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Guo M, Wei L, Yan H, Duan Z, Niu Z, Xiao C. Exposure to ambient air pollution during trimesters of pregnancy and childhood allergic diseases in Wuhan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1962-1972. [PMID: 34155935 DOI: 10.1080/09603123.2021.1929873] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/05/2021] [Indexed: 06/13/2023]
Abstract
The study explored the associations between maternal exposure to air pollution during different trimesters and allergic diseases including asthma, allergic rhinitis, allergic conjunctivitis or/and eczema. Individual exposure to air pollutants was assessed by an inverse distance weighted (IDW) method using daily concentrations of SO2, NO2, PM10, and PM2.5 from air quality monitoring stations. Multiple logistic regression model was performed to estimate the associations between air pollution during each trimester of pregnancy and childhood allergic diseases. A total of 332 children (51.3%) were reported by their parents having been diagnosed with allergic diseases. After adjusting for covariates, allergic diseases were significantly associated with per interquartile range (IQR) increase in NO2, PM10, PM2.5 during the second trimester with odds ratios (ORs) and 95% confidence intervals (95%CIs) being 1.292 (1.005,1.662), 1.210 (1.042,1,405) and 1.270 (1.004,1.606), respectively. These findings suggest that maternal exposure to certain air pollutants during pregnancy, especially in the second trimester, is associated with childhood allergic diseases.
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Affiliation(s)
- Menglan Guo
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, China
| | - Liqing Wei
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, China
| | - Hong Yan
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, China
| | - Zhizhou Duan
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, China
| | - Zhiping Niu
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, China
| | - Chenchang Xiao
- Department of Medicine, City College, Wuhan University of Science and Technology, Wuhan, China
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Ludvigsson JF, Loboda A. Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees. Acta Paediatr 2022; 111:1341-1353. [PMID: 35466444 PMCID: PMC9324783 DOI: 10.1111/apa.16370] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 12/24/2022]
Abstract
Aim Millions of Ukrainian children have been internally displaced or fled to other countries because of the Russian war. This systematic review focused on their health needs and future challenges for clinicians. Methods A systematic literature search of the Medline, Embase and MedRxiv databases from 1 January 2010 to 31 March 2022 identified 1628 papers on the health of Ukrainian children and 112 were relevant to this review. Results In 2019, under‐5 mortality was 8 per 1000 live births in Ukraine. Underweight and adverse childhood experiences, including child abuse, were frequent compared to other European countries, while childhood obesity seemed less common. Alcohol consumption was common in women of reproductive age, including during pregnancy, risking foetal alcohol syndrome. Neonatal screening programmes provided low coverage. Vaccine hesitancy was common and vaccination rates were low. Other concerns were measles, HIV, antibiotic resistance and multi‐resistant tuberculosis. Many children are expected to suffer from psychological and physical trauma due to the war. Other healthcare challenges include low COVID‐19 vaccination rates and a preference for secondary and tertiary care, rather than primary care. Many people cannot afford medication. Conclusion Ukrainian children often have poor health and host countries need to be aware of their needs.
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Affiliation(s)
- Jonas F. Ludvigsson
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Paediatrics Orebro University Hospital Orebro Sweden
- Department of Medicine Columbia University College of Physicians and Surgeons New York New York USA
| | - Andrii Loboda
- Department of Paediatrics, Academic and Research Medical Institute Sumy State University Sumy Ukraine
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Mazur M, Czarnobilska M, Dyga W, Czarnobilska E. Trends in the Epidemiology of Allergic Diseases of the Airways in Children Growing Up in an Urban Agglomeration. J Clin Med 2022; 11:jcm11082188. [PMID: 35456279 PMCID: PMC9031390 DOI: 10.3390/jcm11082188] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/03/2022] [Accepted: 04/11/2022] [Indexed: 01/07/2023] Open
Abstract
The prevalence of asthma and allergies among children has become an increasing problem in the last few decades. Data on the population of children and adolescents, especially living in polluted cities, are limited and based on studies carried out in small groups. In our study, we analyzed the incidence of asthma and allergic rhinitis between 2014 and 2018. We analyzed data collected from nearly 30,000 children aged seven to eight and adolescents aged 16–17, which allowed us to assess the frequency of allergic diseases in the population of children and youth in Krakow. More than 40% of respondents reported allergic symptoms, and nearly 50% of them were not diagnosed and treated. In the group of seven- and eight-year-olds with a positive history of allergies, 52% had allergic rhinitis and 9.1% had asthma. In the group of 16–17-year-olds, allergic rhinitis was diagnosed in 35.8%, while asthma was found in 4.9% of cases. The results obtained over the course of 10 years has shown the reduction in the frequency of asthma (from 22% in the case of asthma in both age groups) and allergic rhinitis cases (from 63.9% in adolescents). In our opinion, this can be considered a positive effect of the preventive measures taken in Kraków after 2010. Although there is still a higher incidence of allergic diseases among children and young people living in urban areas compared to rural areas, the trend apparently has reversed for some diseases.
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Affiliation(s)
- Marcel Mazur
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Botaniczna St. 3, 31-501 Krakow, Poland; (M.M.); (W.D.)
| | - Maria Czarnobilska
- Department of Pathohysiology, Jagiellonian University Medical College, Czysta St. 18, 31-121 Krakow, Poland;
| | - Wojciech Dyga
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Botaniczna St. 3, 31-501 Krakow, Poland; (M.M.); (W.D.)
| | - Ewa Czarnobilska
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Botaniczna St. 3, 31-501 Krakow, Poland; (M.M.); (W.D.)
