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Effect of urban vs. rural residence on the association between atopy and wheeze in Latin America: findings from a case-control analysis.

Endara, P; Vaca, M; Platts-Mills, TA; Workman, L; Chico, ME; Barreto, ML; Rodrigues, LC; Cooper, PJ (2015) Effect of urban vs. rural residence on the association between atopy and wheeze in Latin America: findings from a case-control analysis. Clin Exp Allergy, 45 (2). pp. 438-447. ISSN 1365-2222 https://doi.org/10.1111/cea.12399
SGUL Authors: Cooper, Philip John

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Abstract

BACKGROUND: The association between atopy and asthma is attenuated in non-affluent populations, an effect that may be explained by childhood infections such as geohelminths. OBJECTIVE: To investigate the association between atopy and wheeze in schoolchildren living in urban and rural areas of Ecuador and examine the effects of geohelminths on this association. METHODS: We performed nested case-control studies among comparable populations of schoolchildren living in rural communities and urban neighbourhoods in the Province of Esmeraldas, Ecuador. We detected geohelminths in stool samples, measured recent wheeze and environmental exposures by parental questionnaire, and atopy by specific IgE (sIgE) and skin prick test (SPT) reactivity to aeroallergens. RESULTS: Atopy, particularly sIgE to house dust mite (HDM), was more strongly associated with recent wheeze in urban than rural schoolchildren: (urban, adj. OR 5.19, 95% CI 3.37-8.00, P < 0.0001; rural, adj. OR 1.81, 95%CI 1.09-2.99, P = 0.02; interaction, P < 0.001). The population fractions of wheeze attributable to atopy were approximately two-fold greater in urban schoolchildren: SPT to any allergen (urban 23.5% vs. rural 10.1%), SPT to HDM (urban 18.5% vs. rural 9.6%), and anti-HDM IgE (urban 26.5% vs. rural 10.5%), while anti-Ascaris IgE was related to wheeze in a high proportion of rural (49.7%) and urban (35.4%) children. The association between atopy and recent wheeze was attenuated by markers of geohelminth infections. CONCLUSIONS: Our data suggest that urban residence modifies the association between HDM atopy and recent wheeze, and this effect is explained partly by geohelminth infections.

Item Type: Article
Additional Information: © 2014 The Authors. Made available under the terms of the Creative Commons Attribution 3.0 Unported licence (CC BY 3.0) http://creativecommons.org/licenses/by/3.0/
Keywords: Latin America, atopy, geohelminths, house dust mite, rural, tropics, urban, wheeze, atopy, geohelminths, house dust mite, Latin America, rural, tropics, urban, wheeze, Allergy, 1107 Immunology, 1117 Public Health And Health Services
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Clin Exp Allergy
ISSN: 1365-2222
Language: eng
Dates:
DateEvent
27 January 2015Published
Publisher License: Creative Commons: Attribution 3.0
Projects:
Project IDFunderFunder ID
072405/Z/03/ZWellcome TrustUNSPECIFIED
088862/Z/09/ZWellcome TrustUNSPECIFIED
100714Wellcome TrustUNSPECIFIED
AI-20565National Institute of Allergy and Infectious Diseaseshttp://dx.doi.org/10.13039/100000060
PubMed ID: 25200287
Web of Science ID: WOS:000348874400011
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107431
Publisher's version: https://doi.org/10.1111/cea.12399

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