Association between previous enterobiasis and current wheezing: Evaluation of 1018 children

Abstract

The aim of this study was to investigate the association between parasitosis and allergy. We surveyed all children aged 4-12 years living in poor hygienic conditions in a shantytown of Istanbul. After obtaining data from the International Study of Asthma and Allergies in Childhood (ISAAC) and an additional questionnaire, performing a skin-prick test (SPT), and determining total IgE, stool and perianal tape specimens were obtained from 1018 participating children. The prevalence of past episodes of wheezing, current wheezing, asthma, and rhinitis was 31, 14.6, 10.7, and 26.2%, respectively. Parasitosis was present in 49.1%, Enterobius vermicularis (23.3%), being the most common. A history of treatment for enterobiasis was present in 37%. Comparison of children with and without current enterobiasis revealed no significant difference in allergic manifestations and SPT results, except for serum total IgE level (p = 0.018), whereas children with previous enterobiasis were more likely to have current wheezing (p = 0.012). Current wheezers were more likely to have previous enterobiasis (p = 0.01) and a higher maternal employment level (p = 0.036) when compared with those without. According to logistic regression analysis, covariables significantly positively related with current wheezing were previous enterobiasis (p = 0.003) and being < or =5 years of age (p = 0.043), whereas being the first child of the family (p = 0.043) was negatively related. A previous infection with E. vermicularis was found to potentiate current wheezing in a population living in a shantytown in Istanbul.

Atopy and current intestinal parasite infection: a systematic review and meta‐analysis

“…The majority of studies were published within the past 10 years. As 19 of the 21 included studies were carried out in Central or South America or Africa, [the remaining two studies were from Vietnam (23) and Turkey (18)], our findings are particularly applicable to those regions of the world; though, there are no grounds to suggest that the findings will not be generalizable elsewhere where similar environmental conditions exist. While our primary analysis was for infection with any parasite, the majority of parasites were, in fact, geohelminths, and it may be that other parasite infections will demonstrate a different relationship with atopy but further studies are needed before any conclusions can be drawn.…”

“…Pooled results from the three studies of Schistosomiasis species (16, 17, 29) found current infection was associated with a statistically significant reduction in the odds of current atopy (OR 0.12, 95% CI 0.03–0.57; P = 0.007); however, the results from these studies were heterogeneous ( I 2 = 69%) and all three studies were scored as having lower methodological quality (Figs 6 and Table S1). No effect on the risk of current atopy was seen with E. vermicularis (18, 30), Giardia intestinalis (18), or Blastocystis hominis (18).…”

“…1). Sixteen of the included studies used a cross‐sectional design (16–30) (Obeng et al., unpublished data), four used case–control designs (31–34), and the remaining study was a randomized controlled trial from which we used the baseline data (35). No studies using a cohort design were found.…”

“…Eleven studies presented data using ‘any parasite infection’ as an exposure (18–22, 24, 26, 28, 30, 35) (Obeng et al., unpublished data), and these were used for our primary analysis; the remaining 10 studies had results only for species‐specific infection (16, 17, 23, 25, 27, 29, 31–34). A positive skin sensitization test was defined in one study as a saline‐adjusted wheal of ≥2 mm (32) and in another as ≥1 mm (31); all other included studies used adjusted wheal sizes of ≥3 mm (16, 18–30, 33–35) (Obeng et al., unpublished data) or ≥4 mm (17). Six studies presented results for sensitization to cockroach and mite separately (22, 23, 27, 32, 34) (Obeng et al., unpublished data).…”

“…The pooled analysis of estimates from the 11 studies using any combination of intestinal parasite infection (18–22, 24, 26, 28, 30, 35) (Obeng et al., unpublished data) demonstrated a reduction in the risk of atopy in individuals with any current intestinal parasite infection with an OR of 0.69 (95% CI 0.60–0.79; P < 0.01). Moderate levels of heterogeneity were observed across these studies ( I 2 = 45%).…”