Familial and environmental determinants for wheezing and asthma in a case-control study of school children in Palestine

被引:26
作者
El-Sharif, N
Abdeen, Z
Barghuthy, F
Nemery, B
机构
[1] Katholieke Univ Leuven, Lab Pneumol, Eenheid Longtoxicol, B-3000 Louvain, Belgium
[2] Al Quds Univ, Fac Publ Hlth, Jerusalem, Israel
[3] Al Quds Univ, Fac Med, Dept Community Hlth, Jerusalem, Israel
[4] Arab Hlth Ctr Jerusalem, Jerusalem, Israel
关键词
asthma; children; environment; epidemiology; family; Palestine;
D O I
10.1046/j.1365-2222.2003.01598.x
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background Our prevalence study on Palestinian school children aged 6-12 years showed lower rates for asthma and asthma symptoms than economically developed and industrialized countries. Reasons for such differences are largely unknown, and could possibly be related to different environmental and lifestyle factors. Objective To investigate familial, early life exposures and indoor environmental determinants for asthma in children in Palestine. Methods From the population of our previous study, a group of 273 children with wheeze in the past 12 months (of whom 99 children had physician-diagnosed asthma) were matched with an equal number of non-wheezing controls. This case-control study involved a parental questionnaire; skin prick testing (SPT) with mixed house dust mites, cat and dog dander, mixed grass, mixed trees pollen, Alternaria tenuis, olive tree and cockroach extracts; and serum for total and specific IgE for the same eight allergens. Results Paternal asthma and maternal hayfever significantly tripled the risk for their children to have wheezing. Previous diagnoses of bronchial allergy, bronchitis, pneumonia, or whooping cough, and positive SPT for house dust mites and cockroaches were significantly more likely among wheezing and asthmatic children than controls. Specific IgE levels for house dust mites and cat allergens showed significantly higher risk for reported wheezing. After adjustment for several environmental and sociodemographic factors using multivariate logistic regression analysis, paternal asthma, maternal hayfever, damp houses, cat and cockroach SPT positivity proved to be strong predictors for wheezing symptoms. Conclusion Our study confirmed that familial 'atopic' diseases are significant predictors of childhood asthma in Palestinian children. Moreover, indoor environment such as presence of cats and domestic moulds also appear to play a role. Our findings are consistent with studies in Canada, New Zealand, Estonia and Sweden, and show promise to explore further gene-environment interaction in the genesis of asthma.
引用
收藏
页码:176 / 186
页数:11
相关论文
共 79 条
[1]   ASSOCIATION OF ALLERGIC SYMPTOMS IN CHILDREN WITH THOSE IN THEIR PARENTS [J].
ABDULRAZZAQ, YM ;
BENER, A ;
DEBUSE, P .
ALLERGY, 1994, 49 (09) :737-743
[2]  
*AL QUDS U OP RES, 2002, PAL NUTR PAL HLTH RE
[3]   Wheezing in relation to atopy and environmental factors in Estonian and Swedish schoolchildren [J].
Annus, T ;
Björkstén, B ;
Mai, XM ;
Nilsson, L ;
Riikjärv, MA ;
Sandin, A ;
Bråbäck, L .
CLINICAL AND EXPERIMENTAL ALLERGY, 2001, 31 (12) :1846-1853
[4]   Early, current and past pet ownership: associations with sensitization, bronchial responsiveness and allergic symptoms in school children [J].
Anyo, G ;
Brunekreef, B ;
de Meer, G ;
Aarts, F ;
Janssen, NAH ;
van Vliet, P .
CLINICAL AND EXPERIMENTAL ALLERGY, 2002, 32 (03) :361-366
[5]   Systematic review: Exposure to pets and risk of asthma and asthma-like symptoms [J].
Apelberg, BJ ;
Aoki, Y ;
Jaakkola, JJK .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2001, 107 (03) :455-460
[6]   Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema:: ISAAC [J].
Beasley, R ;
Keil, U ;
von Mutius, E ;
Pearce, N ;
Aït-Khaled, N ;
Anabwani, G ;
Anderson, HR ;
Asher, MI ;
Björkstéin, B ;
Burr, ML ;
Clayton, TO ;
Crane, J ;
Ellwood, P ;
Lai, CKW ;
Mallol, J ;
Martinez, FD ;
Mitchell, EA ;
Montefort, S ;
Robertson, CF ;
Shah, JR ;
Sibbald, B ;
Stewart, AW ;
Strachan, DP ;
Weiland, SK ;
Williams, HC .
LANCET, 1998, 351 (9111) :1225-1232
[7]   Socioeconomic status is a risk factor for allergy in parents but not in their children [J].
Bergmann, RL ;
Edenharter, G ;
Bergmann, KE ;
Lau, S ;
Wahn, U .
CLINICAL AND EXPERIMENTAL ALLERGY, 2000, 30 (12) :1740-1745
[8]   Family size, childhood infections and atopic diseases [J].
Bodner, C ;
Godden, D ;
Seaton, A .
THORAX, 1998, 53 (01) :28-32
[9]   PETS, ALLERGY AND RESPIRATORY SYMPTOMS IN CHILDREN [J].
BRUNEKREEF, B ;
GROOT, B ;
HOEK, G .
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, 1992, 21 (02) :338-342
[10]   Air pollution from truck traffic and lung function in children living near motorways [J].
Brunekreef, B ;
Janssen, NAH ;
deHartog, J ;
Harssema, H ;
Knape, M ;
vanVliet, P .
EPIDEMIOLOGY, 1997, 8 (03) :298-303