Results - Physical Health

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 686-700

P. Kamtsiuris, K. Atzpodien, U. Ellert, R. Schlack, M. Schlaud

Prevalence of somatic diseases in German children and adolescents. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which was conducted from 2003 to 2006, data on acute/infectious and chronic diseases were collected from a population-based sample of 17,641 subjects aged 0 to 17 years. The annual prevalence rates among acute diseases vary widely. Children and adolescents are most frequently affected by acute (infectious) respiratory conditions. 88.5 % of the surveyed children and adolescents experienced at least one episode of common cold within the last 12 months. Among the other acute respiratory infections, bronchitis and tonsillitis were the most frequently encountered conditions with 19.9 % and 18.5 %, respectively. The 12-month prevalence of otitis media and pseudocroup was 11 % and 6.6 %, respectively. 1.5 % of the children and adolescents experienced an episode of pneumonia. Apart from respiratory infections, gastrointestinal infections were very frequently stated as reasons for acute illness. Furthermore, 12.8 % of the children and adolescents experienced a herpetic infection, 7.8 % a conjunctivitis and 4.8 % a urinary tract infection. Lifetime prevalence rates of infectious diseases were as follows: pertussis 8.7 %, measles 7.4 %, mumps 4.0 %, rubella 8.5 %, varicella 70.6 %, scarlet fever 23.5 %. The various chronic somatic diseases in children and adolescents had different lifetime prevalence rates. Most frequently, children and adolescents were affected by obstructive bronchitis (13.3 %), neurodermatitis/atopic eczema (13.2 %) and hay fever (10.7 %). Scoliosis and asthma had been diagnosed by a doctor in 5.2 % and 4.7 % of subjects aged 0–17 years, respectively. The lifetime prevalence rates of the remaining diseases varied between 0.14 % for diabetes mellitus and 3.6 % for convulsions/epileptic fits. For the first time ever, these survey results provide nationwide representative information on the prevalence rates of acute/infectious and chronic diseases in children and adolescents which is based on a population-representative sample.

Keywords  Health survey - Children - Adolescents - KiGGS - Somatic diseases

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 701-710

M. Schlaud, K. Atzpodien, W. Thierfelder

Allergic diseases. Results from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) from 2003–2006 information was collected on allergic diseases (asthma, atopic dermatitis, hay fever, allergic contact eczema) from a population-based sample of 17,641 0–to 17-year-olds, and blood samples were studied for specific IgE antibodies to 20 common allergens. The lifetime prevalence (LTP) of at least one atopic disease was 22.9 % (95 % CI: 22.0–23.7 %), the 12-month prevalence (12MP) was 16.1 % (15.4–16.8 %); boys (17.3; 16.3–18.2 %) were more frequently affected than girls (14.9; 14.0–15.8 %). Children with a background of migration were less often currently affected by an atopic disease, as were children from families of low social status. According to parents' accounts, the LTP of allergic contact eczema was 9.9 % (9.4–10.5 %); girls (13.8;12.9–14.8) were more frequently affected than boys (6.2; 5.6–6.9 %). Of the 3- to 17-year-olds, 40.8 % (39.6–42.0 %) were sensitised to at least one of the allergens tested; boys (45.0; 43.5–46.5 %) more frequently so than girls (36.4; 35.0–37.9 %). In the states of the former FRG, the LTP of allergic contact eczema was higher (10.2; 9.6–10.9 %) than those in the former GDR (8.4 % 7.4–9.6 %); otherwise there were no East-West differences. The KiGGS data provide the first nationally representative data on allergic diseases and sensitisation. The differences in prevalence observed correspond to a great extent with previous studies and may support the hygiene hypothesis. The prevalences in East and West Germany now seem to have equalised.

