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Maniassom C, Defo A, De Blay F, Elenga N. What's childhood asthma in French Guiana? A cohort study based on children referred for allergology consultations at the Cayenne hospital center. Front Public Health 2023; 11:1198937. [PMID: 37744508 PMCID: PMC10513413 DOI: 10.3389/fpubh.2023.1198937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Background Asthma is a multifactorial chronic disease, whose most frequent etiology is allergy, especially to Blomia tropicalis. In French Guiana, the childhood prevalence of Blomia T sensitization is unkwown. The aim of this study was to determine the proportion of sensitization to Blomia T and other mites in asthmatic children, and to describe the characteristics of childhood asthma in French Guiana. Methods A retrospective cohort study focused on children from 0 to 18 years of age, followed for asthma at the Department of Pediatrics of the Cayenne Hospital Center in French Guiana. All asthmatic children followed by the same paediatric allergist were systematically skin-tested with Bt total extract, and Bt-specific IgE tests were additionally performed to confirm specific sensitization. All follow-up variables were collected from medical records. The outcome was sensitization to Blomia tropicalis and other allergens, and the explanatory variables were those of asthma follow-up. Patients were categorized into Blomia tropicalis sensitization yes/no. Logistic regression analysis was used to assess the relationship between follow-up variables and the outcome. Results 302 patients were followed: 177 cases of allergic rhinitis, 135 allergic conjunctivitis, 105 atopic dermatitis, 153 food allergy, and 14 cases of drug allergy. Poly-allergy (respiratory, food, skin, and medicinal) was present in 239 children. There were 158 children followed for asthma, of whom 103 (65%) were sensitized to Blomia tropicalis. The median age of the asthmatic children sensitized to Blomia tropicalis was 7 years, and 3 years for those who were not sensitized (p < 0.001). Among the girls (n = 58), 67% were sensitized to Blomia; 97 (92%) asthmatic children co-sensitized to Blomia tropicalis, Dermatophagoides pteronyssinus, and Dermatophagoides farinae. Multivariate analysis showed that the childhood asthma in French Guiana is characterized by a median age of 7 years (p < 0.001), a high prevalence of Blomia tropicalis (p < 0.001), co-sensitization to other mites (p < 0.001), and a high prevalence of co-sensitization to cockroaches (p = 0.006). The area under the ROC curve was close to 0.9, confirming the quality of our model. Conclusion In French Guiana, asthma is characterized by a high prevalence of Blomia tropicalis sensitization.
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Affiliation(s)
- Chiméne Maniassom
- Department de Pediatrie, Hôpital de Cayenne “Andrée Rosemon”, Cayenne, French Guiana
| | - Antoine Defo
- Department de Pediatrie, Hôpital de Cayenne “Andrée Rosemon”, Cayenne, French Guiana
| | - Frédéric De Blay
- Pôle de Pathologie Thoracique Hôpitaux Universitaires de Strasbourg, Place de l’Hôpital, Strasbourg, France
| | - Narcisse Elenga
- Department de Pediatrie, Hôpital de Cayenne “Andrée Rosemon”, Cayenne, French Guiana
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Mvoundza Ndjindji O, Minto’o Rogombe S, Mougola Bissiengou P, Mveang-Nzoghe A, Leboueny M, Ouloungou Mbina, Maloupazoa Siawaya AC, KuissiKamgaing E, Ndeboko B, Ategbo S, Djoba Siawaya JF. Allergen sensitization and polysensitization pattern of adults and children in an urban Sub-Saharan African setting (Libreville, Gabon). THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2023; 2:23-29. [PMID: 37780101 PMCID: PMC10509960 DOI: 10.1016/j.jacig.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/28/2022] [Accepted: 10/14/2022] [Indexed: 10/03/2023]
Abstract
Background It is believed that allergic diseases are increasing in Africa. However, the health sector in Africa has yet to catch up with this paradigm shift. We looked at the number of patients referred to us for allergy testing and investigated allergen sensitization. Methods A retrospective analysis was done on 97 serum allergen-specific IgE results collected from patients suspected of having allergies in Libreville from 2018 to 2021. Specific IgE responses to 180 allergens were investigated. The general sensitization patterns were analyzed. Also analyzed were sensitization patterns for adults and children. The difference in the IgE-binding allergen positivity rate between groups was calculated by using the chi-square (χ2) test. Results