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Prevalence and risk factors for asthma, rhinitis, eczema, and atopy among preschool children in an Andean city.

ABSTRACT: BACKGROUND:Limited data are available on prevalence and associated risk factors for atopy and allergic diseases from high-altitude urban settings in Latin America. OBJECTIVE:To estimate the prevalence of atopy, asthma, rhinitis, and eczema, and associations with relevant risk factors in preschool children in the Andean city of Cuenca. METHODS:A cross-sectional study was undertaken using a representative sample of 535 children aged 3-5 years attending 30 nursery schools in the city of Cuenca, Ecuador. Data on allergic diseases and risk factors were collected by parental questionnaire. Atopy was measured by skin prick test (SPT) reactivity to a panel of relevant aeroallergens. Associations between risk factors and the prevalence of atopy and allergic diseases were estimated using multivariable logistic regression. RESULTS:Asthma symptoms were reported for 18% of children, rhinitis for 48%, and eczema for 28%, while SPT reactivity was present in 33%. Population fractions of asthma, rhinitis, and eczema attributable to SPT were 3.4%, 7.9%, and 2.9%, respectively. In multivariable models, an increased risk of asthma was observed among children with a maternal history of rhinitis (OR 1.85); rhinitis was significantly increased in children of high compared to low socioeconomic level (OR 2.09), among children with a maternal history of rhinitis (OR 2.29) or paternal history of eczema (OR 2.07), but reduced among children attending daycare (OR 0.64); eczema was associated with a paternal history of eczema (OR 3.73), and SPT was associated with having a dog inside the house (OR 1.67). CONCLUSIONS:A high prevalence of asthma, rhinitis, and eczema symptoms were observed among preschool children in a high-altitude Andean setting. Despite a high prevalence of atopy, only a small fraction of symptoms was associated with atopy. Parental history of allergic diseases was the most consistent risk factor for symptoms in preschool children.

SUBMITTER: Ochoa-Aviles C

PROVIDER: S-EPMC7351199 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Prevalence and risk factors for asthma, rhinitis, eczema, and atopy among preschool children in an Andean city.

Ochoa-Avilés Cristina C Morillo Diana D Rodriguez Alejandro A Cooper Philip John PJ Andrade Susana S Molina María M Parra Mayra M Parra-Ullauri Andrea A Mejía Danilo D Neira Alejandra A Rodas-Espinoza Claudia C Ochoa-Avilés Angélica A

PloS one 20200710 7

<h4>Background</h4>Limited data are available on prevalence and associated risk factors for atopy and allergic diseases from high-altitude urban settings in Latin America.<h4>Objective</h4>To estimate the prevalence of atopy, asthma, rhinitis, and eczema, and associations with relevant risk factors in preschool children in the Andean city of Cuenca.<h4>Methods</h4>A cross-sectional study was undertaken using a representative sample of 535 children aged 3-5 years attending 30 nursery schools in t ...[more]

PMID: 32649729

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Project description:BACKGROUND:Allergic sensitization is associated with eczema, asthma, and rhinitis. However, it is unknown whether and how allergic sensitization is associated over time with acquisition, remission, and persistence of these diseases and their comorbidity. OBJECTIVE:To gain a better understanding of factors including allergic sensitization transitions that influence the temporal pattern of asthma, eczema, and rhinitis and their comorbidity during childhood. METHODS:In the Isle of Wight birth cohort, information on allergic sensitization to common allergens was collected at ages 4, 10, and 18 years along with asthma, rhinitis, and eczema status determined by clinical diagnosis. Logistic regressions were used to estimate subsequent and concurrent odds ratios of diseases transition with allergic sensitization transition status as the main independent variable. Two transition periods were considered, 4 to 10 years of age and 10 to 18 years of age. RESULTS:The odds of new diagnosis of allergic disease (no-yes) was increased among subjects with acquired or persistent allergic sensitization to common allergens compared to subjects with no sensitization (acquisition of sensitization odds ratio [OR]=3.22, P < .0001; persistence of sensitization, OR=6.33, P < .0001). The odds of remission of allergic diseases (yes-no) was lower among subjects with acquired or sustained allergic sensitization (acquisition, OR=0.18, P = .0001; persistence, OR=0.085, P < .0001), compared to subjects not sensitized. Subjects with acquired or persistent allergic sensitization were also had higher odds for persistence of disease (yes-yes) than subjects not sensitized (acquisition, OR=5.49, P = .0001; persistence, OR=11.79, P < .0001). CONCLUSION:Transition of allergic sensitizations to common allergens is a prognostic factor for subsequent or concurrent transition of eczema, asthma, and rhinitis. Prevention or reduction in allergic sensitization has a potential to lead to remission of these conditions.

Project description:BackgroundPrevious studies have shown the increasing prevalence of childhood asthma around the world as well as in China. Nevertheless, little is known about the epidemiology of asthma in preschool children. Thus, the present study investigated the prevalence and severity of asthma in Shanghai, China, and identified related risk factors for asthma in children at the age of 3-6.MethodsInformation was obtained through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Risk factor analysis was carried out using univariate and multivariate logistic regression. The odds ratio (OR)/adjusted odds ratio (aOR) and the 95% confidence interval (CI) were determined.ResultsA total of 6,183 children (3,165 boys and 3,018 girls) covering 12 communities were included in our study, with an average age of 4.2 ± 0.7 years. The prevalence of ever asthma, current asthma, and physician-diagnosed asthma was 16.0, 11.2, and 5.3%, respectively. Parental allergic history, including rhinitis and asthma, was significantly associated with asthma symptoms. The strongest association with current asthma was paternal asthma (aOR = 5.91, 95% CI 3.87-9.01), and maternal asthma had the second strongest association with current asthma (3.85; 2.40-6.17). Among personal factors, allergic rhinitis history, eczema history, food allergy history, and antibiotic use in the first year of life were significantly associated with current asthma (aOR = 1.89, 95% CI 1.52-2.34; aOR = 1.34, 95% CI 1.09-1.64; aOR = 1.68, 95% CI 1.37-2.06; aOR = 1.53, 95% CI 1.25-1.87, respectively). More than once paracetamol use per year and per month were associated with current asthma in a dose-response manner. Additionally, female sex was an independent protective factor for ever asthma (0.82; 0.70-0.96). Among environmental factors, dampness or mildew at home was an independent risk factor for ever asthma (1.50; 1.15-1.97) and current asthma (1.63; 1.21-2.19). Floor heating system was significantly associated with ever asthma (1.57; 1.25-1.98) and current asthma (1.36; 1.04-1.78). Furthermore, dampness or mildew, infrequent house cleaning, and truck traffic in residential streets were significantly associated with asthma symptoms only in old communities, while paracetamol use in the first year of life and flooring materials were significant factors only in new communities.ConclusionThe prevalence of asthma has increased among preschool children in Shanghai over the past three decades. The identified risk factors indicated the combined effects of genetic, personal, and environmental factors on asthma symptoms. Differentiated strategies should be taken for preventing asthma in old and new communities.

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Prevalence and risk factors for asthma, rhinitis, eczema, and atopy among preschool children in an Andean city.

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Prevalence and risk factors for asthma, rhinitis, eczema, and atopy among preschool children in an Andean city.

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