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• Helminthiasis in children is positively associated with asthma. • The extent of helminth infestation is not associated with asthma. • Trichiuris trichura but no other helminths are associated with asthma. The association between helminthiasis and asthma remains inconclusive but can only be investigated in counties where helminthiasis is transitioning from a high to low burden. We investigated this association using data from a childhood respiratory cohort in Sri Lanka. A case-control study was nested within a population-based cohort of children aged 6-14 years in Sri Lanka. The stool samples of 190 children with asthma and 190 children without asthma were analyzed to assess the burden of helminth infestation. Logistic regression models were fitted to investigate the association of gastrointestinal helminth species with asthma. Helminthiasis in children with and without asthma was 23.3% (n = 44) and 15.3% (n = 23), respectively. Those with asthma were more likely to have helminthiasis (odds ratio 3.7; 95% confidence interval 1.7, 7.7; P = 0.001), particularly with Trichiuris trichura (odds ratio 4.5; 95% confidence interval 1.6, 12.3; P = 0.004). Helminth eggs per gram of feces were not associated with asthma (P >0.05). Our findings demonstrate a positive association between T. trichura infestation and asthma and point to the need to fully characterize this association to understand the likely immunological mechanism that drives it. This association highlights an important public health intervention in countries where these infestations are still prevalent, affecting 24% of the population worldwide. [ABSTRACT FROM AUTHOR]

Background and objective: Obstructive sleep apnoea (OSA) and asthma are associated, and nocturnal breathing difficulty that is usually identified as asthma‐like symptoms can be present in both conditions. We investigated how nocturnal asthma‐like symptoms (NAS) and bronchial hyper‐reactivity (BHR) contribute to the association between OSA risk and current asthma, which is currently unknown but a clinically important question. Methods: We used data from 794 middle‐aged participants in a population‐based cohort who provided information on OSA risk (defined by a STOP‐Bang questionnaire score of at least 3), current asthma and NAS, and underwent methacholine bronchial challenge testing. Using regression models, we examined the association between OSA risk and current asthma‐NAS subgroups and investigated any effect modification by BHR. Results: The participants were aged 50 years (49.8% male). OSA risk was associated with NAS with or without current asthma (odds ratio (OR): 2.6; 95% CI = 1.3–5.0; OR: 4.2; 95% CI = 1.1–16.1, respectively), but not with current asthma in the absence of NAS. BHR was associated with current asthma with or without NAS (OR: 2.9; 95% CI = 1.4–5.9; OR: 3.4; 95% CI = 2.0–7.0, respectively) but not with NAS in the absence of current asthma. The associations between OSA risk and current asthma were neither modified nor mediated by BHR. Conclusion: Our findings suggest that some of the nocturnal symptoms perceived as asthma may be OSA symptoms. Patients with nocturnal asthma symptoms should be considered for possible OSA. We assessed the roles of nocturnal asthma‐like symptoms (NAS) and bronchial hyper‐reactivity (BHR) in obstructive sleep apnoea (OSA)–asthma association. OSA is associated with NAS with or without the presence of asthma, but BHR is not associated with NAS when asthma is absent. Some NAS perceived as nocturnal asthma could be symptoms of OSA. See relatedEditorial [ABSTRACT FROM AUTHOR]