Allergic disorders and socio‐economic status: a study of schoolchildren in an urban area of Makassar, Indonesia

Abstract

SummaryBackground In urban centres of developing countries, there is great variation in socioeconomic status (SES) and lifestyle; however, little information is available on allergic disorders in groups with high-or low-SES within the same urban area. Objective To determine the prevalence of allergic disorders and investigate risk factors related to them among high-and low-SES schoolchildren in Makassar, the capital city of South Sulawesi, Indonesia. Method This cross-sectional study was performed in 623 children originating from high-(N = 349) and low-SES (N = 274) schools. Information on reported allergic symptoms and potential factors associated with allergic disorders was obtained by questionnaire. Specific IgE and skin prick test (SPT) reactivity were determined against aeroallergens [Dermatophagoides pteronyssinus (HDM) and cockroach]. Total IgE and helminth infections were also assessed. Result The prevalence of SPT to any aeroallergens was significantly higher in high-SES than in low-SES school (25% vs. 8%, P < 0.001, respectively). However, specific IgE against cockroach and total IgE were significantly lower in high-than in low-SES children. Allergic symptoms were reported more often in low-compared to high-SES children. Specific IgE to aeroallergens significantly increased the risk of SPT positivity to the same aeroallergen in the high-, but not in the low-SES children. In the high-but not in low-SES, there was a significant positive association between SPT to HDM and wheeze. Similarly, cockroach skin reactivity and elevated BMI increased the risk of eczema in the high-SES children only. Conclusion and Clinical Relevance Skin prick test is higher in high-SES, whereas IgE and allergic symptoms are higher in low-SES children. Specific IgE is a risk factor for being SPT-positive, and SPT positivity is a risk factor for allergic symptoms but only in children of high-and not low-SES school. Therefore, the socio-economic status of a child might affect the diagnosis of allergic disease in a developing country.

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