The allergens most commonly causing sensitization were from mites (65%), barley (48%), peach (48%), dog and/or cat dander (44%), house dust (44%), peanut (39%), tomato (39%), cockroach (37%), crab (36%), garlic and/or onion (34%), rye (34%), egg white (32%), shrimp (32%), kiwi (32%), soya bean (32%), citrus mix (29%), cheese (27%), milk (27%), walnut (27%), ox-eye daisy (24%) and orchard grass (24%). Moreover, 60% of patients (36 of 60) were polysensitized to inhalant allergens, 53% (31 of 58) were polysensitized to food allergens, and 29% (14 of 48) were polysensitized to inhalant and food allergens; 65% of patients (53 of 81) were sensitized to allergens originating from mites, fungi (including Candida albicans, Alternaria alternata, Aspergillus fumigatus, Cladosporium herbarum, and Pennicillium notatum), or bacteria (staphylococcal enterotoxin B). Conclusions The sensitization pattern of allergens in our setting is rich and varied, with a high prevalence of polysensitization.
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Affiliation(s)
- Ofilia Mvoundza Ndjindji
- Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori, Libreville, Gabon
| | | | | | - Amandine Mveang-Nzoghe
- Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori, Libreville, Gabon
| | - Marielle Leboueny
- Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori, Libreville, Gabon
| | - Ouloungou Mbina
- Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori, Libreville, Gabon
| | | | - Eliane KuissiKamgaing
- Département de Pédiatrie, Université des Sciences de la Santé, Libreville, Gabon
- Pôle Enfant, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori, Libreville, Gabon
| | - Bénédicte Ndeboko
- Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori, Libreville, Gabon
- Département de Biologie Cellulaire et Biologie Moléculaire, Université des Sciences de la Santé, Libreville, Gabon
| | - Simon Ategbo
- Département de Pédiatrie, Université des Sciences de la Santé, Libreville, Gabon
- Pôle Enfant, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori, Libreville, Gabon
| | - Joel Fleury Djoba Siawaya
- Service Laboratoire, Centre Hospitalier Universitaire Mère-Enfant Fondation Jeanne Ebori, Libreville, Gabon
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Mvoundza Ndjindji O, Djoba Siawaya JF. Mapping Allergic Diseases in Sub-Saharan Africa. FRONTIERS IN ALLERGY 2022; 3:850291. [PMID: 35386659 PMCID: PMC8974792 DOI: 10.3389/falgy.2022.850291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/27/2022] [Indexed: 11/26/2022] Open
Abstract
The consensus is that allergic diseases are increasing in Africa. However, this paradigm shift has not yet been translated into practice. Focused on infectious diseases (malaria, tuberculosis, HIV), health policies in Sub-Saharan Africa have often neglected the diagnosis and management of allergies. Allergic disease mapping is crucial to grasp the full extent of Africa's allergic diseases' impact. This mapping will require diverting resources to diagnose and study allergies, even more at the dawn of precision medicine.
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[Blomia tropicalis: A house dust mite in the tropics]. Rev Mal Respir 2017; 34:791-801. [PMID: 28502519 DOI: 10.1016/j.rmr.2016.10.877] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 10/14/2016] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Blomia tropicalis is a mite that belongs to the superfamily of Glycyphagidae. Initially described as a storage mite, it is now considered as a house dust mite of tropical and sub-tropical areas. STATE OF THE ART Sensitization to this mite is very common in South America and Southeast Asia. Epidemiological studies have also found sensitization to this mite in Africa and Central America. Blo t 5 is the major allergen of B. tropicalis. Co-sensitization to other house dust mites such as Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f) is very common. Cross-reactivity has been described but recombinant allergens revealed by molecular biology techniques do not explain this cross-reactivity. Sensitization to B. tropicalis seems to begin at the age of 36 months, the incidence increases until adulthood, and decreases from the age of 50. The involvement of B. tropicalis in allergic rhinitis and asthma is well described. It is also implicated in other allergic diseases. Few studies have assessed the therapeutic strategies available against this mite but immunotherapy is widely used. PERSPECTIVES Studies are needed to better understand the role of B. tropicalis in human diseases and to develop specific treatments.
