Incidence and Prevalence of Childhood Atopic Diseases in Dutch Primary Care

• DOI: 10.1111/cea.70035
• Publication Date: 2025-03-14T08:44:59Z
• Authors: W. Kuan Chung; Evelien I. T. de ...; Laura Struik; Madelon van Tilbo...; Arthur Bohnen; Patrick J. E. Bin...; Evelien R. van Meel
• Keywords: Primary Immunodeficiency

Atopic diseases, including atopic dermatitis (AD), asthma and allergic rhinoconjunctivitis (AR), are common childhood conditions [1-3]. Although studies in open populations (via general population-based surveys) suggest varying prevalence trends, physician-diagnosed rates primary care remain underexplored. Recent literature questions the assumption of an increase disease prevalence, emphasising shifts increased awareness rather than true epidemiological changes [2, 4, 5]. This study examines incidence diseases children within Rijnmond Primary Care Database (RPCD) [6], with triad—that is, who have been diagnosed AD, AR at any time during childhood. We conducted a retrospective cohort using RPCD, regional database covering over 500,000 patients from 240 practices Rotterdam–Rijnmond, Netherlands. included aged 0–18 years 2013 to 2021. were identified International Classification for (ICPC) codes combined pharmaceutical prescription data utilising Anatomical Therapeutic Chemical (ATC) codes. Additional methods, relevant ICPC ATC case selection, results available Open Science Framework online repository: https://osf.io/4kwb2/?view_only=959223bea5534b31aef5c84e5ac6c13d. AD defined as least two consultations prescriptions, while required plus either prescriptions or positive radioallergosorbent test (RAST). A was considered resolved if no further records appeared 2 years. analysed 66,382 2021, whom 22,123 had AR. Median follow-up 3.34 The remained stable time, 0.89 1.48 per 100 PYs (p < 0.001). Corresponding rose 4.26 6.62 triad also 0.14 0.28 all age-specific displayed Figure 1. Age-specific analysis (Figure 1) showed peak 3 (median onset: 2.9 years, IQR: 1.0–7.6), 17 9.6 7.6–12.5) 10.3 7.3–13.6). peaked age 11 (0.35 PYs, 95% CI: 0.28–0.43). Sex-specific revealed that more boys until five, after which it became prevalent girls. Asthma frequent throughout whole (0.25 PYs) girls (0.19 PYs), (0.41 0.31–0.53) (0.34 0.25–0.46). Our findings indicate between increased. may be due previous underdiagnosis, physician environmental factors. we did not observe decrease COVID-19 pandemic, impact restrictions on healthcare utilisation 2020–2021 should when interpreting trends. Asthma, AT childhood, whereas initially but later 13. three times higher expected by chance, supporting distinct trajectories. Sex differences align existing literature, suggesting hormonal factors contribute persistence [7, 8]. major strength our is large sample size contains patients. However, limitations inherent research must considered. outcomes rely codes, subject individual GP coding variability. While overestimation minimised requiring multiple underestimation occur milder cases require less healthcare. Additionally, duration might underestimated mild symptoms whose close without consultations. Despite this, estimates [9]. Another limitation absence ethnicity, family history exposures such pets secondhand smoke. Finally, food allergy could studied lack specific code, restricting focus In conclusion, rising care, stable. physicians play crucial role identifying early ensuring appropriate treatment strategies, emollient therapy, corticosteroids lifestyle modifications. Further needed explore risk trajectories populations. W. Kuan Chung conceptualised this study, performed extraction, interpretation drafted revised manuscript. Evelien R. van Meel, I. T. de Schepper, Madelon Tilborg-den Boeft, Arthur Bohnen Patrick J. E. Bindels involved conceptualising critically reviewing Laura Struik extraction. All authors read approved final submitted manuscript agree accountable aspects work. thank collaborators providing used study. Beyond usual salary, one received financial compensation their contributions. (project number 2021-027) Governance Board RPCD. Patient de-identified; therefore, patient consent required. declare conflicts interest. support request corresponding author. publicly privacy ethical restrictions.