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Background: The importance of fungal allergens in the development of allergic diseases in a desert environment is uncertain. This study evaluated the prevalence of IgE sensitization to moulds among patients with allergic respiratory diseases in Kuwait - a desert country., Methods: A total of 810 patients (male:female ratio 1.4) with a mean age of 32.3 years (range 2-76 years) with extrinsic asthma or allergic rhinitis were studied. Sera from the patients were tested by the CAP-RAST method for specific IgE to 6 fungi (Penicillium, Cladosporium, Aspergillus, Candida, Alternaria and Helminthosporium). For comparison house dust mite and Bermuda grass were also assessed., Results: The overall positivity to at least one mould was 20.9%. Among 120 matched control subjects, the value was 5. 8%. The value was much higher among patients with asthma alone (45. 8%) or both asthma and rhinitis (28.3%) than those with rhinitis alone (11.8%; p < 0.001). Asthmatic children had the highest sensitization rate (66.0% in the 7- to 12-year age group), which declined sharply with age. Among asthmatics, Candida and Aspergillus had the highest sensitization rates (23.1 and 21.3%, respectively), followed by Helminthosporium (18.8%), Cladosporium (15.9%), Alternaria (14.6%) and Penicillium (13.9%). The values for mite and Bermuda grass were 41.2 and 54.6%, respectively. Among asthmatic children, severe asthma was significantly more frequent among mould-positive (51.6%) than mould-negative patients (17.5%; p < 0. 0001)., Conclusions: Even in this desert environment, sensitization to moulds is quite common among patients with allergic respiratory diseases, with a striking preponderance among children with asthma. Mould allergy could also be an important factor determining asthma severity in this environment., (Copyright 2000 S. Karger AG, Basel)

Background: Bronchial asthma is common in Kuwait, a desert country, but the sensitizing allergens are uncertain. This study investigated the sensitizing allergens in Kuwaiti patients with extrinsic asthma., Methods: A total of 553 asthmatics (male:female ratio: 1.4; mean age: 31.7 years [range 3-76 years]) and 112 matched controls were studied. Sera from all patients/subjects were tested by the CAP-RAST method for specific IgE to 14 locally relevant inhalant allergens., Results: Specific IgE to at least one allergen was detected in 87.2% of the patients compared with 24.1% of controls. Among the confirmed extrinsic asthmatics, the sensitization rates for the allergen groups were as follows: pollens (87.1%), house dust (76.1%), and molds (30.3%). The three most prevalent sensitizing pollens were from Chenopodium (70.7%), Bermuda grass (62.9%), and Prosopis (62.7%), all of which are horticultural plants imported for the purpose of "greening" the desert. For all allergens, except the molds, the prevalence rate was higher in males than females, but age had only a weak effect. Severe asthma occurred significantly more frequently among mold-sensitized patients., Conclusions: These results show that even in a desert environment, pollens and house-dust allergens may be important sensitizing allergens. They also illustrate how practices that "green" the desert can affect public health.

Kuwait, situated in the north-west corner of the Arabian Gulf, has an arid climate with very hot dry summers and mild winters. Sandstorms are a regular climatic feature, occurring most frequently in summer. Before the mid-1950s allergy was not considered to be a problem. Since then it has become a major cause of morbidity; 18% of the population are reported to suffer from its manifestations. Over the past 3 years 1000 asthmatic patients attending a central clinic have been carefully studied. The present paper analyses various aspects of the asthmatic condition in this desert country.