- Correspondence: ; Tel.: +48-12-424-86-50
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Gao H, Niu Y, Wang Q, Shan G, Ma C, Wang H, Hu Y, Guan K, Gu J, Wang J, Wang T, Zhao H, Han H, Chen H, Ruan W, Zhang H, Cong C, Wang L, Liu Y. Analysis of Prevalence and Risk Factors of Adult Self-Reported Allergic Rhinitis and Asthma in Plain Lands and Hilly Areas of Shenmu City, China. Front Public Health 2022; 9:749388. [PMID: 35059372 PMCID: PMC8765605 DOI: 10.3389/fpubh.2021.749388] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: The main aim of this study was to investigate the prevalence and risk factors of adult self-reported allergic rhinitis and asthma in plain lands and hilly areas of Shenmu City in China, and analyze the differences between regions. Methods: The multi-stage stratified random sampling was applied in a cross-sectional survey of adult residents in Shenmu City, from September to December 2019. The unconditional logistic regression analysis was used to screen the influence factors of allergic rhinitis and asthma. Results: 4,706 adults participated in the survey, and 99% (4,655 in 4,706) completed the questionnaires. The prevalence of allergic rhinitis was 25.4%, and the prevalence of asthma was 9.4%. The prevalence of the allergic rhinitis without asthma, asthma without allergic rhinitis, and the combined allergic rhinitis with asthma were 18.9, 2.9, and 6.5%, respectively. The prevalence of allergic rhinitis and asthma existed regional differences. The prevalence of adult self-reported allergic rhinitis was 41.5% in plain lands areas and 22.1% in hilly areas. The prevalence of adult self-reported asthma was 12.8% in plain lands and 8.8% in hilly areas. The prevalence of allergic rhinitis and asthma existed seasonal differences, with the highest prevalence from July to September. The analysis of risk factors showed that higher education [middle and high school (OR 1.72, 95%CI 1.42–2.07); college and above (OR 2.67, 95%CI 1.99–3.59)], comorbidities of other allergic diseases (OR 3.90, 95%CI 3.23–4.70), family history of allergies (OR 2.89, 95%CI 2.36–3.53), and plain lands areas (OR 2.51, 95%CI 2.06–3.05) were the risk factors for the allergic rhinitis without asthma. Aging [40–49 years old (OR 4.29, 95%CI 1.02–18.13); 50–59 years old (OR 5.89, 95%CI 1.40–24.76); ≥60 years old: (OR 6.14, 95%CI 1.41–26.71)], never-smokers (OR 1.66, 95%CI 0.99–2.80), comorbidities of other allergic disorders (OR 2.17, 95%CI 1.42–3.32), and family history of allergies (OR 2.20, 95%CI 1.40–3.47) were the risk factors for the asthma without allergic rhinitis. Advanced age [30–39 years (OR 2.16, 95%CI 1.23–3.82); 40–49 years (OR 2.86, 95%CI 1.56 to 5.25); 50–59 years (OR 2.95, 95%CI 1.58–5.51); ≥60 years old (OR 2.27, 95%CI 1.09–4.72)], higher education [middle and high school (OR 2.23, 95%CI 1.62–3.07); college and above (OR 4.28, 95%CI 2.72–6.74)], non-agricultural workers (OR 1.70, 95%CI 1.18–2.43),never-smokers (OR 2.26, 95%CI 1.51–3.39), comorbidities of other allergic diseases (OR 4.45, 95%CI 3.37–5.88), family history of allergies (OR 5.27, 95%CI 3.98–6.97), and plain lands areas (OR 2.07, 95%CI 1.51–2.86) were the risk factors for the combined allergic rhinitis with asthma. Conclusions: The prevalence of allergic rhinitis and asthma in Shenmu City was relatively high, with regional differences. Genetic and environmental factors were the important risk factors associated with allergic rhinitis and asthma. Our research would provide data support for preventing and controlling allergic rhinitis and asthma in this region in the future, and appropriate prevention and control programs should be formulated according to the characteristics of different regions.
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Affiliation(s)
- Huiping Gao
- Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, China
| | - Yongliang Niu
- Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, China
| | - Qiang Wang
- Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, China
| | - Guangliang Shan
- School of Basic Medicine, Institute of Basic Medical Sciences, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Chao Ma
- School of Basic Medicine, Institute of Basic Medical Sciences, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Haiying Wang
- Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, China
| | - Yaoda Hu
- School of Basic Medicine, Institute of Basic Medical Sciences, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Kai Guan
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jianqing Gu
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Wang
- School of Basic Medicine, Institute of Basic Medical Sciences, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Tao Wang
- School of Basic Medicine, Institute of Basic Medical Sciences, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Hongmei Zhao
- School of Basic Medicine, Institute of Basic Medical Sciences, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui Han
- Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, China
| | - Haiyuan Chen
- Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, China
| | - Wenxia Ruan
- Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, China
| | - Hanlin Zhang
- School of Basic Medicine, Institute of Basic Medical Sciences, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Cong Cong
- School of Basic Medicine, Institute of Basic Medical Sciences, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Lianglu Wang
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yonglin Liu
- Shenmu Hospital, The Affiliated Shenmu Hospital of Northwest University, Shenmu, China
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DZIARZHYNSKAYA NADZEYA, HINDZIUK ANDREY, HINDZIUK LARISA, SYSOEVA IRINA, KRUPSKAYA DARYA, URBAN ULIA, CHERNIAVSKAYA NATALYA, VISHNEVSKAYA ALEXANDRA, MAKAROVA ELENA, ERMAK SVETLANA, HINDZIUK NELLI. Airborne chemical pollution and children's asthma incidence rate in Minsk. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 62:E871-E878. [PMID: 35603254 PMCID: PMC9104677 DOI: 10.15167/2421-4248/jpmh2021.62.4.1568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 10/28/2021] [Indexed: 11/12/2022]
Abstract
Introduction Asthma manifestations are closely connected with air pollution. Discovering interconnection between concentrations of air pollutants and asthma incidence rate among children provides information for developing effective measures to reduce air pollution and improve population health. Study purpose was to carry out hygienic analysis of the influence of atmospheric air quality on the incidence rate of bronchial asthma of children in Minsk in 2009-2018. Methods During 2019 retrospective health cohort study was conducted, data from stationary air quality monitoring posts were collected. Correlation analysis was conducted by determining the Pearson coefficient. Results Ten-year levels of asthma incidence rate had a moderate downward trend; the highest levels were registered among 5-9-year-old children. 74.7% of all cases of asthma were registered among children under 10 years: 33,61% among 1-4-year-old and 41.09% - among 5-9-year-old. Results of the study showed that concentrations of ammonia, particulate matter (dust/aerosol undifferentiated in composition) and lead in Minsk were characterized by downward trend, carbon oxide and nitrogen dioxide concentrations remained unstable, elevated levels of formaldehyde remained near highways with heavy traffic. Strong evidence was found for concentrations of particulate matter (dust/aerosol undifferentiated in composition) (R = 0.76-0.85, p < 0.05), lead (R = 0.69-0.97, p < 0.05), ammonia (R = 0.64-0.72, p < 0.05) nitrogen dioxide (R = 0.63-0.8, p < 0.05) and children's asthma incidence rate. Conclusions Obtained results indicate that particulate matter, lead, ammonia and nitrogen dioxide concentrations hesitation causes changes in children's asthma incidence levels. Not being the initial cause of the disease, they influence epidemic process and can be the target for preventive measures.
