Prevalence of Asthma in the South Fore People of the Okapa District of Papua New Guinea

Turner, Keven J.; Dowse, Gary K.; Stewart, Geoffrey A.; Alpers, Michael P.; Woolcock, Ann J.

doi:10.1159/000233772

Cited by 17 publications

(17 citation statements)

References 5 publications

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“…The hypothesis that parasitosis can provide immunological protection against asthma has been entertained over several decades in the context of the low rates of childhood asthma previously reported for low-income countries [13]. The fact that rates of parasitization have been shown to be comparable in asthmatic and nonasthmatic subjects has been cited as evidence, not necessarily conclusive, against this hypothesis [33,34].…”

Section: Discussionmentioning

confidence: 99%

“…Another change in lifestyle that may have led to an introduction of house dust mites into sleeping quarters is the replacement of the traditional floor mats by blankets and mattresses. This has been offered as an explanation for the relatively sudden increase in asthma in all ages in Papua New Guinea from 0.9% in 1972 [12] to 7.3% in 1984 [13]. Urban studies in Kenyan adults [14] and Tanzanian children [15] show that asthma patients exhibit a high A respiratory health and home environment questionnaire was administered at school to parents or guardians.…”

Section: Aamentioning

confidence: 99%

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Urban-rural differences in questionnaire-derived markers of asthma in Kenyan school children

Ja¹,

LW²,

Mw³

et al. 1998

Eur Respir J

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Grade 4 Kenyan children attending 10 randomly selected public primary schools in Nairobi (urban) and the Muranga District (rural) were surveyed to establish the prevalence of symptom markers of asthma and to assess the impact of urbanization. A respiratory health and home environment questionnaire was administered at school to parents or guardians. The questionnaire response rates were 94.2% (568/ 603) for Nairobi and 89.6% (604/674) for Muranga. The prevalence rates for asthma, defined as "attacks of shortness of breath with wheeze", were 95% for urban and 3.0% for rural children (odds ratio (OR) urban versus rural: 3.42; 95% confidence interval (CI): -1.96-5.91). This urban-rural gradient persisted after adjusting for urban-rural differences in host factors (including duration of breastfeeding and family history of asthma and/or allergy), but was largely explained by urban-rural differences in environmental factors, including indoor animals, sharing a bedroom with a smoker, parental education, house ventilation and exposure to motor vehicle fumes en route to school (adjusted OR: 1.59; 95% CI: 0.70-3.55). Similar results were obtained for all other symptoms. These findings confirm the clinical impression that asthma is an important illness in Kenya and underline the need for the further study of environmental factors amenable to intervention, particularly in urban areas.

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Section: Discussionmentioning

confidence: 99%

Section: Aamentioning

confidence: 99%

Urban-rural differences in questionnaire-derived markers of asthma in Kenyan school children

Ja¹,

LW²,

Mw³

et al. 1998

Eur Respir J

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“…Among the Fore people of New Guinea, asthma appeared first in adults returning to villages after working in a Europeaninfluenced city. Only thereafter did it appear in children (10). Similarly, in a Xhosa village in South Africa, asthma first appeared in students educated in Cape Town, and increased in prevalence among the other villagers sharply after their return (11).…”

Section: Asthma As a Transmissible Diseasementioning

confidence: 99%

Microbial Manipulation of Immune Function for Asthma Prevention: Inferences from Clinical Trials

Yoo

Tcheurekdjian

Lynch

et al. 2007

Proceedings of the American Thoracic Society

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The "hygiene hypothesis" proposes that the increase in allergic diseases in developing countries reflects a decrease in infections during childhood. Cohort studies suggest, however, that the risks of asthma are increased in children who suffer severe illness from a viral respiratory infection in infancy. This apparent inconsistency can be reconciled through consideration of epidemiologic, clinical, and animal studies. The elements of this line of reasoning are that viral infections can predispose to organ-specific expression of allergic sensitization, and that the severity of illness is shaped by the maturity of immune function, which in turn is influenced by previous contact with bacteria and viruses, whether pathogenic or not. Clinical studies of children and interventional studies of animals indeed suggest that the exposure to microbes through the gastrointestinal tract powerfully shapes immune function. Intestinal microbiota differ in infants who later develop allergic diseases, and feeding Lactobacillus casei to infants at risk has been shown to reduce their rate of developing eczema. This has prompted studies of feeding probiotics as a primary prevention strategy for asthma. We propose that the efficacy of this approach depends on its success in inducing maturation of immune function important in defense against viral infection, rather than on its effectiveness in preventing allergic sensitization. It follows that the endpoints of studies of feeding probiotics to infants at risk for asthma should include not simply tests of responsiveness to allergens, but also assessment of intestinal flora, immune function, and the clinical response to respiratory viral infection.Keywords: asthma; gastrointestinal; lactobacilli; microbes; prevention The purpose of this review is to sketch the rationale for a theory of asthma's pathogenesis. The proposed theory is that asthma is caused, at least in part, by infection, especially in infancy, by a respiratory virus, most likely a human rhinovirus (HRV). The development of asthma may thus be a function of the "asthmagenic" pathogenicity of the strains of RV causing asthma in infancy and of the efficacy of antiviral immune function at the time of infection. This review notes how the validity of this theory might be examined by adding additional outcomes to ongoing trials of feeding a "probiotic," like Lactobacillus casei, to infants as a primary prevention strategy for allergic disease. Space constraint does not permit more than a brief, partial review

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“…Studies from industrialized countries all over the world indicate an increasing prevalence of allergic diseases and atopy during recent decades [1-8]. Allergies are becoming a more and more serious problem in most modern societies.…”

Section: Introductionmentioning

confidence: 99%

Western Lifestyle and Increased Prevalence of Atopic Diseases

Herbert

Barnetson

Weninger

et al. 2009

World Allergy Organization Journal

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BackgroundAllergic diseases represent an increasing problem in public health in most modern societies as their prevalence has risen markedly during recent decades. Nevertheless, the causes of this increase are not yet fully explained.ObjectiveWe investigated the correlation of Western lifestyle pattern in varying intensity to the prevalence of atopic diseases in 5 small villages on Karkar Island, in northeast Papua New Guinea.MethodsTwo hundred forty-eight native people from 5 villages on tropical Karkar Island have been included in this study. The degree of Western lifestyle was assessed (questionnaire and observation) for each village. The prevalence of atopic diseases was evaluated by personal and family history, physical and dermatological examination, skin prick test (10 allergens), and measurement of total and specific immunoglobulin E levels (20 common allergens).ResultsThe more easily accessible and thus more "modern" and westernized coastal villages showed a significantly higher prevalence of habitants suffering from atopic diseases than a traditional mountain village (6.8% vs 0.0%, P = 0.034, Fisher exact test). A total of 4.4% (11/248) of the examined islanders suffered from an atopic disease. Atopic eczema seems to be absent on Karkar Island.ConclusionsThe results of this study suggest that so-called Western lifestyle may contribute to the development of atopic diseases.

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Prevalence of Asthma in the South Fore People of the Okapa District of Papua New Guinea

Cited by 17 publications

References 5 publications

Urban-rural differences in questionnaire-derived markers of asthma in Kenyan school children

Urban-rural differences in questionnaire-derived markers of asthma in Kenyan school children

Microbial Manipulation of Immune Function for Asthma Prevention: Inferences from Clinical Trials

Western Lifestyle and Increased Prevalence of Atopic Diseases

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