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Risk factors for acute asthma in tropical America: a case-control study in the City of Esmeraldas, Ecuador.
- Source :
-
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology [Pediatr Allergy Immunol] 2015 Aug; Vol. 26 (5), pp. 423-30. - Publication Year :
- 2015
-
Abstract
- Background: Despite the high asthma rates described in Latin America, asthma risk factors in poor urban settings are not well established. We investigated risk factors for acute asthma among Ecuadorian children.<br />Methods: A matched case-control study was carried out in a public hospital serving a coastal city. Children with acute asthma were age- and sex-matched to non-asthmatics. A questionnaire was administered, and blood, as well as stool, and nasopharyngeal swabs were collected.<br />Results: Sixty cases and 119 controls aged 5-15 were evaluated. High proportions of cases were atopic with population-attributable fractions for atopy of 68.5% for sIgE and 57.2% for SPT. Acute asthma risk increased with greater titers of mite IgE (3.51-50 kU/l vs. <0.70kU/l - OR 4.56, 95% CI 1.48-14.06, p = 0.008; >50kU/l vs. <0.70kU/l - OR 41.98, 95% CI: 8.97-196.39, p < 0.001). Asthma risk was significantly independently associated with bronchiolitis (adj. OR: 38.9, 95% CI 3.26-465), parental educational level (adj. OR 1.26, 95% CI: 1.08-1.46), and presence of sIgE (adj. OR: 36.7, 95% CI: 4.00-337), while a reduced risk was associated with current contact with pets (adj. OR: 0.07, 95% CI: 0.01-0.56). Rhinovirus infection was more frequent in cases (cases 35.6% vs. controls 7.8%, p = 0.002). None of the cases were on maintenance therapy with inhaled corticosteroids and most relied on emergency department for control.<br />Conclusions: A high proportion of children presenting to a public hospital with acute asthma were allergic to mite, particularly at high IgE titer. Poor asthma control resulted in overuse of emergency care.<br /> (© 2015 The Authors. Pediatric Allergy and Immunology Published by John Wiley & Sons Ltd.)
- Subjects :
- Acute Disease
Adolescent
Age Distribution
Allergens adverse effects
Allergens immunology
Animals
Anti-Asthmatic Agents therapeutic use
Asthma diagnosis
Asthma drug therapy
Asthma immunology
Biomarkers blood
Case-Control Studies
Child
Child, Preschool
Disease Progression
Ecuador epidemiology
Emergency Service, Hospital
Female
Hospitals, Public
Humans
Immunoglobulin E blood
Immunologic Tests
Inhalation Exposure adverse effects
Insect Proteins immunology
Logistic Models
Male
Mites immunology
Multivariate Analysis
Odds Ratio
Prognosis
Respiratory Tract Infections epidemiology
Respiratory Tract Infections immunology
Respiratory Tract Infections virology
Risk Factors
Asthma epidemiology
Urban Health
Subjects
Details
- Language :
- English
- ISSN :
- 1399-3038
- Volume :
- 26
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
- Publication Type :
- Academic Journal
- Accession number :
- 25955441
- Full Text :
- https://doi.org/10.1111/pai.12401