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Affiliation(s)
- NADZEYA DZIARZHYNSKAYA
- Belarusian State Medical University, Minsk, Belarus
- Correspondence: Nadzeya Dziarzhynskaya, Belarusian State Medical University, Minsk, Belarus; 2 Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus - E-mail:
| | | | | | | | - DARYA KRUPSKAYA
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
| | - ULIA URBAN
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
| | | | | | - ELENA MAKAROVA
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
| | - SVETLANA ERMAK
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
| | - NELLI HINDZIUK
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
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Leung ASY, Tham EH, Li J, Pacharn P, Takizawa T, Lee E, Xing Y, Leung TF, Hong SJ, Wong GWK. The role of the environment in shaping the trends of childhood asthma - An Asian perspective. Pediatr Allergy Immunol 2021; 32:1152-1164. [PMID: 33760296 DOI: 10.1111/pai.13508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/14/2021] [Accepted: 03/19/2021] [Indexed: 12/15/2022]
Abstract
Asthma has now become one of the most common atopic disorders not only in developed countries but also in many developing countries. The etiology is likely due to a complex interaction between genetic and environmental factors. In many Asian countries, the prevalence of asthma has also been documented by validated instruments to be increasing rapidly over the past two decades. However, studies in rural areas in Asia with a traditional farming environment revealed markedly lower asthma prevalence when compared with residents in nearby cities despite having similar genetic background. Among the environmental factors implicated in the pathogenesis of asthma, air pollution, dietary patterns, viral infections, and early microbial exposure have been studied extensively around the world. Asia provides many opportunities to study these potential factors as there are many ethnic groups living in distinctly different environments. The understanding of the roles of these factors in affecting the early immune system and subsequent development of asthma will enable us to develop potential primary preventive strategies against a disease which affects millions worldwide.
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Affiliation(s)
- Agnes S Y Leung
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Elizabeth Huiwen Tham
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jing Li
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Punchama Pacharn
- Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Takumi Takizawa
- Department of Pediatrics, Graduate School of Medicine, Gunma University, Gunma, Japan
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Yuhan Xing
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Ting-Fan Leung
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Soo-Jong Hong
- Childhood Asthma and Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gary W K Wong
- Department of Paediatrics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
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Beridze V, Bakhtadze T, Beridze S, Phagava K, Chkhaidze I, Brożek GM, Zejda JE. Coexistence of asthmatic and non-respiratory allergic symptoms in children of Batumi Region, Georgia: occurrence and association with known diagnosis of asthma. Cent Eur J Public Health 2021; 29:23-27. [PMID: 33831283 DOI: 10.21101/cejph.a6143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 01/04/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Our recent studies showed that in children in the Batumi region, Georgia, underdiagnosis of asthma is 65%, and that not all children with known asthma had a history of allergic disorders. So, we decided to assess the association of known diagnosis of paediatric asthma with asthma-like symptoms and non-respiratory allergic symptoms and diseases using questionnaire-derived data provided by respiratory health survey. METHODS Subjects of the cross-sectional population-based study were 3,239 urban and 2,113 rural children aged 5-17 years whose respiratory status was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. For children with a known diagnosis of asthma, the occurrence of respiratory symptoms suggestive of asthmatic tendency and of allergic symptoms and diseases was measured and statistical association of known asthma with the respiratory and allergic symptoms was expressed as odds ratios (OR) and their 95% confidence intervals (95% CI). RESULTS Respiratory and all allergic symptoms and diseases, except for eczema, were statistically significantly (p < 0.05) more prevalent in children with asthma than in children without asthma. Based on the distribution of asthma vis-à-vis asthmatic tendency without or with allergic symptoms and allergic diseases the following odds ratios expressing likelihood of asthma were obtained: for asthmatic tendency: OR = 18.09 (95% CI: 11.82-27.68), for any allergic symptom: OR = 6.85 (95% CI: 4.69-10.02), for any allergic disease: OR = 10.75 (95% CI: 7.36-15.70), for asthmatic tendency with coexisting any allergic symptom: OR = 18.94 (95% CI: 12.96-27.68), for asthmatic tendency with coexisting any allergic disease: OR = 25.65 (95% CI: 17.47-37.67), and for asthmatic tendency with coexisting any allergic symptom and allergic disease: OR = 27.02 (95% CI: 18.18-40.15). CONCLUSIONS The findings support the view that in epidemiological setting questionnaire-based studies on asthma seems to more readily identify cases in children with more severe clinical presentation of the disease and with coexisting allergic disorders, perhaps reflecting diagnostic practices of consulting paediatricians.
