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Asthma and Allergic Disorders in Uganda: A Population-Based Study Across Urban and Rural Settings.


ABSTRACT: BACKGROUND:Allergic diseases are increasing in sub-Saharan Africa, but few studies have characterized the burden among adults. OBJECTIVE:We conducted a study to evaluate the prevalence and risk factors of allergic disorders in urban and rural Uganda. METHODS:We present a cross-sectional analysis of enrollment data from a population-based cohort study of adults aged ?35 years in urban and rural Uganda. Sociodemographic and both lifetime and 12-month respiratory symptoms data were collected and spirometry was conducted following standard guidelines. RESULTS:In 1,308 adults (median age 43.8 years and 52.3% female), we found an age-adjusted prevalence of 6.8% for asthma (9.8% urban, 4.3% rural; P < .001), 11.9% for allergic rhinitis (16.4% urban, 7.8% rural; P < .001), and 8.2% for eczema (9.9% urban, 7.8% rural; P = .15). Urbanization was the primary driver of asthma, accounting for 61.4% of cases (95% confidence interval [CI] 22.0% to 83.4%), and was the strongest risk factor for any allergic illness (odds ratio [OR] = 1.87, 95% CI 1.39-2.51). Parental asthma was not associated with allergic illness. Asthma was associated with a lower forced expiratory volume in 1 second (FEV1) by 0.56 z scores (95% CI 0.33-0.80). We found a dose-response association between lower quintiles of the FEV1/forced vital capacity ratio and both hospitalization (OR = 1.77, 95% CI 1.21-2.59) and impairment in daily activities (1.65, 1.20-2.27). CONCLUSIONS:Asthma and allergic rhinitis were twice as prevalent in urban settings. Asthma was associated with greater impairment and worse lung function outcomes. We identified a high prevalence of allergic disorders in Uganda, which can be expected to increase due to urbanization and resultant exposures throughout early development.

SUBMITTER: Morgan BW 

PROVIDER: S-EPMC6050146 | biostudies-literature | 2018 Sep - Oct

REPOSITORIES: biostudies-literature

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Asthma and Allergic Disorders in Uganda: A Population-Based Study Across Urban and Rural Settings.

Morgan Brooks W BW   Siddharthan Trishul T   Grigsby Matthew R MR   Pollard Suzanne L SL   Kalyesubula Robert R   Wise Robert A RA   Kirenga Bruce B   Checkley William W  

The journal of allergy and clinical immunology. In practice 20180201 5


<h4>Background</h4>Allergic diseases are increasing in sub-Saharan Africa, but few studies have characterized the burden among adults.<h4>Objective</h4>We conducted a study to evaluate the prevalence and risk factors of allergic disorders in urban and rural Uganda.<h4>Methods</h4>We present a cross-sectional analysis of enrollment data from a population-based cohort study of adults aged ≥35 years in urban and rural Uganda. Sociodemographic and both lifetime and 12-month respiratory symptoms data  ...[more]

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