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1. Prevalence and risk factors for asthma, rhinitis, eczema, and atopy among preschool children in an Andean city.

Author

Ochoa-Avilés C, Morillo D, Rodriguez A, Cooper PJ, Andrade S, Molina M, Parra M, Parra-Ullauri A, Mejía D, Neira A, Rodas-Espinoza C, and Ochoa-Avilés A

Subjects
Allergens, Child, Preschool, Cross-Sectional Studies, Ecuador epidemiology, Female, Humans, Hypersensitivity epidemiology, Male, Prevalence, Risk Factors, Skin Tests, Surveys and Questionnaires, Asthma epidemiology, Eczema epidemiology, Rhinitis epidemiology
Abstract

Background: Limited data are available on prevalence and associated risk factors for atopy and allergic diseases from high-altitude urban settings in Latin America., Objective: To estimate the prevalence of atopy, asthma, rhinitis, and eczema, and associations with relevant risk factors in preschool children in the Andean city of Cuenca., Methods: A cross-sectional study was undertaken using a representative sample of 535 children aged 3-5 years attending 30 nursery schools in the city of Cuenca, Ecuador. Data on allergic diseases and risk factors were collected by parental questionnaire. Atopy was measured by skin prick test (SPT) reactivity to a panel of relevant aeroallergens. Associations between risk factors and the prevalence of atopy and allergic diseases were estimated using multivariable logistic regression., Results: Asthma symptoms were reported for 18% of children, rhinitis for 48%, and eczema for 28%, while SPT reactivity was present in 33%. Population fractions of asthma, rhinitis, and eczema attributable to SPT were 3.4%, 7.9%, and 2.9%, respectively. In multivariable models, an increased risk of asthma was observed among children with a maternal history of rhinitis (OR 1.85); rhinitis was significantly increased in children of high compared to low socioeconomic level (OR 2.09), among children with a maternal history of rhinitis (OR 2.29) or paternal history of eczema (OR 2.07), but reduced among children attending daycare (OR 0.64); eczema was associated with a paternal history of eczema (OR 3.73), and SPT was associated with having a dog inside the house (OR 1.67)., Conclusions: A high prevalence of asthma, rhinitis, and eczema symptoms were observed among preschool children in a high-altitude Andean setting. Despite a high prevalence of atopy, only a small fraction of symptoms was associated with atopy. Parental history of allergic diseases was the most consistent risk factor for symptoms in preschool children., Competing Interests: The authors have declared that no competing interests exists.

Published
2020
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2. Impact of early life exposures to geohelminth infections on the development of vaccine immunity, allergic sensitization, and allergic inflammatory diseases in children living in tropical Ecuador: the ECUAVIDA birth cohort study.

Author

Cooper PJ, Chico ME, Guadalupe I, Sandoval CA, Mitre E, Platts-Mills TA, Barreto ML, Rodrigues LC, Strachan DP, and Griffin GE

Subjects
Asthma epidemiology, Child, Child, Preschool, Ecuador epidemiology, Eczema epidemiology, Epidemiologic Research Design, Female, Helminthiasis epidemiology, Humans, Hypersensitivity epidemiology, Immunity, Innate immunology, Infant, Infant, Newborn, Longitudinal Studies, Models, Immunological, Pregnancy, Pregnancy Complications, Parasitic epidemiology, Pregnancy Complications, Parasitic parasitology, Skin Tests, Asthma immunology, Eczema immunology, Helminthiasis immunology, Hypersensitivity immunology, Pregnancy Complications, Parasitic immunology, Vaccines immunology
Abstract