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Mbatchou Ngahane BH, Noah D, Nganda Motto M, Mapoure Njankouo Y, Njock LR. Sensitization to common aeroallergens in a population of young adults in a sub-Saharan Africa setting: a cross-sectional study. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2016; 12:1. [PMID: 26734065 PMCID: PMC4700563 DOI: 10.1186/s13223-015-0107-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 12/17/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Sensitization to aeroallergens increases the risk of developing asthma or allergic rhinitis. Data on sensitization to airborne allergens in the general population in sub-Saharan Africa are lacking. The aim of this study was to determine the prevalence and determinants of sensitization to common aeroallergens in a population of young adults. METHODS A cross-sectional study was conducted among students of the Faculty of Medicine and Pharmaceutical Sciences of the University of Douala between 1st February and 30th April 2014. We consecutively recruited all the students present in class or in hospital during our visit. They filled an anonymous questionnaire and underwent skin prick tests with common aeroallergens. A logistic regression model of the SPSS.20 software was used to investigate factors associated with sensitization to common aeroallergens. RESULTS Of the 600 students included in the study, 305 (50.8 %) were female. The mean age of participants was 22.6 ± 2.7 years. The prevalence of sensitization to aeroallergens was 42.8 % (95 % CI 38.8-46.8). Dermatophagoides pteronyssimus (24.2 %), Dermatophagoides farinae (22.8 %), Blomia tropicalis (23.3 %) and Blatella germanica (15.2 %) were the most common allergens found. Allergic rhinitis, asthma symptoms and family atopy were independently associated to sensitization to common aeroallergens. CONCLUSION A significant proportion of young adults are sensitized to common aeroallergens. Dust mites and cockroach should be included in the panel of aeroallergens in Cameroon.
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Affiliation(s)
- Bertrand Hugo Mbatchou Ngahane
- />Department of Internal Medicine, Douala General Hospital, PO Box 4856, Douala, Cameroon
- />Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Diane Noah
- />Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Malea Nganda Motto
- />Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Yacouba Mapoure Njankouo
- />Department of Internal Medicine, Douala General Hospital, PO Box 4856, Douala, Cameroon
- />Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Louis Richard Njock
- />Department of Ear Nose and Throat, Douala General Hospital, Douala, Cameroon
- />Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
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Pefura-Yone EW, Mbele-Onana CL, Balkissou AD, Kenmegne-Noumsi EC, Boulleys-Nana JR, Kolontchang-Yomi BL, Theubo-Kamgang BJ, Ndjeutcheu-Moualeu PI, Ebouki ER, Kengne AP. Perennial aeroallergens sensitisation and risk of asthma in African children and adolescents: a case-control study. J Asthma 2015; 52:571-5. [PMID: 25494554 DOI: 10.3109/02770903.2014.995306] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The distribution and impact of various aeroallergens on asthma occurrence vary across regions. We investigated the association between sensitisation to perennial aeroallergens and asthma risk in children and adolescents in Yaounde, Cameroon. METHODS This was a case-control study involving children and adolescents with asthma (cases) vs. non-allergic counterparts (controls). Children/adolescents with doctor-diagnosed asthma were included over a period of 30 months, and controls were selected from the community through random sampling. Logistic regression models were used to relate perennial aeroallergens sensitisation with asthma. RESULTS The asthma and control groups included, respectively, 151 and 372 participants, with no sex ratio difference. The mean age (standard deviation) was 11.9 (4.4) years in cases and 11.3 (3.7) years in controls. The prevalence of sensitisation to any aeroallergen (cases vs. controls) was 76.8% (116/151) and 32.3% (120/372), p < 0.001. Sensitisation to mites was found in 104 (68.9%) cases vs. 56 (15.1%) controls, p < 0.001. In multivariable analysis, sensitisation to Alternaria alternata, Blattella germanica and dander (cat and dog) was not associated with asthma. However, sensitisation to mites was significantly associated with asthma. Odds ratios (95% CI) for sensitisation to Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis in relation with asthma were 7.28 (3.75-14.15), 2.65 (1.27-5.45) and 3.23 (1.68-6.21), respectively. CONCLUSIONS Sensitisation to mites was the main perennial allergenic factor associated with asthma in children and adolescents in this setting. This has application for the selection of patients with asthma who could benefit from the control of exposure to mites and specific immunotherapy.
