Bursa ili 6-14 yaş grubu çocuklarda arı alerjisi ve semptomlarının görülme sıklığı
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Date
2012
Authors
Özel, Mustafa
Journal Title
Journal ISSN
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Publisher
Uludağ Üniversitesi
Abstract
Dünyada ve ülkemizde çocukluk çağında arı alerjisi ve arı sokmaları sonrası görülen reaksiyonların görülme sıklığı ile ilgili epidemiyolojik çalışmalar kısıtlı sayıdadır.Bu çalışmada Bursa ili kent merkezinde 6-14 yaş grubu okul çocuklarında arı sokması görülme sıklığı, arı sokmasına bağlı reaksiyonların görülme sıklığı, görülen semptomlar, arı sokması ve alerjisine sebep olan arı türleri, arı alerjisi ile ilgili çeşitli özellikler, çocukların anne ve babaları tarafından cevaplandırılan anket formları kullanılarak araştırılmıştır.Çalışma popülasyonu toplam 3944 çocuktan oluştu. Popülasyonun 1976'i (%50,1) erkek, 1968'sı (%49,9) kız çocuklardan oluşuyordu. Çocukların yaşları 6-14 yaş, ortalama yaşları 10,19 ± 2,30 olarak bulundu.Çalışma popülasyonunda (n: 3944), yaşam boyu en az bir kez arı tarafından sokulma prevalansı (yaşam boyu veya kümülatif prevalans) %36,1 (n:1422), son bir yılda arı tarafından sokulma varlığı (son bir yıldaki prevalans) %4,5 (n:178) olarak bulundu.Çalışma popülasyonunun genelinde yaşam boyu arı sokması sonrası görülen en ciddi reaksiyon olarak (n:3944) lokal reaksiyon (normal lokal reaksiyon) %35,0 (n:1382), geniş lokal reaksiyon %0,76 (n:30), sistemik reaksiyon (arı alerjisi, anafilaksi) %0,25 (n:10) oranlarında saptandı.Yaşamları boyunca en az bir kez arı tarafından sokulan çocuklarda (n: 1422); lokal reaksiyon %97,2 (n:1382), geniş lokal reaksiyon (%2,1) (n:30), sistemik reaksiyon %0,7 (n:10) oranlarında bildirildi. Sistemik reaksiyon bildiren 10 olguda sistemik reaksiyonun sadece deri bulguları 9 olguda (%0,6) ve sistemik reaksiyonun solunum sistemi ve kardiyovasküler sistem gibi sistemik bulguları 1 olguda %0,1 gözlendiği bulundu.Tüm arı sokması vakalarında (n: 2597) bildirilen arı cinsleri sırasıyla; bal arısı (n: 1409) %54,3, yaban arısı (n: 626) %24,1 bilinmeyen veya hatırlanmayan arı cinsi (n: 436) %16,8 olarak bulundu.Yaşam boyu en az bir kez arı tarafından sokulma öyküsü olan çocuklarda (n:1422) ilk arı sokma yaşı ortalama 6,8 ± 2,9 yaş olarak saptandı. Anne, baba veya kardeşlerde arı sokması sonrası geniş lokal veya sistemik reaksiyon görülme öyküsü 59 (%4,1) çocukta mevcuttu.Tüm çalışma popülasyonundaki (n: 3944) çocuklarda doktor tanılı diğer alerjik hastalıkların sıklığı sorgulandığında; astım %10,9 çocukta, alerjik rinit %10,2 çocukta, besin alerjisi %6,4 çocukta, atopik dermatit %4,3 çocukta, alerjik konjunktivit %3,9 çocukta, ürtiker %2,0 çocukta, ilaç alerjisi %1,7 çocukta saptandı.Arı sokması sonrasında geniş lokal veya sistemik reaksiyon gelişimi için olası risk faktörleri incelendiğinde; sistemik reaksiyon gelişimi için herhangi bir istatistiksel olarak anlamlı risk faktörü saptanmadı. Geniş lokal reaksiyon gelişimi için son 12 ayda arı sokma sayısı (p:0,020), çocukta diğer alerjik hastalık bulunması (p:0,020) ve ailede arı sokması sonrası sistemik reaksiyon öyküsü (p:0,023) bağımsız risk faktörleri olarak saptandı.Bursa il merkezinde çocukluk çağında arı sokmaları ve arı sokmalarına bağlı geniş lokal veya sistemik (alerjik) reaksiyonlar dikkate değer bir oranda görülmektedir.Arı sokması sonrası görülen reaksiyonların standart anket formları ile araştırıldığı çok merkezli çalışmaların yapılması, arı sokması sonrası gelişen reaksiyonların görülme sıklığının saptanmasına olanak sağlayacaktır. Çocukluk çağında arı venomu alerjisine yaklaşım konusunda bu verilerin yararlı olacağı düşünülmüştür.