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Affiliation(s)
- Vakhtang Beridze
- M. Iashvili Batumi Maternity and Child Central Hospital, Shota Rustaveli State University, Batumi, Georgia
| | - Tamar Bakhtadze
- M. Iashvili Batumi Maternity and Child Central Hospital, Shota Rustaveli State University, Batumi, Georgia
| | - Sophio Beridze
- M. Iashvili Batumi Maternity and Child Central Hospital, Shota Rustaveli State University, Batumi, Georgia
| | - Karaman Phagava
- Department of Paediatrics, Tbilisi State Medical University, Tbilisi, Georgia
| | | | - Grzegorz Marek Brożek
- Department of Epidemiology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Katowice, Poland
| | - Jan Eugeniusz Zejda
- Department of Epidemiology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Katowice, Poland
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Guercio V, Pojum IC, Leonardi GS, Shrubsole C, Gowers AM, Dimitroulopoulou S, Exley KS. Exposure to indoor and outdoor air pollution from solid fuel combustion and respiratory outcomes in children in developed countries: a systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 755:142187. [PMID: 33017761 DOI: 10.1016/j.scitotenv.2020.142187] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
Epidemiological studies have shown a positive association between exposure to outdoor and indoor solid fuel combustion and adverse health effects. We reviewed the epidemiological evidence from Europe, North America, Australia and New Zealand on the association between outdoor and indoor exposure to solid fuel combustion and respiratory outcomes in children. We performed a systematic review and meta-analysis. Pooled relative risks (RRs) and 95% confidence intervals (CI) were calculated using random-effects models. We identified 74 articles. Due to limited evidence on other exposures and outcomes, we performed meta-analyses on the association between indoor wood burning exposure and respiratory outcomes. The RR for the highest vs the lowest category of indoor wood exposure was 0.90 (95% CI 0.77-1.05) considering asthma as an outcome. The corresponding pooled RRs for lower respiratory infection (LRI) and upper respiratory infection (URI) were 1.11 (95% CI 0.88, 1.41) and 1.11 (95% CI 0.85, 1.44) respectively. No association was found between indoor wood burning exposure and risk of wheeze and cough. Inconsistent and limited results were found considering the relationship between indoor wood burning exposure and other respiratory outcomes (rhinitis and hay fever, influenza) as well as indoor coal burning exposure and respiratory outcomes in children. Results from epidemiological studies that evaluated the relationship between the exposure to outdoor emissions derived from indoor combustion of solid fuels are too limited to allow firm conclusions. We found no association between indoor wood burning exposure and risk of asthma. A slight, but not significant, increased risk of LRI and URI was identified, although the available evidence is limited. Epidemiological studies evaluating the relationship between indoor coal burning exposure and respiratory outcomes, as well as, studies considering exposure to outdoor solid fuels, are too limited to draw any firm conclusions.
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Affiliation(s)
- Valentina Guercio
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom.
| | - Iulia C Pojum
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom
| | - Giovanni S Leonardi
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom
| | - Clive Shrubsole
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom
| | - Alison M Gowers
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom
| | - Sani Dimitroulopoulou
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom
| | - Karen S Exley
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom
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Galiniak S, Rachel M. Comparison of fractional exhaled nitric oxide in asthmatics with and without allergic rhinitis. Biomarkers 2021; 26:174-183. [PMID: 33435738 DOI: 10.1080/1354750x.2020.1871410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE OF THE STUDY The aim of this study was to measure the concentration of FeNO in asthmatics with and without allergic rhinitis (AR) and to determine usefulness of the test in the assessment of asthma control in the Polish population. The next objective of this study was to estimate the cut-off point of FeNO which might be a good indicator of uncontrolled asthma. MATERIALS AND METHODS The measurements were taken using the Hyp'Air FeNO in 303 adult patients with asthma, AR, comorbid AR and asthma, and non-diseased volunteers. RESULTS FeNO level in healthy adults was similar to the FeNO concentration in AR as well as controlled asthmatic patients without and with AR. Patients with partly controlled and uncontrolled asthma with and without AR had higher FeNO (>60 ppb) levels when compared to adults with controlled disease. The optimal cut-off point of FeNO > 46 ppb and FeNO > 33 ppb was estimated for identification of uncontrolled asthmatics without and with AR, respectively. CONCLUSION In conclusion, we found a significant correlation between the FeNO concentration and the level of asthma symptom control in asthmatic patients with and without AR.
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Affiliation(s)
| | - Marta Rachel
- Medical College of Rzeszów University, Rzeszów, Poland.,Allergology Department, Provincial Hospital No 2, Rzeszów, Poland
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Dias CS, Mingoti SA, Ceolin APR, Dias MADS, Friche AADL, Caiaffa WT. The influence of climatic conditions on hospital admissions for asthma in children and adolescents living in Belo Horizonte, Minas Gerais, Brazil. CIENCIA & SAUDE COLETIVA 2020; 25:1979-1990. [PMID: 32402021 DOI: 10.1590/1413-81232020255.04442018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 05/09/2019] [Indexed: 11/21/2022] Open
Abstract
Limited research exists on the influence of climatic conditions on the risk of hospital admission for asthma in Minas Gerais, Brazil. The objectives of this article are: a) to evaluate the influence of climatic conditions on hospital admissions for asthma and lower respiratory tract infections (LRTIs) among children and adolescents living in Belo Horizonte during the period 2002 to 2012 and identify epidemic peaks of admissions for asthma; b) to compare local seasonal patterns of admissions for asthma and LRTIs. Using hospital admission data stratified by aged group, regression analysis was performed to determine the relationship between the variables. Epidemic peaks were identified using an ARIMA model. There was an increase in admissions for asthma with an increase in relative humidity after rainy periods; admissions for bronchiolitis were associated with low levels of maximum temperature and rainfall. Rainy periods can lead to an increase in indoor and outdoor humidity, facilitating fungal proliferation, while cold periods can lead to an increase in the spread of viruses.
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Affiliation(s)
- Cláudia Silva Dias
- Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, MG, Brazil,
| | - Sueli Aparecida Mingoti
- Departamento de Estatística, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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11
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Symptom-based screening tool for asthma syndrome among young children in Uganda. NPJ Prim Care Respir Med 2020; 30:18. [PMID: 32376892 PMCID: PMC7203121 DOI: 10.1038/s41533-020-0175-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 04/09/2020] [Indexed: 11/08/2022] Open
Abstract
Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensus diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
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12
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Zejda JE, Beridze V, Bakhtadze T, Beridze S, Abuladze L, Partenadze N, Lawson J. Prevalence of and factors associated with underdiagnosis of pediatric asthma in Batumi, Georgia. Allergol Immunopathol (Madr) 2020; 48:73-77. [PMID: 31477393 DOI: 10.1016/j.aller.2019.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/12/2019] [Accepted: 05/22/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE A recent survey in Batumi, Georgia showed a low prevalence of asthma in children (1.8%). A potential explanation is underdiagnosis of asthma. To investigate this, we conducted a follow up to the survey with the objective of estimating the level of childhood asthma underdiagnosis and to describe factors related to it. METHODS Subjects included 437 survey participants who had a history of asthma-like symptoms and no diagnosis of asthma. All children underwent clinical examination (spirometry, skin prick tests, FeNO measurement) to identify new cases of asthma. The distribution of host and environmental factors was compared between the group with newly identified asthma and a group of 59 children with previously known asthma (diagnosed asthma). RESULTS Clinical investigation identified 107 cases of undiagnosed asthma. The corrected asthma prevalence estimate was 5.1% (95%CI: 4.4%-5.9%) suggesting that 65% of asthma cases were undiagnosed. Compared to children with diagnosed asthma, children with undiagnosed asthma were younger (8.2±1.6 vs. 9.3±2.1; p=0.0005), had less frequent history of allergic disorders (38.3% vs. 64.4%; p=0.001), and a lower prevalence of parental asthma (1.8% vs. 8.4%; p=0.04). The groups did not differ in terms of environmental characteristics except for more exposure to passive smoking in the undiagnosed asthma group (p=0.01). Multivariate analysis confirmed results of simple analyses. CONCLUSION In Batumi, 65% of children with asthma remain undiagnosed. Older age of a child, coexisting allergic disorders, and parental asthma seem to facilitate diagnosis. Implementation of current diagnostic guidelines should improve diagnostic accuracy of pediatric asthma in Batumi.