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Affiliation(s)
- Eric Walter Pefura-Yone
- a Department of Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences , University of Yaounde I , Yaounde , Cameroon
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Pefura-Yone EW, Kengne AP, Balkissou AD, Boulleys-Nana JR, Efe-de-Melingui NR, Ndjeutcheu-Moualeu PI, Mbele-Onana CL, Kenmegne-Noumsi EC, Kolontchang-Yomi BL, Theubo-Kamgang BJ, Ebouki ER, Djuikam-Kamga CK, Magne-Fotso CG, Amougou F, Mboumtou L, Ngo-Yonga M, Petchou-Talla EL, Afane-Ze E, Kuaban C. Prevalence of asthma and allergic rhinitis among adults in Yaounde, Cameroon. PLoS One 2015; 10:e0123099. [PMID: 25853516 PMCID: PMC4390233 DOI: 10.1371/journal.pone.0123099] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 02/27/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Population-based estimates of asthma and allergic rhinitis in sub-Saharan African adults are lacking. We assessed the prevalence and determinants of asthma and allergic rhinitis in urban adult Cameroonians. METHODS A community-based survey was conducted from December 2013 to April 2014 among adults aged 19 years and above (N = 2,304, 57.3% women), selected through multilevel stratified random sampling across all districts of Yaounde (Capital city). Internationally validated questionnaires were used to investigate the presence of allergic diseases. Logistic regressions were employed to investigate the determinants of allergic conditions. RESULTS Prevalence rates were 2.7% (95% CI: 2.1-3.4) for asthma-ever, 6.9% (5.9-7.9) for lifetime wheezing, 2.9% (92.2-3.6) for current wheezing and 11.4% (10.1-12.7) for self-reported lifetime allergic rhinitis; while 240 (10.4%) participants reported current symptoms of allergic rhinitis, and 125 (5.4%) had allergic rhino-conjunctivitis. The prevalence of current asthma medication use and self-reported asthma attack was 0.8 (0.4-1.2) and 1 (0.6-1.4) respectively. Multivariable adjusted determinants of current wheezing were signs of atopic eczema [2.91 (1.09-7.74)] and signs of allergic rhinitis [3.24 (1.83-5.71)]. Age group 31-40 years [0.27(0.09-0.78), p = 0.016] was an independent protective factor for wheezing. Determinants of current rhinitis symptoms were active smoking [2.20 (1.37-3.54), p<0.001], signs of atopic eczema [2.84 (1.48-5.46)] and current wheezing [3.02 (1.70-5.39)]. CONCLUSION Prevalence rates for asthma and allergic rhinitis among adults in this population were at the lower tails of those reported in other regions of the world. Beside the classical interrelation between allergic diseases found in this study, active smoking was an independent determinant of allergic rhinitis symptoms. Nationwide surveys are needed to investigate regional variations.
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Affiliation(s)
- Eric Walter Pefura-Yone
- Department of Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- Pneumology service, Yaounde Jamot Hospital, Yaounde, Cameroon
| | - André Pascal Kengne
- South African Medical Research Council, Cape Town, South Africa
- University of Cape Town, Cape Town, South Africa
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Emmanuel Afane-Ze
- Department of Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- Pneumology service, Yaounde Jamot Hospital, Yaounde, Cameroon
| | - Christopher Kuaban
- Department of Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
- Faculty of Heath Sciences, University of Bamenda, Bamenda, Cameroon
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