Prevalence of wheeze and asthma and relation to atopy in urban and rural Ethiopia

Yemaneberhan, Haile; Bekele, Zegeye; Venn, Andrea; Lewis, Sarah; Parry, Eldryd; Britton, John

doi:10.1016/s0140-6736(97)01151-3

Cited by 325 publications

(266 citation statements)

References 26 publications

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“…5,30,31 In contrast, asthma remains uncommon in rural areas of the world where physical exercise such as walking is a part of daily life, and children spend less time watching television. 27,[32][33][34] We believe that this relationship between sedentary lifestyle and increased wheezing bears additional investigation.…”

Section: Discussionmentioning

confidence: 91%

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Asthma Hospitalization Trends in Charleston, South Carolina, 1956 to 1997: Twenty-fold Increase Among Black Children During a 30-Year Period

et al. 2001

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ABSTRACT. Objective. The increase in asthma prevalence has been documented worldwide, affecting many races living in many different climates. Multiple studies have demonstrated that the most striking prevalence and morbidity of asthma in the United States has been in black children, but little research has determined the scale of the increase, or specifically when the disease became severe in this group. This study sought to determine exactly when the rise in asthma hospitalizations among black patients began and what the pattern of asthma hospitalizations has been in different races and age groups over a 40-year period in 1 urban area.Methods. A retrospective chart review of discharges from the Medical University of South Carolina was conducted from 1956 to 1997. Charts with the primary discharge diagnosis of asthma were examined for discharge date, race, and age group (0-to 4-year-olds, 5-to 18-yearolds, 19-to 50-year-olds, >51-year-olds). The diagnostic codes used were based on the International Classification of Diseases (ICD)-6, 1956 -1957; ICD-7, 1958 -1967; ICD-8, 1968 -1978; and ICD-9, 1979 -1997. Over the period studied, this hospital was the primary inpatient provider for children in this area, and the only provider for uninsured children. Between 1960 and 1990, the racial makeup of the area remained stable, as did the percentage of blacks living at the poverty level. The raw number of asthma discharges, rate per 10 000 discharges of the same race, and rate per 100 000 population in Charleston County were tabulated for each age group and racial category.Results. Over the time period examined, there has been a progressive increase in asthma hospitalizations in black individuals of all age groups and in whites under 18 years. The most striking increase has been in black children 0 to 18 years old (Figure). The increase either as raw values or as a rate per 100 000 began around 1970, and was linear. This increase in black children discharged with asthma as a rate per 100 000 population was 20-fold: the rate increased from 18 in 1970 to 370 in 1997. Asthma discharges as a rate per 10 000 black children discharged increased by 24-fold from 1960 to 1997. Total discharges from the hospital increased from 49 000 to 128 000 per year over this period. Blacks made up only 28% of discharges in 1957, but that proportion increased to 56% in 1960 and remained relatively stable over the following 35 years. The increase seen in white children 0 to 18 years of age as a rate per 100 000 population was 5-fold and began around 1980. Both increases seem to be consistent over the time period studied, and continued to 1997.Conclusions. Among a predominantly poor black population living in a southern US city, there has been a steady increase in childhood asthma hospitalizations over the past 30 years. A significant although less dramatic rise has occurred in white children. Over this time period, although there have been many changes in lifestyle that could have contributed to this rise, there have been no major changes in hou...

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Section: Discussionmentioning

confidence: 91%

“…Indeed, in Africa and other developing countries, asthma is consistently a disease associated with affluence. 27 Several factors could contribute to a higher rate of asthma in poor urban communities such as Charleston. This population could be receiving less regular medical care, leading to more episodes of asthma requiring hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Asthma Hospitalization Trends in Charleston, South Carolina, 1956 to 1997: Twenty-fold Increase Among Black Children During a 30-Year Period

et al. 2001

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“…3,9 Many studies of allergic diseases show a rural environment to be protective but the mechanism of this effect is unknown. 10,11 There are conflicting reports on the effect of parasitic intestinal load in the pathogenesis of atopy, 12,13 and whether helminthiasis is protective 14,15 or a risk factor for allergy. 16 Anti-parasitic treatment was reported to improve the course of VKC in two case series, 8,17 and a hospital-based study in Nigeria showed that patients with VKC had a larger intestinal parasite load in their stools than unaffected controls.…”

Section: Introductionmentioning

confidence: 99%

Vernal Keratoconjunctivitis in School Children in Rwanda and Its Association with Socio-Economic Status: A Population-Based Survey

Smedt¹,

Nkurikiye²,

Fonteyne³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Vernal keratoconjunctivitis (VKC) is an allergic eye disease and an important cause of hospital referral among children in Africa and Asia. Hospital-based studies have suggested a role for parasites in its pathogenesis. To determine the prevalence and risk factors for VKC in Central Africa, we conducted a nested population-based case control study in Rwanda, involving randomly selected primary schools from different environments (rural/urban) and climate. A prevalence of VKC of 4.0% (95% confidence interval 3.3–4.7%) was found among 3,041 children studied (participation rate 94.7%). The intestinal parasitic burden was not related to VKC. Besides hot dry climate (odds ratio [OR] = 1.5, P = 0.05) and male gender (OR = 1.7, P = 0.005), multivariate analysis identified higher economic status as a risk for VKC (OR = 1.4, P = 0.005). The effect on VKC of higher economic status appears not to act through differences in parasitic intestinal load.

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“…In addition, several studies, most performed in the Tropics, have provided further evidence that atopic disorders occur more commonly among individuals living in urban, more affluent and westernized areas as compared with those living in rural areas with traditional lifestyle (22)(23)(24)(25)(26). As to sub-Saharan Africa, the situation appears to be more complex.…”

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confidence: 99%

Asthma and atopy – the price of affluence?

Hertzen

Haahtela²

2004

Allergy

121

110

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Irrespective of improved knowledge of many aspects of atopic diseases, the unfavorable trends in their prevalence particularly among children could not have been reversed. A growing body of evidence suggests that something may lack from our societal affluence that has the capacity to provide protection against the development of atopic diseases. Much attention during the last years has been devoted to the hygiene hypothesis. This review outlines the impact of environment and lifestyle, particularly from the perspective of the East–West gradient, on the development of atopic diseases, with a special emphasis on the hygiene hypothesis in its broadest sense.

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Prevalence of wheeze and asthma and relation to atopy in urban and rural Ethiopia

Cited by 325 publications

References 26 publications

Asthma Hospitalization Trends in Charleston, South Carolina, 1956 to 1997: Twenty-fold Increase Among Black Children During a 30-Year Period

Asthma Hospitalization Trends in Charleston, South Carolina, 1956 to 1997: Twenty-fold Increase Among Black Children During a 30-Year Period

Vernal Keratoconjunctivitis in School Children in Rwanda and Its Association with Socio-Economic Status: A Population-Based Survey

Asthma and atopy – the price of affluence?

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