Influence of poverty and infection on asthma in Latin America

被引:30
作者
Cooper, Philip J. [1 ,2 ,3 ]
Rodrigues, Laura C. [4 ]
Barreto, Mauricio L. [5 ]
机构
[1] Ctr Invest FEPIS, Quininde, Esmeraldas Prov, Ecuador
[2] Univ Liverpool, Liverpool Sch Trop Med, Liverpool L3 5QA, Merseyside, England
[3] Univ San Francisco Quito, Colegio Ciencias Salud, Quito, Ecuador
[4] London Sch Hyg & Trop Med, London WC1, England
[5] Univ Fed Bahia, Inst Saude Coletiva, Salvador, BA, Brazil
基金
英国惠康基金;
关键词
asthma; atopy; childhood infections; diet; Latin America; obesity; poverty; psychosocial stress; HOUSE-DUST MITE; CHILDHOOD ASTHMA; MEDITERRANEAN DIET; RISK-FACTORS; EARLY-LIFE; RESPIRATORY SYMPTOMS; PSYCHOSOCIAL FACTORS; AIRWAY INFLAMMATION; HELMINTH INFECTIONS; CYTOKINE PRODUCTION;
D O I
10.1097/ACI.0b013e3283510967
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Purpose of review Asthma in Latin America is a growing public health problem and seems to be most prevalent and cause most morbidity among poor urban populations. This article will review the findings of recent human studies of the associations of asthma prevalence in Latin America with factors associated with poverty and inequality including childhood infections, stress, environment, nutrition and diet. Recent findings Most asthma in childhood in Latin America is nonatopic and has been associated with exposures related to environmental dirt, diet and psychosocial distress. These factors are strongly linked to poverty and inequality. Interestingly, infections with bacterial, viral and parasitic pathogens in childhood appear to attenuate atopy in childhood but have no effect on asthma symptoms. There are biologically plausible mechanisms by which dirt exposures (e.g. endotoxin and other microbial products and nonmicrobial irritants), diet and obesity and psychosocial stress may cause airways inflammation. Summary Most childhood asthma in Latin America is nonatopic for which important risk factors are those of poverty including poor hygiene (i.e. dirt), poor diet and obesity and psychosocial stress. There is evidence that exposures to infections in early childhood reduce atopy but not asthma. Research is needed to identify causes of nonatopic asthma that may be suitable for primary prevention or other public health intervention strategies for asthma in Latin America.
引用
收藏
页码:171 / 178
页数:8
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