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Eur Respir J 2004; 24:406-412
Copyright ©ERS Journals Ltd 2004

Phase II of the International Study of Asthma and Allergies in Childhood (ISAAC II): rationale and methods

S.K. Weiland1, B. Björkstén2, B. Brunekreef3, W.O.C. Cookson4, E. von Mutius5, D.P. Strachan6 and the International Study of Asthma and Allergies in Childhood Phase II Study Group

1 Dept of Epidemiology, University of Ulm, Ulm, and 5 Children's Hospital, University of Munich, Munich, Germany. 2 Centre for Allergy Research and Institute of Environmental Medicine, Karolinska Institute Stockholm, Stockholm, Sweden. 3 Institute for Risk Assessment Sciences, University of Utrecht, Utrecht, the Netherlands. 4 Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, and 6 St. Georges's Hospital Medical School, London, UK

CORRESPONDENCE: S.K. Weiland, Dept of Epidemiology, University of Ulm, Helmholzstr. 22, 89081, Ulm, Germany. Fax: 49 7315031069. E-mail: stephan.weiland@medizin.uni-ulm.de

Keywords: Asthma, childhood, eczema, epidemiology, International Study of Asthma and Allergies in Childhood Phase II, rhinitis

Received: August 5, 2003
Accepted March 22, 2004

The coordination and central laboratory analyses of the European centres were supported by the Fifth Framework Programme of the European Commission, Brussels, Belgium (QLK4-CT-1999-01288). Support details for the local studies are given in the Funding of local studies section at the end of this article. Pharmacia Diagnostics (Uppsala, Sweden) generously made reagents available at a nominal cost. ALK (Horsholm, Denmark) generously provided reagents for fieldwork in several low-income countries without charge.

International comparative studies, investigating whether disease incidence or prevalence rates differ between populations and, if so, which factors explain the observed differences, have made important contributions to the understanding of disease aetiology in many areas. In Phase I of the International Study of Asthma and Allergies in Childhood (ISAAC), the prevalence rates of symptoms of asthma, allergic rhinitis and atopic eczema in 13–14-yr-olds, assessed by standardised questionnaires, were found to differ >20-fold between the 155 study centres around the world. Phase II of ISAAC aims to identify determinants of these differences by studying informative populations.

A detailed study protocol was developed for use in community-based random samples of children aged 9–11 yrs. The study modules include standardised questionnaires with detailed questions on the occurrence and severity of symptoms of asthma, allergic rhinitis and atopic eczema, their clinical management, and a broad range of previous and current exposure conditions. In addition, standardised protocols were applied for examination of flexural dermatitis, skin-prick testing, bronchial challenge with hypertonic saline, blood sampling for immunoglobulin E analyses and genotyping, and dust sampling for assessment of indoor exposures to allergens and endotoxin.

To date, ISAAC II field work had been completed or started in 30 study centres in 22 countries.

The majority of centres are in countries that participated in International Study of Asthma and Allergies in Childhood Phase I and reflect almost the full range of the observed variability in Phase I prevalence rates.




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