Effect of body mass on exercise-induced bronchospasm and atopy in African children

Calvert, James; Burney, Peter

doi:10.1016/j.jaci.2005.05.025

Cited by 51 publications

(55 citation statements)

References 35 publications

(25 reference statements)

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“…[19] While worldwide the relationship between socioeconomic status and childhood asthma is mixed, two of three SA studies found that greater socioeconomic deprivation is associated with lower childhood asthma rates. [5,6] This study supports this conclusion, finding that more severe household poverty was associated with lower asthma prevalence. Mediation analysis revealed a more complex story: living in more severely impoverished households was associated with more outdoor housework and in turn lower odds of having asthma; however, it was also associated with greater anxiety and in turn higher odds of having asthma.…”

Section: Discussionsupporting

confidence: 85%

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Socioeconomic factors associated with asthma prevalence and severity among children living in low-income South African communities

2016

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Background. Rates of asthma, poverty and social deprivation are high among young people in South Africa (SA), yet asthma interventions largely remain focused on biomedical factors. Objective. To investigate associations between socioeconomic factors and childhood asthma. Methods. We recruited 6 002 children aged 10 -17 years from six low-income urban and rural sites in three SA provinces. Self-report questionnaires measured health status, sociodemographics and socioeconomic factors. Logistic regression and mediation analyses were used to test models of risk factors for asthma prevalence and severity (frequency of attacks). Results. Child anxiety (odds ratio (OR) 1.08; 95% confidence interval (CI) 1.04 -1.12) and community violence (OR 1.14; 95% CI 1.00 -1.30) were associated with increased odds of having asthma. Children doing more outdoor housework (OR 0.83; 95% CI 0.71 -0.98) and living in greater poverty (OR 0.93; 95% CI 0.88 -0.99) had lower odds of having asthma. Severe asthma was predicted by child depression (OR 1.14; 95% CI 1.03 -1.26) and greater household poverty (OR 1.14; 95% CI 1.01 -1.28). Most socioeconomic factors operated in 'risk pathways' , wherein structural factors (e.g. urban living) were associated with individual factors (e.g. fewer outdoor tasks), which predicted greater odds of having asthma or severe exacerbations. Conclusions. This study suggests the need to consider the context of childhood asthma in SA for improved prevention and treatment. A multidisciplinary approach may be more effective than a biomedical model, given the plausible effects of psychosocial stress and poverty on asthma outcomes.

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Section: Discussionsupporting

confidence: 85%

“…These found either that better socioeconomic circum stances (e.g. higher income, employment) are related to a higher prevalence of childhood asthma, [5,6] or no association. [7] In contrast, the only study that investigated disease severity found that the prevalence of frequent asthma symptoms (monthly or more) increased with socioeconomic deprivation.…”

mentioning

confidence: 98%

Socioeconomic factors associated with asthma prevalence and severity among children living in low-income South African communities

2016

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“…17,22,83,84 Furthermore, the values of EIB may be limited by environmental factors such as temperature, humidity, or air pollution. 17,22,85 …”

mentioning

confidence: 99%

The impact of asthma and COPD in sub-Saharan Africa

Gemert

Molen

Jones

et al. 2011

Primary Care Respiratory Journal

117

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“…[17] Multiple factors have been implicated such as dietary changes, a more closed indoor climate, physical in-activity, electrification and medication. Other factors that deserve consideration are that an increased body mass index may lead to an increased prevalence of atopic disease, [18] while prolonged breastfeeding has a protective effect in the development of allergic disease. [19] Exposure to environmental tobacco smoke has an adverse effect on lung function in asthmatic children.…”

Section: Fig 4 Association Between Maternal Allergy and Childhood Amentioning

confidence: 99%

A case for revising the strength of the relationship between childhood asthma and atopy in the developing world

et al. 2013

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Introduction. Asthma is the commonest chronic condition of children. Diagnosis remains difficult and many surrogate markers are used, such as documenting evidence of atopy. Method. Two studies investigated the role of atopy in childhood asthma. The first documented the prevalence and nature of allergy sensitivities in a group of asthmatic children compared with non-asthmatic children in Pretoria, South Africa. The second enrolled a random sample of asthmatic children and their mothers attending the Children's Chest and Allergy Clinic at Steve Biko Academic Hospital, Pretoria. Children were classified as having atopic or non-atopic asthma. Mothers completed a questionnaire to reveal atopic features. Results. In the first study, only 45.0% of asthmatic children had a positive skin-prick test (SPT), as opposed to 16.2% of control children. This is a lower proportion than in many reported international studies. In the second study, 64 children with atopic asthma and 36 with non-atopic asthma were studied, along with their mothers. The proportion of children with atopic asthma did not differ for mothers with and without a positive SPT (p=0.836), a history of asthma (p=0.045) or symptoms suggestive of an allergic disease (p=1.000), or who were considered to be allergic (p=0.806). The odds ratio (OR) of a child having atopic asthma when he or she had a mother with a doctordiagnosed history of asthma was 4.76, but the sensitivity was low (21.9%).Conclusion. The data demonstrate that fewer asthmatic children in South Africa are atopic than was previously thought. Also, all maternal allergic or asthmatic associations are poor predictors of childhood atopic asthma. Despite the increased risk of atopic asthma in a child of a mother who has a doctor diagnosis of asthma (OR 4.76; p=0.045), this is a poor predictor of atopic asthma (sensitivity 21.9%).

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Effect of body mass on exercise-induced bronchospasm and atopy in African children

Cited by 51 publications

References 35 publications

Socioeconomic factors associated with asthma prevalence and severity among children living in low-income South African communities

Socioeconomic factors associated with asthma prevalence and severity among children living in low-income South African communities

The impact of asthma and COPD in sub-Saharan Africa

A case for revising the strength of the relationship between childhood asthma and atopy in the developing world

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