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Affiliation(s)
- J E Zejda
- Department of Epidemiology, School of Medicine, Medical University of Silesia, Katowice, Poland.
| | - V Beridze
- Faculty of Natural Sciences and Health Care, Shota Rustaveli State University, Batumi, Georgia
| | - T Bakhtadze
- Faculty of Natural Sciences and Health Care, Shota Rustaveli State University, Batumi, Georgia
| | - S Beridze
- Faculty of Natural Sciences and Health Care, Shota Rustaveli State University, Batumi, Georgia
| | - L Abuladze
- Maternity and Child Health Center, Batumi, Georgia
| | - N Partenadze
- Maternity and Child Health Center, Batumi, Georgia
| | - J Lawson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Canada
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13
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de Oliveira TB, Moscon JG, Ferreira ENDN, da Veiga ABG. Prevalence of symptoms of asthma and allergic rhinitis in children in Southern Brazil: a ten-year monitoring study. J Asthma 2019; 57:373-380. [PMID: 30720381 DOI: 10.1080/02770903.2019.1573253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: This study analyzes and describes trends in prevalence of asthma and rhinitis in children 6-7 years old living in Santo Ângelo, Brazil, by comparing data from 2007, 2012, and 2017. Methods: The ISAAC (International Study of Asthma and Allergies in Childhood) standardized written questionnaire was used in a three cross-sectional survey. The questionnaire was applied between March and May of 2007, 2012 and 2017. Results: A total of 701 children participated in the survey: 225 children in 2007, 229 in 2012, and 247 in 2017. There were no differences in the prevalence of current wheeze in the years of this study. On the other hand, a higher percentage of children were diagnosed with asthma in 2012 (26.2%) than in 2007 (10.2%) and 2017 (10.1%) (p < 0.05); however, the severity of asthma was lower in 2012 when compared to other years. Regarding cases of probable asthma - which included patients with suspected asthma or wheezing and nocturnal cough without a diagnosis of asthma - these corresponded to 15.7, 17.0, and 25.1% of the cases in 2007, 2012 and 2017, respectively. For other allergic diseases, we found no statistical difference in the frequency of symptoms of current rhinitis (55.5%, 54.6%, 51.8% in 2007, 2012, and 2017, respectively), allergic rhinitis (45.3%, 45.0%, 36.4% in 2007, 2012, and 2017, respectively), or pollinosis (17.8%, 12.7%, 14.2% in 2007, 2012, and 2017, respectively). Conclusions: The prevalence of probable asthma increased from 2007 to 2017. The prevalence of symptoms and diagnosis of allergic rhinitis and pollinosis was relatively high and these allergies must be considered in the pediatric population of the region.
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Affiliation(s)
- Tiago Bittencourt de Oliveira
- Universidade Regional Integrada do Alto Uruguai e das Missões - URI, Departamento Ciências da Saúde, Santo Ângelo, RS, Brazil.,Universidade Federal de Ciências da Saúde de Porto Alegre, Programa de Pós-Graduação em Patologia, Porto Alegre, RS, Brazil
| | - Jordana Griebeler Moscon
- Universidade Regional Integrada do Alto Uruguai e das Missões - URI, Departamento Ciências da Saúde, Santo Ângelo, RS, Brazil
| | | | - Ana Beatriz Gorini da Veiga
- Universidade Federal de Ciências da Saúde de Porto Alegre, Programa de Pós-Graduação em Patologia, Porto Alegre, RS, Brazil
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14
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Fazlollahi MR, Najmi M, Fallahnezhad M, Sabetkish N, Kazemnejad A, Bidad K, Shokouhi Shoormasti R, Mahloujirad M, Pourpak Z, Moin M. Paediatric asthma prevalence: The first national population-based survey in Iran. CLINICAL RESPIRATORY JOURNAL 2019; 13:14-22. [PMID: 30472812 DOI: 10.1111/crj.12975] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 09/26/2018] [Accepted: 11/17/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND The actual prevalence of paediatric asthma as a worldwide chronic disease has been surveyed in developed countries. However, no sufficient survey has been conducted in most of the eastern developing countries. Herein, we took measures to evaluate the prevalence of paediatric asthma in Iran. METHODS In this national cross-sectional study, the prevalence of asthma symptoms was estimated throughout the country using a randomized multistage stratified cluster sampling method in 16 410 and 16 850 individuals aged 6-7 and 13-14 years, respectively. A validated questionnaire including core questions of the International Study of Asthma and Allergies in Childhood (ISAAC) was applied between November 2015 and February 2016. RESULTS The total prevalence of asthma was 10.9% (n = 3624) (95% confidence interval [CI]: 10.6%-11.2%) which was significantly higher among 13- to 14-year olds compared to a younger age group (12.4% vs. 9.4%, P < 0.001), males versus females (12.1% vs. 9.8%, P < 0.001) and residents of urban compared to rural areas (P = 0.003). The prevalence of severe asthma was 3.9%, being significantly more prevalent in higher age groups and male individuals (P < 0.001). A significant relationship was found between asthma and passive smoking in both 6- to 7- and 13- to 14-year olds (P < 0.001). CONCLUSIONS The prevalence of asthma and severe asthma in the paediatric population of Iran was similar to other developing countries. It is recommended to pay special attention to urban regions, male individuals and higher age groups for better controlling of asthma. Nevertheless, further national surveys are necessary to determine the trend of paediatric asthma in Iran.
