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Hay fever, asthma, and eczema and early infectious diseases among children in Kilimanjaro, Tanzania.
Am J Hum Biol. 2017 May 06; 29(3)AJ

Abstract

OBJECTIVES

To investigate the hygiene (or "old friends") hypothesis in a high-infectious disease (ID) environment, rural Kilimanjaro, Tanzania.

METHODS

Among a cross-sectional sample of 2- to 7-year-old children, we collected physician-diagnosed hay fever, asthma, and eczema, history of hospitalization, family size, and household environment information via questionnaire; performed active and passive surveillance for ID; and, evaluated total immunoglobulin E (IgE) and biomarkers of inflammation in dried blood spot specimens. We used regression models to describe patterns in allergic diseases.

RESULTS

Complete information was available for 280 children: 12.5% had been diagnosed with hay fever; 18.9% with eczema; 2.1% with asthma. There was a positive association between hay fever and eczema diagnoses (π2 : 4.07; P = 0.044); total IgE was positively associated with eczema (β: 0.24; P = 0.100) and allergic diseases together (β: 0.26; P = 0.042). ID were common: the incidence of any ID diagnosis was 28 per 100 children per month. Hay fever was inversely associated with household animals (OR: 0.27; P = 0.006), and positively associated with earth housing materials (OR: 1.93; P = 0.079) and hospitalization in infancy with an ID (3.16; P = 0.066); patterns were similar when allergic disease outcomes were considered together. Few associations between these predictors and eczema or asthma alone were apparent.

CONCLUSIONS

Allergic diseases were common among children in Kilimanjaro. The inverse association between household animals and allergy is consistent with the hygiene/old friends hypothesis; however, positive associations between allergic diseases and earth housing materials and early hospitalization with ID bear further explanation.

Authors+Show Affiliations

Department of Anthropology, Binghamton University (SUNY), Binghamton, New York, 13902. Department of Anthropology, University of Washington, Seattle, Washington, 98195. Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, 98195.Department of Anthropology, University of Washington, Seattle, Washington, 98195. Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, 98195.Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, 98195.Department of Anthropology, University of Washington, Seattle, Washington, 98195. Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, 98195.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28083975

Citation

Wander, Katherine, et al. "Hay Fever, Asthma, and Eczema and Early Infectious Diseases Among Children in Kilimanjaro, Tanzania." American Journal of Human Biology : the Official Journal of the Human Biology Council, vol. 29, no. 3, 2017.
Wander K, Shell-Duncan B, Brindle E, et al. Hay fever, asthma, and eczema and early infectious diseases among children in Kilimanjaro, Tanzania. Am J Hum Biol. 2017;29(3).
Wander, K., Shell-Duncan, B., Brindle, E., & O'Connor, K. (2017). Hay fever, asthma, and eczema and early infectious diseases among children in Kilimanjaro, Tanzania. American Journal of Human Biology : the Official Journal of the Human Biology Council, 29(3). https://doi.org/10.1002/ajhb.22957
Wander K, et al. Hay Fever, Asthma, and Eczema and Early Infectious Diseases Among Children in Kilimanjaro, Tanzania. Am J Hum Biol. 2017 May 6;29(3) PubMed PMID: 28083975.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hay fever, asthma, and eczema and early infectious diseases among children in Kilimanjaro, Tanzania. AU - Wander,Katherine, AU - Shell-Duncan,Bettina, AU - Brindle,Eleanor, AU - O'Connor,Kathleen, Y1 - 2017/01/13/ PY - 2016/03/25/received PY - 2016/08/24/revised PY - 2016/12/13/accepted PY - 2017/1/14/pubmed PY - 2018/2/1/medline PY - 2017/1/14/entrez JF - American journal of human biology : the official journal of the Human Biology Council JO - Am J Hum Biol VL - 29 IS - 3 N2 - OBJECTIVES: To investigate the hygiene (or "old friends") hypothesis in a high-infectious disease (ID) environment, rural Kilimanjaro, Tanzania. METHODS: Among a cross-sectional sample of 2- to 7-year-old children, we collected physician-diagnosed hay fever, asthma, and eczema, history of hospitalization, family size, and household environment information via questionnaire; performed active and passive surveillance for ID; and, evaluated total immunoglobulin E (IgE) and biomarkers of inflammation in dried blood spot specimens. We used regression models to describe patterns in allergic diseases. RESULTS: Complete information was available for 280 children: 12.5% had been diagnosed with hay fever; 18.9% with eczema; 2.1% with asthma. There was a positive association between hay fever and eczema diagnoses (π2 : 4.07; P = 0.044); total IgE was positively associated with eczema (β: 0.24; P = 0.100) and allergic diseases together (β: 0.26; P = 0.042). ID were common: the incidence of any ID diagnosis was 28 per 100 children per month. Hay fever was inversely associated with household animals (OR: 0.27; P = 0.006), and positively associated with earth housing materials (OR: 1.93; P = 0.079) and hospitalization in infancy with an ID (3.16; P = 0.066); patterns were similar when allergic disease outcomes were considered together. Few associations between these predictors and eczema or asthma alone were apparent. CONCLUSIONS: Allergic diseases were common among children in Kilimanjaro. The inverse association between household animals and allergy is consistent with the hygiene/old friends hypothesis; however, positive associations between allergic diseases and earth housing materials and early hospitalization with ID bear further explanation. SN - 1520-6300 UR - https://www.unboundmedicine.com/medline/citation/28083975/Hay_fever_asthma_and_eczema_and_early_infectious_diseases_among_children_in_Kilimanjaro_Tanzania_ L2 - https://doi.org/10.1002/ajhb.22957 DB - PRIME DP - Unbound Medicine ER -