brasil
Klang Valley, Malaysia
Casablanca, Morocco
Kota Bharu, Malaysia
Castellón, Spain
Kottayam, India
Central Santiago, Chile
Krakow (1993), Poland
Chandigarh, India
Kraków (1995), Poland
Chantaburi, Thailand
Kuopio County, Finland
Chapel Hill, Usa
Kutaisi, Georgia
Chennai (3), India
Kuwait, Kuwait
Chiang Mai, Thailand
La Habana, Cuba
Chiangrai, Thailand
Lappland Area, Finland
Chicago (3), Usa
Lattakia, Syria
Chicago (4), Usa
Lima, Peru
Chiloe, Chile
Linköping, Sweden
Chongqing, China
Lisbon, Portugal
Christchurch, New Zealand
Lome, Togo
Ciudad de México (1), Mexico
Lucknow, India
Ciudad de México (3), Mexico
Ludhiana, India
Ciudad de México (4), Mexico
Maceió, Brasil
Ciudad Victoria, Mexico
Madras (2), India
Cluj, Romania
Madras (3), India
Coimbra, Portugal
Madrid, Spain
Colleferro-Tivoli, Italy
Malta, Malta
Conakry, République De Guinée
Managua, Nicaragua
Córdoba, Argentina
Manaus Amazonas, Brasil
Cosenza, Italy
Mantova, Italy
Costa Rica, Costa Rica
Marrakech, Morocco
Cremona, Italy
Marseille, France
Crétail, France
Melbourne, Australia
Cuernavaca, Mexico
Mérida, Mexico
Curitiba, Brasil
7 Davangere, India Metro Manilla, Philippines
The International Study of Asthma and Allergies in Childhood
The ISAAC Story
Centres cont.
Rural Kharkiv, Ukraine
Mexicali Valley, Mexico
Rural Latvia, Latvia
Milano, Italy
Rural Santa Maria, Brasil
Monterrey, Mexico
Salta, Argentina
Montevideo, Uruguay
Salvador, Brasil
Montpellier, France
Salzburg, Austria
Moscow, Russia
Samarkand, Uzbekistan
Muar, Malaysia
San Pedro Sula, Honduras
Mumbai (16), India
San Salvador, El Salvador
Mumbai (18), India
San Sebastián, Spain
Mumbai (29), India
Santa Cruz, Bolivia
Munich, Germany
Santa Maria, Brasil
Münster, Germany
Santo Andre, Brasil
Nagpur, India
São Paulo, Brasil
Nairobi, Kenya
São Paulo West, Brasil
Nakorn Pathom, Thailand
Sarasota, Usa
Narva, Estonia
Saskatoon, Canada
Nelson, New Zealand
Scotland, United Kingdom
Netherlands, Netherlands
Seattle, Usa
Netherlands (Utrecht), Netherlands
Semarang, Indonesia
Neuquén, Argentina
Seoul, South Korea
New Delhi (7), India
Shanghai, China
Neyveli, India
Siauliai, Lithuania
Nis, Serbia And Montenegro
Siena, Italy
Niue Island, Niue
Singapore, Singapore
North east and Yorkshire, United Kingdom
Skopje, Republic Of Macedonia
North Gaza, Palestine
Sofia, Bulgaria
North Thames, United Kingdom
Sombor, Serbia And Montenegro
North West, United Kingdom
Sousse, Tunisia
Nouvelle Caledonie, Nouvelle Caledonie
South and West, United Kingdom
Nova Iguaçu, Brasil
South Santiago, Chile
Novi Sad, Serbia And Montenegro
South Thames, United Kingdom
Novosibirsk, Russia
Sri Lanka, Sri Lanka
Nuku alofa, Tonga
St Augustine, Trinidad And Tobago
Orissa, India
Stockholm/Uppsala, Sweden
Östersund, Sweden
Strasbourg, France
Palermo, Italy
Sunderland, United Kingdom
Pamplona, Spain
Surrey/Sussex, United Kingdom
Panevezys, Lithuania
Suva, Fiji
Passo Fundo, Brasil
Svábhegy, Hungary
Paysandú, Uruguay
Sydney 13-14, Australia
Perth, Australia
Sydney 6-7, Australia
Pessac, France
Szeged, Hungary
Pichincha, Ecuador
Taipei, Taiwan
Pimpri, India
Tallinn, Estonia
Podgorica, Serbia And Montenegro
Taoyuan, Taiwan
Polokwane, South Africa
Tartous, Syria
Polynesie Francaise, French Polynesia
Tashkent, Uzbekistan
Port-Gentil, Gabon
Tbilisi, Georgia
Portimao, Portugal
Tehran, Iran
Porto, Portugal
Thessaloniki, Greece
Porto Alegre, Brasil
Tibet, China
Poznan, Poland
Tiranë, Albania
Provincial Korea, South Korea
Tobago, Trinidad And Tobago
Pune, India
Tochigi, Japan
Punta Arenas, Chile
Tokelau, Tokelau
Quito, Ecuador
Toluca, Mexico
Rabat, Morocco
Tong Zhou, China
Ramallah, Palestine
Torino, Italy
Rarotonga, Cook Islands
Trent, United Kingdom
Rasht, Iran
Trento, Italy
Rasta Peth, India
Tromsø, Norway
Recife, Brasil
Turku and Pori County, Finland
Rep. Of Ireland, Republic Of Ireland
Urban Cote d Ivoire, Cote D'Ivoire
Reunion Island, Reunion Island
Urfahr-Umgebung, Austria
Reykjavik, Iceland
Uruguaiana, Brasil
Riga, Latvia
Valdivia, Chile
Rijeka, Croatia
Valencia, Spain
Roma, Italy
Valladolid, Spain
Rosario, Argentina
Rosario City, Argentina Vancouver, Canada 8
The International Study of Asthma and Allergies in Childhood
The ISAAC Story
Centres cont.
Verona, Italy
Villahermosa, Mexico
Viterbo, Italy
Vitória da Conquista, Brasil
Wales, United Kingdom
Wellington, New Zealand
West Algiers, Algeria
Wilaya of Algiers, Algeria
West Marne, France
West Midlands, United Kingdom
West Sussex, United Kingdom
Wulumuqi, China
Wulumuqi(9), China
Yaounde, Cameroon
Zanjan, Iran
Appendices
ISAAC Maps 354
List of Centres 363
Summary of all publications 374
Publications 377
References 397
Steering Committee Photos 399
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