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Affiliation(s)
- Mohammad Reza Fazlollahi
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Najmi
- Center of Non-communicable Diseases Management, Deputy for health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mojtaba Fallahnezhad
- Razi Science Researchers Institute, Tehran, Iran.,Health Department of Zanjan, University of Medical Sciences, Zanjan, Iran
| | - Nastaran Sabetkish
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Katayoon Bidad
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Maryam Mahloujirad
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Pourpak
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Moin
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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15
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Olaniyan T, Dalvie MA, Röösli M, Naidoo R, Künzli N, de Hoogh K, Parker B, Leaner J, Jeebhay M. Asthma-related outcomes associated with indoor air pollutants among schoolchildren from four informal settlements in two municipalities in the Western Cape Province of South Africa. INDOOR AIR 2019; 29:89-100. [PMID: 30339304 DOI: 10.1111/ina.12511] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/31/2018] [Accepted: 10/13/2018] [Indexed: 06/08/2023]
Abstract
The health impact of indoor air pollution in informal settlement households has not been extensively studied in South Africa. This cross-sectional study investigated the association between asthma and common indoor exposures among schoolchildren from four informal settlements located in two municipalities in the Western Cape Province. A total of 590 children, aged 9-11 years, were recruited. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was administered to caregivers. Pulmonary function assessment included spirometry and fractional exhaled nitric oxide (FeNO). Phadiatop test for atopy was done. The prevalence of doctor-diagnosed asthma was 3.4% (n = 20) among whom only 50% were on treatment. The prevalence of current wheeze was 12.9%, and 17.6% had airway obstruction (FEV1 < lower limit of normal), while 10.2% had airway inflammation (FeNO > 35 ppb). In adjusted logistic regression models, dampness, visible mold growth, paraffin use for cooking, and passive smoking were associated with a twofold to threefold increased risk in upper and lower airway outcomes. The strongest association was that of visible mold growth with rhinitis (adjusted odds ratio-aOR 3.37, 95% CI: 1.69-6.71). Thus, there is a need for improved diagnosis of childhood asthma and Indoor Air Quality in informal settlement households.
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Affiliation(s)
- Toyib Olaniyan
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Mohamed Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Rajen Naidoo
- University of Kwazulu-Natal, Durban, South Africa
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Bhawoodien Parker
- Department of Environmental Affairs and Developmental Planning, Western Cape Government, Cape Town, South Africa
| | - Joy Leaner
- Department of Environmental Affairs and Developmental Planning, Western Cape Government, Cape Town, South Africa
| | - Mohamed Jeebhay
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Division of Occupational Medicine, University of Cape Town, Cape Town, South Africa
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16
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An international comparison of risk factors between two regions with distinct differences in asthma prevalence. Allergol Immunopathol (Madr) 2018; 46:341-353. [PMID: 29588089 DOI: 10.1016/j.aller.2018.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 12/13/2017] [Accepted: 01/03/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Investigation of the geographic variation in asthma prevalence can improve our understanding of asthma etiology and management. The purpose of our investigation was to compare the prevalence of asthma and wheeze among adolescents living in two distinct international regions and to investigate reasons for observed differences. METHODS A cross-sectional survey of 13-14 year olds was completed in Saskatoon, Canada (n=1200) and Skopje, Republic of Macedonia (n=3026), as part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3 study. Surveys were self-completed by students following the ISAAC protocol. Multiple logistic regression models were used to investigate associations with reports of asthma and current wheeze. A mediation analysis was then completed. RESULTS Asthma prevalence was much higher in Saskatoon than Skopje (21.3% vs. 1.7%) as was the prevalence of current wheeze (28.2% vs. 8.8%). Higher paracetamol (acetaminophen) use was a consistent risk factor for asthma and wheeze in both locations and showed dose-response relationships. In both countries, paracetamol use and physical activity mediated some of the association for both asthma and wheeze. In Saskatoon, among those with current wheeze, 42.6% reported ever having a diagnosis of asthma compared to 10.2% among Skopje adolescents. CONCLUSIONS The results suggest that the variation in risk factors between the two locations may explain some of the differences in the prevalence of asthma and wheeze between these two study sites. However, diagnostic labeling patterns should not be ruled out as another potential explanatory factor.
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17
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Emeryk A, Bartkowiak-Emeryk M, Raus Z, Braido F, Ferlazzo G, Melioli G. Mechanical bacterial lysate administration prevents exacerbation in allergic asthmatic children-The EOLIA study. Pediatr Allergy Immunol 2018; 29:394-401. [PMID: 29575037 DOI: 10.1111/pai.12894] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Despite progress in asthma management, prevention of asthma exacerbation remains challenging in school-aged children with allergic asthma. New therapeutic approaches are needed. Previously, a chemical bacterial lysate has been successfully used in preschool children to reduce wheezing attacks. We assessed the effect of Polyvalent Mechanical Bacterial Lysate (PMBL® ) Tablet on asthma clinical course and control in 6- to 16-year-old children with partly controlled or uncontrolled allergic asthma. METHODS A randomized, double-blind, placebo-controlled, parallel-group study was performed in 152 patients exhibiting allergic asthma assigned to receive Placebo or PMBL® . Eligible patients underwent four visits during the 9-month study. Asthma control level was assessed by ACT/C-ACT score. RESULTS The main criterion was not achieved as ACT/C-ACT changes were similar in both groups at the end of the 3-month treatment period. However, the mean number (±SD) of asthma exacerbations was significantly lower with PMBL® Tablet than with Placebo at Week 12 (0.3 ± 0.6 vs 0.8 ± 1.1, P = .009) and over the total study period (1.1 ± 1.3 vs 1.9 ± 2.0, P = .01). Consistently, the mean number of days with exacerbation per patient was significantly lower with PMBL® Tablet (13.3 ± 11.2 vs 19.8 ± 15.7 over the whole study, P = .009). Treatment with PMBL® Tablet prolonged the time to second exacerbation by 55% (Hazard Ratio [HR]=0.45; 95% Confidence Interval [CI] 0.27 to 0.77, P = .002) and to third exacerbation by 74% (HR=0.26; 95% CI 0.12 to 0.58, P < .001). No serious adverse event related to PMBL® Tablet administration was recorded. CONCLUSION Administration of PMBL® Tablet represents a safe and effective means for significantly reducing the rate of exacerbations in school-aged allergic asthmatic children. (EudraCT 2013-000737-12 and NCT02541331).
