BackgroundIn recent years, the prevalence of asthma, rhinoconjunctivitis and eczema symptoms in childhood has considerably increased in developing countries including Bolivia, possibly due to changes in lifestyle, environmental and domestic factors. This study aimed to assess the association between environmental factors and asthma, rhinoconjuctivitis and eczema symptoms in school-aged children from Oropeza Province in Chuquisaca, Bolivia.MethodsA cross-sectional study was performed in 2340 children attending the fifth grade in 36 randomly selected elementary schools in Oropeza province. The prevalence of symptoms was determined using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Environmental factors were assessed by the ISAAC environmental questionnaire including questions related to exposure to pets, farm animals, indoor and outdoor pollution, presence of disease vectors at home and precarious household conditions. Generalized linear mixed-effects models were adjusted for age, sex and place of living.ResultsThirty seven percent of children reported that at least one of their parents smoked at home. Wood or coal was used as cooking fuel in 19% of the homes and 29% reported intense truck traffic on the street where they lived. With respect to hygiene conditions, 86% reported exposure to dogs, 59% exposure to cats and 36% regular contact to farm animals. More than one precarious household condition was reported by 8% of children. In the adjusted model exposure to dog (adjusted OR 1.4; CI 95% 1.0-1.9), cat (1.2; 1.0-1.5), farm animals (1.5; 1.2-1.8); intense truck traffic (1.3; 1.0-1.6), parents smoking at home (1.2; 1.0-1.5), presence of disease vectors at home (fourth quartile vs. first quartile: 1.6; 1.2-2.3) and two or more precarious household conditions (1.5; 1.0-2.2) were significantly associated with rhinoconjunctivitis symptoms. The associations were similar for asthma and eczema symptoms; however it did not reach the level of statistical significance for all items.ConclusionOur results support previous findings reported for poor communities especially in Latin America, showing that lower hygiene conditions did not have protective effect against asthma and rhinoconjunctivitis and eczema symptoms.

BackgroundAsthma and allergies are world-wide common chronic diseases among children and young people. Little information is available about the prevalence of these diseases in rural areas of Latin America. This study assesses the prevalence of symptoms of asthma and allergies among children in urban and rural areas at Oropeza Province in Bolivia.MethodsThe Spanish version of the ISAAC standardized questionnaire and the ISAAC video questionnaire were implemented to 2584 children attending the fifth elementary grade in 36 schools in Oropeza province (response 91%). Lifetime, 12 months and severity prevalence were determined for asthma, rhinitis and eczema symptoms. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated adjusting for age using generalized linear mixed-effects models.ResultsMedian age of children was 11 years, 74.8% attended public schools, and 52.1% were female. While children attending urban schools had lower prevalence of self-reported wheeze in the written questionnaire (adjusted OR 0.6; 95% CI 0.4-1.9), they were more likely than children attending rural schools to report wheeze in the video questionnaire (aOR 2.1; 95% CI 1.0-2.6). They also reported more frequently severe rhinoconjunctivitis (aOR 2.8; 95% CI 1.2-6.6) and severe eczema symptoms (aOR 3.3; 95% CI 1.0-11.0).ConclusionOverall in accordance with the hygiene hypothesis, children living in urban areas of Bolivia seem to have a higher prevalence of symptoms of asthma and allergies compared to children living in the country side. In order to develop primary prevention strategies, environmental factors need to be identified in future studies.

Background: Several studies have linked dietary intake and asthma symptoms, nevertheless the results are still inconclusive and data from developing country are scarce. Objective: To assess the association of Food patterns and current asthma symptoms in school-aged children from rural and urban areas of Oropeza Province-Bolivia. Methods: A total of 1655 children attending the fi fth elementary grade were invited to participate in a cross-sectional study in rural and urban areas of Oropeza province. Current Asthma symptoms were defi ned following the International Study of Asthma and Allergies in Childhood (ISSAC) recommendation (written and video questionnaire). Food patterns were defi ned using the ISAAC environmental questionnaire. The Mediterranean diet (MD) score was calculated based on this information. Crude and adjusted logistic regression models were calculated including age, sex and place of living. Results: The age range was between 9-15 years (Median 11), and 47.9% were male. Current asthma symptoms were reported in a 17% considering the written questionnaire (WQ) and in a 6% considering the video questionnaire (VQ). Higher consumption of nuts [(p=0.01, aOR= 1.6(1.1-2.2)], corn [(p=0.03, aOR= 1.5(1.0-2.2)] and fast food [(p=0.06, aOR= 1.4(1.0-2.0)] showed positive association with current asthma symptoms. Greater adherence to the MD was associated with lower risk of asthma symptoms. Conclusion: Promotion of healthy food patterns in children is needed in order to avoid the rapid increase of non-communicable diseases in this region.