Keywords  Health Survey - Children - Adolescents - Allergies - Atopies - Sensitisation - Asthma - Atopic dermatitis - Hay fever - Allergic contact eczema

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 711-717

U. Ellert, H. Neuhauser, A. Roth-Isigkeit

Pain in children and adolescents in Germany: the prevalence and usage of medical services. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

As part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), representative data were collected on pain in 14,959 children and adolescents aged 3 to 17 years in Germany. The results are reported separately for 11–17-year olds, who were asked themselves, and 3–10 year olds, whose parents reported on their pain. Among the 3–10 year olds, the prevalence of pain over three months was 64.5% and among the 11–17 year olds it was 77.6% (71.1% altogether for the 3–17 year old children). Pain prevalence increased significantly with age; in all age groups girls reported pain significantly more often than boys of the same age. In the 3–10 year olds the most common pain localisation was stomach pains, followed by pain in the head and throat. Children and adolescents aged 11 to 17 most often reported headaches, followed by pains in the stomach and back. Pain occurring at least once a week in the last three months was reported by 24.3% of the 11–17 year old children and adolescents and by 9.9% of the 3–10 year old children suffering from pain. More than half (54.1%) of the 3–10 year olds and more than one third of the 11–17 year olds (35.9%) who reported recurrent principal pain consulted a doctor for this reason; 36.7% and 46.7% respectively took medicine. These results show that pain is a relevant problem in children and adolescents in Germany.

Keywords  Health Survey - Children - Adolescents - Pain - Epidemiology - Use of medical services

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 718-727

H. Kahl, R. Dortschy, G. Ellsäßer

Injuries among children and adolescents (1–17 years) and implementation of safety measures. Results of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

Parent interviews with regard to their children's accidents and to accident protective measures in the Health Interview and Examination Survey for Children and Adolescents (KiGGS) aimed at extending our knowledge of age- and gender-specific injuries and to identify risk groups and risk factors for injury prevention. The parents of 16,706 children (aged 1–17 years) were asked about their children's injuries within the last 12 months which were medically treated, and about accident mechanisms, consequences of injuries, and ambulatory and hospital treatment. In addition, parents and children aged 11 to 17 years (n = 6813) were asked to give information on protective measures. According to the parents 15.9 % of the children had at least one injury within the last 12 months, 15.2 % because of an accident and 0.8 % because of assault. In the age group 1–17 boys have been injured significantly more often than girls (17.9 % vs. 14,0 %). Overall, 13.3 % of 2,410 injured children and adolescents were hospitalized. Two thirds of the accidents among toddlers were domestic accidents (60 %) whereas leisure and sport accidents were most prevalent in children and adolescents aged 5–14 years and 15–17 years (32.1 % and 38.9 %). The proportion of accidents in child care facilities and educational institutions tripled from infancy to school age (age 5–14 years) (10.9–28.7 %), as did traffic accidents (5.6–16.7 %). The three most frequent injury mechanisms in the age range 1–17 years were falls on level ground (35.2 %), falls from heights (25.2 %) and collisions with objects or persons (20.6 %). Falls from heights showed the highest risk in toddlers (35.8 %). Contusions, sprains and strains increased to a highest level of 50.9 % in adolescents; likewise, bone fractures increased from 10.7 % in toddlers to 21.8 % in adolescents aged 15–17 years. An influence of socioeconomic status on injuries overall and on consequences of injuries was not seen. For traffic accidents in children aged 1–17 years boys (p = 0.019) and girls (p = 0.047) from families with lower socioeconomic status showed higher rates of accidents than children from families with higher socioeconomic status. The application of protective measures was lowest in the age group 14–17 years. While according to the parents about 90 % of children aged 3–4 years wear a helmet when riding a bicycle or when skating, this quote was lower in the age group 5–14 (60 %) and dropped to about 15 % in the age group 14–17 (about 15 %). Also the rate for using protective clothes was lowest in age group 14–17 (boys 41.8 %; girls 52.2 %). In children and adolescents the rate of self-reported helmet use is lower than estimated by their parents. In all age groups migration background and low socioeconomic status were associated with lower use of protective measures (helmets and protective clothes). The age related data analysis should be the starting point in prevention measures for specific risk groups considering migration and socioeconomic status. Prevention activities in traffic should focus on families with low social status. Adolescents should be specifically and adequately addressed regarding the benefits of certain safety measures when riding a bicycle and when skating.