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Affiliation(s)
- Andrzej Emeryk
- Department of Paediatric Pulmonology and Rheumatology, University Children Hospital of Lublin, Lublin, Poland
| | | | - Zbigniew Raus
- LaserMed Diagnosis and Treatment Centre, Chełm, Poland
| | - Fulvio Braido
- Allergy and Respiratory Diseases Department, University of Genoa, IRCCS A.O.U San Martino- IST, Genova, Italy
| | - Guido Ferlazzo
- Laboratory of Immunology and Biotherapy, Department of Human Pathology, University of Messina, Messina, Italy
| | - Giovanni Melioli
- Allergy and Respiratory Diseases Department, University of Genoa, IRCCS A.O.U San Martino- IST, Genova, Italy
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18
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Mentz G, Robins TG, Batterman S, Naidoo RN. Acute respiratory symptoms associated with short term fluctuations in ambient pollutants among schoolchildren in Durban, South Africa. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 233:529-539. [PMID: 29102883 PMCID: PMC5764788 DOI: 10.1016/j.envpol.2017.10.108] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/26/2017] [Accepted: 10/26/2017] [Indexed: 05/10/2023]
Abstract
Ambient air pollution has been associated with adverse respiratory outcomes, especially among children with asthma. This study reports on associations between daily ambient air pollutant concentrations and the respiratory symptoms of schoolchildren living in Durban, South Africa. This city is Africa's busiest port and a key hub for imported crude oil and exported refined petroleum and petrochemical products, and it experiences a mixture of air pollutants that reflects emissions from industry, traffic and biomass burning. Children in four communities in the highly industrialized southern portion of the city were compared to children of similar socio-economic profiles living in the north of the city. One school was selected in each community. A total of 423 children were recruited. Symptom logs were completed every 1.5-2 h over 3-week period in each of four seasons. Ambient concentrations of NO2, NO, SO2, CO, O3, PM2.5 and PM10 were measured throughout the study. Generalized estimating equation (GEE) models were used to estimate odds ratios (ORs) and assess lag effects (1-5 days) using single pollutant (single lags or distributed lags) models. Concentrations of SO2 and NOx were markedly higher in the south, while PM10 did not vary. Significant increase in the odds ratios of cough were identified for the various lags analyzed. The OR of symptoms was further increased among those living in the south compared to the north. In conclusion, in this analysis of over 70,000 observations, we provide further evidence that exposure to PM10, SO2, NO2 and NO is associated with significantly increased occurrence of respiratory symptoms among children. This was evident for cough, shortness of breath, and chest tightness, across the four pollutants and for different lags of exposure. This is the first study describing these changes in sub-Saharan Africa.
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Affiliation(s)
- Graciela Mentz
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1420 Washington Heights, Room M6007 SPH II 2029, Ann Arbor, MI 48109-2029, USA.
| | - Thomas G Robins
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1420 Washington Heights, Room M6007 SPH II 2029, Ann Arbor, MI 48109-2029, USA.
| | - Stuart Batterman
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1420 Washington Heights, Room M6007 SPH II 2029, Ann Arbor, MI 48109-2029, USA.
| | - Rajen N Naidoo
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Room 321, George Campbell Building, Durban, 4041, South Africa.
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Abstract
PURPOSE OF REVIEW The prevalence of asthma was thought to be low in most low-income countries, but several reports have indicated this is not always true. This is a narrative review of recent publications on the burden of asthma in low and middle-income countries (LMIC) and underprivileged communities from developed countries. RECENT FINDINGS Several studies have reported a low prevalence of asthma is LMIC, but indicate it is increasing. In the last few years, however, many surveys demonstrated this may not always be true. An analysis of the International Study for Asthma and Allergy in Childhood phase III database indicated although the prevalence of asthma among children and adolescents is higher in the developed countries, symptoms of asthma are often more severe in less affluent nations. The rate of uncontrolled asthma is also higher among underprivileged communities of developed countries. Secondary analysis of data generated by the WHO's world health survey performed among adults of 70 countries indicate symptoms of asthma are less frequent in middle-income countries and more frequent in the extremes, low income and high income. This sort of U shaped distribution suggests the disease (or syndrome) comprise more than one major phenotype related to diverse underlying mechanisms. In fact, recent reports show symptoms of asthma among the poor are associated with unhygienic living conditions, which may reduce the risk of atopy but increase the risk of nonatopic wheezing. Urbanization and exposure to air pollution also seem to contribute to an increasing prevalence severity of asthma in LMIC. Access to proper diagnosis and treatment with controller medications for asthma, specially with inhaled corticosteroids is feasible and cost-effective, reduce symptoms, health resource utilization, improves quality of life, and reduce mortality in low-resource settings. SUMMARY Prevalence of asthma was thought to be low in low-income countries, but several reports have indicated this is not always true. Under diagnosis, under treatment, exposure to air pollution, and unhygienic living conditions may contribute to a higher frequency and severity of symptoms of asthma among the poor. Proper diagnosis and treatment with controller medications for asthma is feasible and cost-effective in low-resource settings.
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20
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Duba A, Goriewa K, Wachowska U, Wiwart M. Alternaria alternata (Fr.) Keissl with mutation G143A in the Cyt b gene is the source of a difficult-to-control allergen. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:469-478. [PMID: 29043591 DOI: 10.1007/s11356-017-0426-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 10/05/2017] [Indexed: 06/07/2023]
Abstract
The saprotrophic fungus Alternaria alternata is widespread in the agro-environment and produces more than ten allergenic proteins, mostly protein Alt a 1. The frequency of the Alt a 1 gene was analyzed in a group of A. alternata isolates from winter wheat kernels obtained in Poland, and the effectiveness of various fungicides targeting the pathogen was evaluated. The Alt a 1 gene was identified in four of the seven tested isolates. A. alternata colonized 35.67% kernels on average, but its frequency increased in stored grain where the presence of epiphytes was noted on 23.09 to 51.38% kernels, and endophytes-in 26.21 to 42.01% of kernels. The efficacy of field-applied fungicides did not exceed 50%, despite the fact that A. alternata is highly sensitive to propiconazole, fenpropimorph, and tebuconazole under in vitro conditions. The analyzed isolates were characterized by limited sensitivity to azoxystrobin (EC50 ranged from 0.505 to 1.350 μg cm-3) due to a mutation at codon 143 of the CYT b gene, responsible for resistance to quinone outside inhibitor fungicides, which was noted in all isolates. The spread of A. alternata can be effectively controlled with suitable fungicides and by monitoring the prevalence of pathogenic isolates in the environment.
