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Observational Study
. 2017 Nov 12;7(11):e018091.
doi: 10.1136/bmjopen-2017-018091.

Risks for comorbidity in children with atopic disorders: an observational study in Dutch general practices

David H J Pols  1 , Arthur M Bohnen  1 , Mark M J Nielen  2 , Joke C Korevaar  2 , Patrick J E Bindels  1
Affiliations
Observational Study

Risks for comorbidity in children with atopic disorders: an observational study in Dutch general practices

David H J Pols et al. BMJ Open. .

Abstract

Objective: This study aimed to investigate both atopic and non-atopic comorbid symptoms and diseases in children with physician-diagnosed atopic disorders (atopic eczema, asthma and allergic rhinitis).

Methods: All children aged 0-18 years listed in a nationwide primary care database (the Netherlands Institute for Health Services Research-Primary Care Database) with routinely collected healthcare data in 2014 were selected. Children with atopic disorders were matched on age and gender with non-atopic controls within the same general practice. A total of 404 International Classification of Primary Care codes were examined. Logistic regression analyses were performed to examine the associations between the presence of atopic disorders and (non-)atopic symptoms and diseases by calculating ORs.

Results: Having one of the atopic disorders significantly increased the risk of having other atopic-related symptoms, even if the child was not registered as having the related atopic disorder. Regarding non-atopic comorbidity, children with atopic eczema (n=15 530) were at significantly increased risk for (infectious) skin diseases (OR: 1.2-3.4). Airway symptoms or (infectious) diseases (OR: 2.1-10.3) were observed significantly more frequently in children with asthma (n=7887). Children with allergic rhinitis (n=6835) had a significantly distinctive risk of ear-nose-throat-related symptoms and diseases (OR: 1.5-3.9). Neither age nor gender explained these increased risks.

Conclusion: General practitioners are not always fully aware of relevant atopic and non-atopic comorbidity. In children known to have at least one atopic disorder, specific attention is required to avoid possible insufficient treatment and unnecessary loss of quality of life.

Keywords: Epidemiology; Paediatrics; Primary Care.

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Conflict of interest statement

Competing interests: None declared.

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