Background: Geohelminth infections are highly prevalent infectious diseases of childhood in many regions of the Tropics, and are associated with significant morbidity especially among pre-school and school-age children. There is growing concern that geohelminth infections, particularly exposures occurring during early life in utero through maternal infections or during infancy, may affect vaccine immunogenicity in populations among whom these infections are endemic. Further, the low prevalence of allergic disease in the rural Tropics has been attributed to the immune modulatory effects of these infections and there is concern that widespread use of anthelmintic treatment in high-risk groups may be associated with an increase in the prevalence of allergic diseases. Because the most widely used vaccines are administered during the first year of life and the antecedents of allergic disease are considered to occur in early childhood, the present study has been designed to investigate the impact of early exposures to geohelminths on the development of protective immunity to vaccines, allergic sensitization, and allergic disease., Methods/design: A cohort of 2,403 neonates followed up to 8 years of age. Primary exposures are infections with geohelminth parasites during the last trimester of pregnancy and the first 2 years of life. Primary study outcomes are the development of protective immunity to common childhood vaccines (i.e. rotavirus, Haemophilus influenzae type B, Hepatitis B, tetanus toxoid, and oral poliovirus type 3) during the first 5 years of life, the development of eczema by 3 years of age, the development of allergen skin test reactivity at 5 years of age, and the development of asthma at 5 and 8 years of age. Potential immunological mechanisms by which geohelminth infections may affect the study outcomes will be investigated also., Discussion: The study will provide information on the potential effects of early exposures to geohelminths (during pregnancy and the first 2 years of life) on the development of vaccine immunity and allergy. The data will inform an ongoing debate of potential effects of geohelminths on child health and will contribute to policy decisions on new interventions designed to improve vaccine immunogenicity and protect against the development of allergic diseases., Trial Registration: Current Controlled Trials ISRCTN41239086.

Published
2011
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3. Hygiene, atopy and wheeze–eczema–rhinitis symptoms in schoolchildren from urban and rural Ecuador

Author

Cooper, Philip J, Vaca, Maritza, Rodriguez, Alejandro, Chico, Martha E, Santos, Darci N, Rodrigues, Laura C, and Barreto, Mauricio L

Subjects
Hypersensitivity, Immediate, Male, Rural Population, Wheeze-Rhinitis-Eczema, Adolescent, Urban Population, Urban-Rural, Eczema, Respiratory Epidemiology, Feces, Risk Factors, Surveys and Questionnaires, Prevalence, Animals, Humans, Child, Students, Respiratory Sounds, Rhinitis, Skin Tests, Schools, Atopy, Farming, Hygiene, Allergens, Cross-Sectional Studies, Child, Preschool, Housing, Female, Ecuador
Abstract

Background Rural residence is protective against atopy and wheeze–rhinitis–eczema symptoms in developed countries, an effect attributed to farming and poor hygiene exposures. There are few data from developing countries addressing this question. We compared atopy and wheeze–rhinitis–eczema symptoms between urban and rural Ecuador, and explored the effects of farming and poor hygiene exposures. Methods We performed cross sectional studies of schoolchildren living in rural and urban Ecuador. Data on symptoms and farming/hygiene exposures were collected by parental questionnaire, atopy by allergen skin prick test reactivity and geohelminth infections by stool examinations. Results Among 2526 urban and 4295 rural schoolchildren, prevalence was: atopy (10.0% vs 12.5%, p=0.06), wheeze (9.4% vs 10.1%, p=0.05), rhinitis (8.1% vs 6.4%, p=0.02) and eczema (5.9% vs 4.7%, p=0.06). A small proportion of symptoms were attributable to atopy (range 3.9–10.7%) with greater attributable fractions for respiratory symptoms observed in urban schoolchildren. Respiratory symptoms were associated with poor hygiene/farming exposures: wheeze with lack of access to potable water; and rhinitis with household pets, no bathroom facilities and contact with large farm animals. Birth order was inversely associated with respiratory symptoms. Area of residence and atopy had few effects on these associations. Conclusions Urban schoolchildren living in Ecuador have a similar prevalence of atopy, eczema and wheeze but a higher prevalence of rhinitis compared with rural children. Some farming and poor hygiene exposures were associated with an increase in the prevalence of wheeze or rhinitis while birth order was inversely associated with these symptoms.

Published
2013

4. Cohort Profile: The Ecuador Life (ECUAVIDA) study in Esmeraldas Province, Ecuador

Author

Cooper, Philip J, Chico, Martha E, Platts-Mills, Thomas Ae, Rodrigues, Laura C, Strachan, David P, and Barreto, Mauricio L

Subjects
Adult, Hypersensitivity, Immediate, Male, Rural Population, Eczema, Helminthiasis, Young Adult, Pregnancy, Surveys and Questionnaires, Helminth, Humans, Prospective Studies, Child, Cohort Profiles, Skin Tests, Allergic Diseases, Infant, Newborn, Infant, Environmental Exposure, Asthma, Immunity, Innate, Microbial Exposures, Child, Preschool, Pregnancy Complications, Parasitic, Female, Ecuador
Abstract

