Allergic Rhinitis Clinical Trial
Official title:
Prospective Longitudinal Study on the Association Between Treatment of Allergic Rhinitis and Cognitive Ability in Children
Pilot study on the association between allergic rhinitis and cognitive ability in 174 children aged 11-14 within the same year group at school in which 140 Allergic Rhinitis subjects and 34 non-Allergic Rhinitis subjects. Primary outcome measures include cognitive tests (Trait Making Test, Digit Span Test, Stroop Test, Chinese Auditory Verbal Learning Test, Verbal Fluency Test), so as to assess the cognitive ability of allergic rhinitis patients before and after treatment compared to a control group. Rhinitis Symptom Utility Index (RSUI) of patients will be the secondary outcome measured through questionnaires. Positive skin prick test and endoscopy examination (taking place in Prince of Wales hospital) will be required before the diagnosis of allergic rhinitis. The data will be analysed by the Multilevel models.
INTRODUCTION Allergic rhinitis is the reportedly second most common reported chronic health
condition in Hong Kong children under the age of 14, with the Child Health Survey 2005-2006
indicating a prevalence of 24.5%. Allergic rhinitis is a type I hypersensitivity reaction,
which occurs when IgE antibodies are produced against allergens, leading to the activation of
mast cells which release inflammatory mediators. Common allergens in Hong Kong include house
dust mite and cockroaches. Allergic rhinitis causes a multitude of symptoms including
itching, sneezing, nasal discharge, post-nasal drip, and nasal congestion. It can cause poor
quality sleep, leading to daytime sleepiness, decreased cognitive ability, mood instability
and fatigue. Allergic rhinitis leading to a reduction in quality of life in adults has been
well established, leading to impediment of cognitive processes and poorer ability in
attention-requiring activities (e.g. driving). These symptoms can similarly significantly
impede a child's education and quality of life. It is estimated that up to 90% of allergic
rhinitis patients are untreated, insufficiently treated, or inappropriately treated.
With regards to children and teenagers, some studies have suggested that allergic rhinitis
can cause significant cognitive difficulties, with detrimental effects on children's
education and examination performance, however others suggest there is no association. A
longitudinal cohort study in 2014 on the treatment of allergic rhinitis in children showed an
improvement in attention and divided attention after 1 year of treatment. There are little
studies regarding the effect of treatment of allergic rhinitis on cognitive abilities in
children.
RESEARCH OBJECTIVES
1. To investigate, if any, the differences between normal and allergic rhinitis patients in
terms of cognitive function
2. To investigate the impact of allergic rhinitis on different areas of cognitive function
3. To investigate the improvement of cognitive function in children after 8 weeks of
standard treatment of allergic rhinitis
RESEARCH HYPOTHESIS Children with allergic rhinitis are expected to have a heightened
improvement in cognitive abilities after the treatment compared to the normal control group
due to relief of their nasal symptoms.
STUDY DESIGN This study is a prospective longitudinal pilot study to take place from 15 1 Nov
Dec 2017 to 31 Dec 2018. Final report will be completed 30 June 2019.
STUDY SAMPLE AND SETTING The study is to be performed in Hong Kong, with subjects aged 11-14
studying Form 1 and 2 in secondary school being recruited. Recruitment and cognitive testing
will take place at the secondary school, whilst physician follow up and skin prick tests will
take place at Prince of Wales Hospital. Healthy individuals as well as patients with a
history of allergic rhinitis will be recruited. Chinese will be the main language used. The
total number of the Form 1 students within the school will be around 200. The estimated
participation rate will be approximately 70%. As the prevalence of allergic rhinitis in Hong
Kong children under the age of 14 is approximately 24.5%, the expected number of Allergic
Rhinitis participants and non-Allergic Rhinitis participants are 140 and 34 respectively.
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