Epidemiologic studies about bee stings and allergic reactions after bee stings during childhood are very rare in Turkey and even in the world.In this study we have researched bee sting prevalence?s of bee stings and allergic reactions after bee stings, symptoms, bee species causing bee venom allergy, different specialties of bee venom allergy among 6 to 14 years old school children using questionnaires filled by their parents.Our study population consisted of 3944 school children. 1976 (50.1%) of them were boys and 1968 (49.9%) were girls. Their ages ranged between 6 and 14 and the mean age was 10.19±2,30 years.Among study population (n:3944), whole life (cumulative prevalence) at least once bee sting prevalence was 36.1 (n:1422). The ratio of children who were stung during the last year was 4.5% (n:178).Among study population (n:3944), the most severe reaction seen after a bee sting was local reaction (n:1382) (35.0%). Large local reaction was seen in 30 (0.76%) children and systemic reaction was seen in 10 (0.25%) children.Among the children whoever experienced at least one bee sting (n:1422), local reaction was the most seen allergic reaction with 97.2% (n:1382). Large local reaction was seen in 30 children (2.1%) and systemic reaction was seen in 10 children (0.6%). Of these 10 children with systemic reactions, 9 (0.6%) of them only experienced systemic skin lesions, one (0.1 %) patient had experienced respiratory and cardiovascular system symptoms.Among all bee stings (n:2597) honey bee was the most seen bee species with 54.3% (n:1409). Wasps were the cause in 24.1% (626) of the cases. Unknown or unremembered bee species were the cause in 16.8% (436) of all cases.Mean first sting age was 6.8±2.9 among the children who ever experienced a bee sting. Large local or systemic reaction history in families of the children was positive in 4.1% (n:59) of all children (n:3944).Among all children (n:3944), physician diagnosed allergic diseases were positive in 10.9% children. Asthma was seen in 10.9%, allergic rhinitis was seen in 10.2%, food allergy was seen in 6.3%, atopic dermatitis was seen in 4.3%, allergic conjunctivitis was seen in 3.9%, urticaria was seen in 2.0% and drug allergy was seen in 1.7% of all children.As a result of multivariate logistic regression analysis in order to analyze risk factors for large local and systemic reactions after bee stings; nothing was found to be a risk factor for systemic reactions. Age at study time (p=0.11), mean bee sting count during last year (p=0.020), any allergic disease in child (p=0.020) and bee venom allergy in the family (p=0.023) were independent risk factors for large local reactions.Our study shows that bee stings and large local ? systemic allergic reactions after bee stings are seen significantly high among school children in Bursa city center.Multicenter epidemiologic studies researching bee stings and allergic reactions after bee stings should be made in order to acquire important data about the prevalence?s. We think that our data will be useful for understanding and management of bee venom allergy.
Epidemiologic studies about bee stings and allergic reactions after bee stings during childhood are very rare in Turkey and even in the world.In this study we have researched bee sting prevalence?s of bee stings and allergic reactions after bee stings, symptoms, bee species causing bee venom allergy, different specialties of bee venom allergy among 6 to 14 years old school children using questionnaires filled by their parents.Our study population consisted of 3944 school children. 1976 (50.1%) of them were boys and 1968 (49.9%) were girls. Their ages ranged between 6 and 14 and the mean age was 10.19±2,30 years.Among study population (n:3944), whole life (cumulative prevalence) at least once bee sting prevalence was 36.1 (n:1422). The ratio of children who were stung during the last year was 4.5% (n:178).Among study population (n:3944), the most severe reaction seen after a bee sting was local reaction (n:1382) (35.0%). Large local reaction was seen in 30 (0.76%) children and systemic reaction was seen in 10 (0.25%) children.Among the children whoever experienced at least one bee sting (n:1422), local reaction was the most seen allergic reaction with 97.2% (n:1382). Large local reaction was seen in 30 children (2.1%) and systemic reaction was seen in 10 children (0.6%). Of these 10 children with systemic reactions, 9 (0.6%) of them only experienced systemic skin lesions, one (0.1 %) patient had experienced respiratory and cardiovascular system symptoms.Among all bee stings (n:2597) honey bee was the most seen bee species with 54.3% (n:1409). Wasps were the cause in 24.1% (626) of the cases. Unknown or unremembered bee species were the cause in 16.8% (436) of all cases.Mean first sting age was 6.8±2.9 among the children who ever experienced a bee sting. Large local or systemic reaction history in families of the children was positive in 4.1% (n:59) of all children (n:3944).Among all children (n:3944), physician diagnosed allergic diseases were positive in 10.9% children. Asthma was seen in 10.9%, allergic rhinitis was seen in 10.2%, food allergy was seen in 6.3%, atopic dermatitis was seen in 4.3%, allergic conjunctivitis was seen in 3.9%, urticaria was seen in 2.0% and drug allergy was seen in 1.7% of all children.As a result of multivariate logistic regression analysis in order to analyze risk factors for large local and systemic reactions after bee stings; nothing was found to be a risk factor for systemic reactions. Age at study time (p=0.11), mean bee sting count during last year (p=0.020), any allergic disease in child (p=0.020) and bee venom allergy in the family (p=0.023) were independent risk factors for large local reactions.Our study shows that bee stings and large local ? systemic allergic reactions after bee stings are seen significantly high among school children in Bursa city center.Multicenter epidemiologic studies researching bee stings and allergic reactions after bee stings should be made in order to acquire important data about the prevalence?s. We think that our data will be useful for understanding and management of bee venom allergy.
Description
Keywords
Arı alerjisi, Venom, Epidemiyoloji, Çocuk, Anafilaksi, Sistemik reaksiyon, Geniş lokal reaksiyon, Bee, Venom, Bee allergy, Children, Anaphylaxis, Systemic reactions, Large local reactions
Citation
Özel, M. (2012). Bursa ili 6-14 yaş grubu çocuklarda arı alerjisi ve semptomlarının görülme sıklığı. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.