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2015-06-11T17:27:14Z No. of bitstreams: 1 Mauricio Lima. 2014.pdf: 1013895 bytes, checksum: 049178f11b0a0acea7bc1bf41a3008c7 (MD5) Made available in DSpace on 2015-06-11T17:27:14Z (GMT). No. of bitstreams: 1 Mauricio Lima. 2014.pdf: 1013895 bytes, checksum: 049178f11b0a0acea7bc1bf41a3008c7 (MD5) Previous issue date: 2014-07 The ECUAVIDA birth cohort is studying the impact of exposures to soil-transmitted helminth (STH) parasites and early-life microbial exposures on the development of atopy, allergic diseases and immune responses in childhood. A total of 2404 newborns were recruited between 2006 and 2009 in a public hospital serving the rural district of Quininde, Esmeraldas Province, in a tropical region of coastal Ecuador. Detailed measurements were done around the time of the birth, at 7 and 13 months and at 2 and 3 years, and data collection is ongoing at 5 and 8 years. Data being collected include questionnaires for: sociodemographic, lifestyle, psychosocial (at 4-6 years only) and dietary (at 6-7 years only) factors; childhood morbidity and clinical outcomes; stool samples for parasites; blood samples for DNA, measurements of vaccine responses and other measures of immune function/inflammation; and anthropometrics. Allergen skin prick test reactivity is done from 2 years and measures of airway function and inflammation at 8 years. London

Published
2015

5. Effects of maternal geohelminth infections on allergy in early childhood

Author

Cooper, Philip J., Chico, Martha E., Amorim, Leila D., Sandoval, Carlos, Vaca, Maritza, Strina, Agostino, Campos, Ana Clara, Rodrigues, Laura C., Barreto, Mauricio L., and Strachan, David P.

Subjects
Male, Immunology, atopy, Eczema, Helminthiasis, epg, Eggs per gram, immune system diseases, Immune Deficiencies, Infection, and Systemic Immune Disorders, Pregnancy, Risk Factors, parasitic diseases, otorhinolaryngologic diseases, Hypersensitivity, Odds Ratio, Immunology and Allergy, Animals, Humans, HDM, House dust mite, Geohelminths, Respiratory Sounds, Pyroglyphidae, Infant, Newborn, Infant, SPT, Skin prick test, early childhood, Allergens, Patient Outcome Assessment, maternal infections, Maternal Exposure, wheeze, Child, Preschool, Female, OR, Odds ratio, Follow-Up Studies
Abstract

BACKGROUND: Maternal geohelminth infections during pregnancy may protect against allergy development in childhood. OBJECTIVE: We sought to investigate the effect of maternal geohelminths on the development of eczema, wheeze, and atopy during the first 3 years of life. METHODS: A cohort of 2404 neonates was followed to 3 years of age in a rural district in coastal Ecuador. Data on wheeze and eczema were collected by means of questionnaire and physical examination at 13, 24, and 36 months of age. Atopy was measured based on skin prick test (SPT) reactivity to 9 allergens at 36 months. Maternal stool samples were examined for geohelminths by microscopy. Data on potential confounders was collected after birth by questionnaire. RESULTS: Geohelminths were observed in 45.9% of mothers. Eczema and wheeze were reported for 17.7% and 25.9%, respectively, of 2069 (86.1%) children with complete follow-up to 3 years, and allergen SPT reactivity to any allergen was present in 17.2% and to house dust mite in 8.7%. Maternal geohelminth infections were not significantly associated with eczema (adjusted odds ratio [OR], 1.26; 95% CI, 0.98-1.61), wheeze (adjusted OR, 1.02; 95% CI, 0.82-1.27), and SPT reactivity to any allergen (adjusted OR, 0.79; 95% CI, 0.61-1.01). In subgroup analyses maternal geohelminths were associated with a significantly reduced risk of SPT reactivity to mite and other perennial allergens, and maternal ascariasis was associated with an increased risk of eczema and reduced risk of SPT reactivity to all allergens. CONCLUSION: Our data do not support a protective effect of maternal infections with geohelminth parasites during pregnancy against the development of eczema and wheeze in early childhood, although there was evidence in subgroup analyses for a reduction in SPT reactivity to house dust mites and perennial allergens.

Published
2016

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