Keywords  Health Survey - Children - Adolescents - Injuries - Falls - Socioeconomic status - Migration status - Helmet rates - Protective measures

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 728-735

H. Neuhauser, M. Thamm

Blood pressure measurement in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Methodology and initial results [pdf]

Abstract

Hypertension is one of the main risk factors for cardiovascular disease and ranks among the leading causes of morbidity and mortality worldwide. Hypertension in children is rare, but the blood pressure rank in relation to peers is often maintained from childhood into adulthood and is therefore of great public health relevance. For this reason, one of the aims of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) was to collect representative data on blood pressure in children aged 3 to 17 years, in order to create an epidemiological basis for a comprehensive analysis of blood pressure in children and adolescents in Germany. Two oscillometric blood pressure measurements were obtained using an automated device (Datascope Accutorr Plus) and two readings of systolic, diastolic and mean arterial pressure and of heart rate were obtained in a standardised fashion in 14.730 children (7203 girls and 7527 boys). The main aim of this article is a detailed description of the blood pressure measurement in KiGGS, which is important for the interpretation of our findings compared to other studies. Our initial results on the distribution of systolic and diastolic blood pressure confirm previous findings of increasing blood pressure with age and height and of higher systolic blood pressure levels among boys compared with girls from the age of 14 years.

Keywords  Health Survey - Children - Adolescents - Blood pressure - Blood pressure measurement - Oscillometric blood pressure measurement - Hypertension

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 736-743

B.-M. Kurth, A. Schaffrath Rosario

The prevalence of overweight and obese children and adolescents living in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

Overweight and obesity are an increasing problem: worldwide, for Germany and for children and adolescents. Until now there have been no representative and age-specific assessments of the prevalence of obesity among children and adolescents in Germany. Thus, the standardised height and weight measurements gathered in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) have, for the first time, provided national, representative data about overweight and obesity in young people. The terms ‘overweight’ and ‘obese’ are defined based on percentiles of the body mass index (BMI) of the Kromeyer-Hauschild reference system. Of children and adolescents between the ages of 3 and 17, 15% exceed the 90th BMI percentile of the reference data and are thus overweight, 6.3% exceed the 97th BMI percentile and thus suffer from obesity by this definition. The proportion of overweight rises from 9% of 3–6-year-olds to 15% of 7–10-year-olds and 17% of 14–17-year-olds. The prevalence of obesity is 2.9%, 6.4% and 8.5% for the same age groups respectively. No clear differences between boys and girls or between East and West Germany are detected. Children are at a higher risk of being overweight or obese if they have a lower socioeconomic status, have a migration background, or have mothers who are also overweight.

Keywords  Health survey - Children - Adolescents - Body mass index BMI - Overweight - Obesity

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 744-749

M. Thamm, U. Ellert, W. Thierfelder, K.-P. Liesenkötter, H. Völzke

Iodine intake in Germany. Results of iodine monitoring in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

Iodine is an essential trace element which is found in too low quantities in the soil in Germany. The resulting iodine deficiency in human beings is countered by iodine prophylaxis, essentially consisting of iodised table salt and the iodisation of agricultural animal feed. In iodine monitoring during the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), the thyroid volumes of all children and adolescents from six years of age were determined using sonography. To assess iodine intake among the population, iodine excretion in the urine was also measured. The median ioduria value was 117 μg/l, putting it at the lower end of the scale of 100–200 μg/l recommended by the World Health Organisation. It can be concluded from these results that the iodine prophylaxis has been successful and that iodine intake has improved compared with the past. In accordance with the WHO recommendations there is no iodine deficiency in Germany any more; however, at the same time the population's iodine intake is at a relatively low level. The aim is at least to keep up what has been achieved, meaning that measures to improve iodine intake must not be allowed to slacken.

Keywords  Health survey - Children - Adolescents - Iodine - Iodine intake - Thyroid gland

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 750-756

C. Scheidt-Nave, U. Ellert, U. Thyen, M.Schlaud

Prevalence and characteristics of children and youth with special health care needs (CSHCN) in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

In order to arrive at population-based estimates on the prevalence and characteristics of children and adolescents with specific health care needs (CSHCN), screening instruments focussing on the consequences of physical, mental and behavioral problems rather than on medical diagnoses have been developed. One of the most feasible and widely tested instruments, the CSHCN screener was added to the self-administered questionnaire for parents of children participating in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The overall weighted prevalence of CSHCN was 16.0% among boys and 11.4% among girls. Children at kindergarten or school age were more than 2-3 times more likely to screen positive compared to toddlers. Up to 14 years, the sex difference persisted through all age groups and was most pronounced between the ages of 3 and 10 years. Children with a migrant background had significantly lower rates of CSHCN compared to non-migrants. This was particularly true for boys (8.0% vs. 17.1%). CSHCN status was not related to social status, urbanization or residence in former West vs. former East Germany. Except for the lack of association with social status, these results are in good accordance with observations from the US National Survey of CSHCN.

