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Risk factors for asthma in urban Ghana.
J Allergy Clin Immunol. 2001 Sep; 108(3):363-8.JA

Abstract

BACKGROUND

Asthma is increasing in prevalence and severity in Africa. Previous studies have suggested that the prevalence of atopy in West Africa was low.

OBJECTIVE

We sought to investigate the risk factors for asthma in Ghanaian school children.

METHODS

Fifty children (age range, 9-16 years) with a physician diagnosis of asthma and asthma symptoms within the previous 12 months and 50 age- and sex-matched healthy control subjects were randomly selected and evaluated by means of questionnaire, skin testing, total and specific IgE measurements, and allergen level measurements from bed dust samples (mite, cat, dog, and cockroach).

RESULTS

Asthmatic children were exposed to higher levels of mite allergens than were control children (geometric mean, 19 microg/g [95% CI, 13.6-26.5] vs. 11.2 microg/g [7.4-15.7]; P <.05). Cat and dog allergen levels were low. There was a marked dissociation between skin test responses and the presence of specific IgE to cat and dog (CAP method). However, 84% of subjects with positive cat dander-specific IgE levels in cat CAP tests and negative skin test responses did not have Fel d 1-specific IgE (chimeric ELISA). In the univariate analysis significant associations with the patient group were found for sensitization to mite (odds ratio [OR], 9.3; 95% CI, 3.7-23.4) and cockroach (OR, 3.9; 95% CI, 1.3-11.6), inner-city residence (OR, 3.5; 95% CI, 1.4-8.9), asthma in family member (OR, 3.5; 95% CI, 1.4-9.0), low (<5) position in sibship (OR, 3.6; 95% CI, 1.2-11), presence of smoker in home (OR, 3.7; 95% CI, 1.2-11.9), small household size (OR, 0.57; 95% CI, 0.35-0.93), and use of electricity as domestic fuel (OR, 0.34; 95% CI, 0.12-0.97). In the multivariate analysis sensitization to mites remained the strongest risk factor associated with the asthmatic group (OR, 10.4; 95% CI, 3.5-30.9). The other significant associations were inner-city residence (OR, 4.8; 95% CI, 1.5-5.2), sensitization to cockroach (OR, 4.9; 95% CI, 1.3-18.6), and position in sibship of less than 5 (OR, 6.3; 95% CI, 1.3-29.4).

CONCLUSION

Sensitization to dust mite and cockroach allergens, inner-city residence, and low position in sibship were independent risk factors for asthma in Ghanaian children.

Authors+Show Affiliations

Department of Child Health, Komfo Anokye Teaching Hospital, PO Box 1934, Kumasi, Ghana.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11544454

Citation

Addo-Yobo, E O., et al. "Risk Factors for Asthma in Urban Ghana." The Journal of Allergy and Clinical Immunology, vol. 108, no. 3, 2001, pp. 363-8.
Addo-Yobo EO, Custovic A, Taggart SC, et al. Risk factors for asthma in urban Ghana. J Allergy Clin Immunol. 2001;108(3):363-8.
Addo-Yobo, E. O., Custovic, A., Taggart, S. C., Craven, M., Bonnie, B., & Woodcock, A. (2001). Risk factors for asthma in urban Ghana. The Journal of Allergy and Clinical Immunology, 108(3), 363-8.
Addo-Yobo EO, et al. Risk Factors for Asthma in Urban Ghana. J Allergy Clin Immunol. 2001;108(3):363-8. PubMed PMID: 11544454.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for asthma in urban Ghana. AU - Addo-Yobo,E O, AU - Custovic,A, AU - Taggart,S C, AU - Craven,M, AU - Bonnie,B, AU - Woodcock,A, PY - 2001/9/7/pubmed PY - 2001/10/12/medline PY - 2001/9/7/entrez SP - 363 EP - 8 JF - The Journal of allergy and clinical immunology JO - J Allergy Clin Immunol VL - 108 IS - 3 N2 - BACKGROUND: Asthma is increasing in prevalence and severity in Africa. Previous studies have suggested that the prevalence of atopy in West Africa was low. OBJECTIVE: We sought to investigate the risk factors for asthma in Ghanaian school children. METHODS: Fifty children (age range, 9-16 years) with a physician diagnosis of asthma and asthma symptoms within the previous 12 months and 50 age- and sex-matched healthy control subjects were randomly selected and evaluated by means of questionnaire, skin testing, total and specific IgE measurements, and allergen level measurements from bed dust samples (mite, cat, dog, and cockroach). RESULTS: Asthmatic children were exposed to higher levels of mite allergens than were control children (geometric mean, 19 microg/g [95% CI, 13.6-26.5] vs. 11.2 microg/g [7.4-15.7]; P <.05). Cat and dog allergen levels were low. There was a marked dissociation between skin test responses and the presence of specific IgE to cat and dog (CAP method). However, 84% of subjects with positive cat dander-specific IgE levels in cat CAP tests and negative skin test responses did not have Fel d 1-specific IgE (chimeric ELISA). In the univariate analysis significant associations with the patient group were found for sensitization to mite (odds ratio [OR], 9.3; 95% CI, 3.7-23.4) and cockroach (OR, 3.9; 95% CI, 1.3-11.6), inner-city residence (OR, 3.5; 95% CI, 1.4-8.9), asthma in family member (OR, 3.5; 95% CI, 1.4-9.0), low (<5) position in sibship (OR, 3.6; 95% CI, 1.2-11), presence of smoker in home (OR, 3.7; 95% CI, 1.2-11.9), small household size (OR, 0.57; 95% CI, 0.35-0.93), and use of electricity as domestic fuel (OR, 0.34; 95% CI, 0.12-0.97). In the multivariate analysis sensitization to mites remained the strongest risk factor associated with the asthmatic group (OR, 10.4; 95% CI, 3.5-30.9). The other significant associations were inner-city residence (OR, 4.8; 95% CI, 1.5-5.2), sensitization to cockroach (OR, 4.9; 95% CI, 1.3-18.6), and position in sibship of less than 5 (OR, 6.3; 95% CI, 1.3-29.4). CONCLUSION: Sensitization to dust mite and cockroach allergens, inner-city residence, and low position in sibship were independent risk factors for asthma in Ghanaian children. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/11544454/Risk_factors_for_asthma_in_urban_Ghana_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(01)16700-X DB - PRIME DP - Unbound Medicine ER -