Keywords  Health survey - Children - Adolescents - Health care needs - Chronic diseases - CSHCN screener

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 757-770

W. Thierfelder, R. Dortschy, B. Hintzpeter, H. Kahl, C. Scheidt-Nave

Biochemical measures in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

In the framework of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) a variety of biochemical parameters was determined in order to provide objective information on health status and particular health risks, in addition to parent interview data and anthropometric measurements. Overall 43 parameters covered three areas of particular public health interest: micronutrient deficiency, seroepidemiology of infectious diseases and immunization status, and risk indicators or risk factors for chronic non-communicable diseases. A review of available evidence regarding valid reference or cutoff values as well as the standardization of laboratory methods led to the categorization of these parameters into five classification categories. Here, we discuss the present first descriptive results on selected parameters representing the various categories. In order to determine the public health impact of measurement results, and perhaps even derive normative reference data relevant to health care, more detailed analyses will be required. In the first step, these will focus on cross-sectional analyses of the association between biochemical parameters and other health-related anthropometric and sociodemographic variables. Intermediate and long-term objectives will include the construction of multidimensional reference values taking into account several laborato ry data and other clinical information at the same time, and the prognostic validation of reference or cut-off values based on a follow- up of the study participants for clinical outcomes.

Keywords  Health-Survey - Children - Adolescents - Biochemical measures

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 771-774

S. Diedrich, E. Schreier

The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): State of immunity against poliomyelitis in German children [pdf]

Abstract

One of the goals of the WHO is the worldwide eradication of poliomyelitis in the coming years. Europe was declared poliofree in 2002, but increasing migration may lead to a come-back of circulating polioviruses. A high level of population immunity protects against imported wild viruses from endemic areas. The first seroprevalence data since the switch from live to inactivated vaccine in Germany (OPV to IPV) are provided. A serum panel was tested (n=2,046) in order to study the serological status against poliomyelitis. The microneutralization test on RD cells was used. Overall, neutralizing antibodies against poliovirus types 1, 2 and 3 were detected in 97.4%, 97.6%, and 93.6% of samples, respectively. Of the test persons, 91.7% had antibodies against all three virus types. Only 26 children simultaneously lacked neutralizing antibodies for all three serotypes (1.3%). No significant correlation between gender, region (East/West)), migration status (with/without migration background) and antibody prevalence to polioviruses was found. The seroprevalence of antibodies against all three types of polioviruses indicates a very high level of population immunity in German children. It must be maintained through consequently performed vaccination programmes.

Keywords  Health survey - Children - Adolescents - Neutralizing antibodies - Poliovirus - Poliomyelitis

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 775-783

A. Starker, T. Lampert, A. Worth, J. Oberger, H. Kahl, K. Bös

Motor Fitness. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

Motor fitness was investigated in children and adolescents aged 4–17 using specific short tests. These tested the motor abilities: co-ordination, strength, cardiorespiratory fitness and flexibility. Among the 4–10 year olds, the focus of the investigation was on recording coordination, strength and flexibility; in the age group of the 11–17 year olds it was on recording cardiorespiratory fitness. The current investigation describes motor fitness based on the tested abilities according to age, sex and sociodemographic aspects. In all the test tasks, as expected, there are better results from older children and adolescents than from younger ones. Among the 4–10 year olds, girls display a slightly higher motor fitness in five out of the six tasks. In cardiorespiratory fitness, the cycle ergometer test for the 11-17 year olds shows better results for boys. The results indicate that there is a correlation between migrant status, social status and motor fitness. The shown differences point out that possible intervention programmes should be specifically attuned to age and sex as well as to the concerns of children and families with a migrant background and those of low social status. These collected data on motor fitness produced a database, representative of Germany. This will enable statements on state and development of motor fitness in children and adolescents in the future.

Keywords  Health survey - Children - Adolescents - Co-ordination - Strength - Flexibility - Cardiorespiratory fitness

Contents
Methodology and Conduct of Field Work
Results - Health Behaviour, Development
Results - Physical Health
Results - Mental Health, Use of Medical Services
Module Studies

Last updated: June 2007