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Affiliation(s)
- Adrian Duba
- Department of Entomology, Phytopathology and Molecular Diagnostics, University of Warmia and Mazury in Olsztyn, Prawocheńskiego 17, 10-719, Olsztyn, Poland
| | - Klaudia Goriewa
- Department of Plant Breeding and Seed Production, University of Warmia and Mazury in Olsztyn, pl. Łódzki 3, 10-10-724, Olsztyn, Poland
| | - Urszula Wachowska
- Department of Entomology, Phytopathology and Molecular Diagnostics, University of Warmia and Mazury in Olsztyn, Prawocheńskiego 17, 10-719, Olsztyn, Poland.
| | - Marian Wiwart
- Department of Plant Breeding and Seed Production, University of Warmia and Mazury in Olsztyn, pl. Łódzki 3, 10-10-724, Olsztyn, Poland
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21
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Lawson JA, Brozek G, Shpakou A, Fedortsiv O, Vlaski E, Beridze V, Rennie DC, Afanasieva A, Beridze S, Zejda J. An international comparison of asthma, wheeze, and breathing medication use among children. Respir Med 2017; 133:22-28. [PMID: 29173445 DOI: 10.1016/j.rmed.2017.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 11/01/2017] [Accepted: 11/02/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is variation in childhood asthma between countries with typically higher prevalence in "Westernized" nations. We compared asthma, respiratory symptoms, and medication prevalence in Eastern and Central European regions and Canada. METHODS We conducted a cross-sectional survey study of children (5-15 years) from one urban centre in each of Canada, Belarus, Poland, Republic of Georgia (Adjara), Republic of Macedonia, and Ukraine. Surveys were distributed through randomly selected schools to parents (2013-2015). RESULTS The prevalence of asthma differed by country from 20.6% in Canada to 1.5% in Ukraine (p < 0.001). This association remained after confounder adjustment. Except for Canada (58.7%) and Poland (42.5%), less than 10% of children with a history of wheeze had a diagnosis of asthma. Regardless of country, more than 50% of children with a diagnosis of asthma used breathing medications in the past year. Finally, except for Georgia (12.1%), all countries had a prevalence of ever wheeze above 20% (23.8% in Poland to 30.9% in Macedonia). CONCLUSIONS Despite large differences in asthma prevalence, respiratory morbidity was more comparable suggesting asthma prevalence may be underestimated. Further validation of asthma diagnosis is needed. It is important to promote best diagnostic practices among first contact physicians.
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Affiliation(s)
- Joshua A Lawson
- Department of Medicine, University of Saskatchewan, Saskatoon, Canada; Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada.
| | - Grzegorz Brozek
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | | | - Olga Fedortsiv
- Horbachevsky State Medical University, Ternopil, Ukraine
| | - Emilija Vlaski
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Macedonia
| | | | - Donna C Rennie
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada; College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Anna Afanasieva
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | | | - Jan Zejda
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
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Alhekail GA, Althubaiti A, AlQueflie S. The association between body mass index and frequency of emergency department visits and hospitalization for asthma exacerbation in a pediatric population. Ann Saudi Med 2017; 37:415-419. [PMID: 29229888 PMCID: PMC6074121 DOI: 10.5144/0256-4947.2017.415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The prevalence of both asthma and obesity are increasing. Although some studies suggest an association between body mass index (BMI) and frequency of emergency department (ED) visits and hospitalization for asthma exacerbation, any association remains unproven. OBJECTIVE Estimate the frequency of asthma exacerbation in obese children, and identify any relationship between BMI and frequency of ED visits and hospitalization for asthma exacerbation. DESIGN Retrospective review of medical records. SETTINGS Tertiary children's hospital, Riyadh. SUBJECTS AND METHODS All children aged 2-15 years who attended the ED for asthma exacerbation between January 2015 and January 2016 were included. Children with comorbidities or undocumented asthma were excluded. The Centers for Disease Control and Prevention BMI-for-age growth charts for boys and girls aged 2 to 20 years were used to classify underweight, normal, overweight, and obese. MAIN OUTCOME MEASURES The frequency of ED visits and the rate, frequency, and duration of hospitalization. RESULTS Of the 1000 cases reviewed, 64.6% were boys and the mean age (standard deviation) of all sub.jects was 5.6 (3.3) years. The proportions of overweight and obese children was 11.8% and 12.1%, respectively. There was no association between increased BMI and frequency of ED visits for asthma exacerbation (P=.84), duration of hospitalization (P=.41) or frequency of hospitalization (P=.89). CONCLUSION There was no evidence of an association between BMI and frequency of ED visits and hospitalization for asthma exacerbation among children. LIMITATIONS This study included patients as young as 2 years, while asthma is only well-defined in children > 5 years. Asthma triggers that can cause exacerbation despite body weight were not included. We included only frequency of ED visits and hospitalization, which may be inadequate to measure asthma severity.
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Affiliation(s)
- Ghadah Abdulrahman Alhekail
- Dr. Ghadah Abdulrahman Alhekail, College of Medicine, King Saud bin Abdulaziz University for Health Sciences,, PO Box 3660, Riyadh 11426, Saudi Arabia, T: +966502451666, , ORCID: http://orcid.org/0000-0003-0571-6457
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Beridze V, Abuladze L, Partenadze N, Bakhtadze T, Lawson J, Zejda JE. Childhood asthma in Batumi, Georgia: Prevalence and environmental correlates. J Asthma 2017; 55:43-49. [PMID: 27901622 DOI: 10.1080/02770903.2016.1247169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE A relative lack of data for Eastern Europe and unknown epidemiology of childhood asthma in Batumi (Georgia) justified a study aimed at determining the prevalence of physician-diagnosed asthma and related respiratory conditions, a comparison of the prevalence of these conditions between urban and rural children, and identification of their environmental correlates. METHODS Subjects of the cross-sectional population-based study were 3238 urban and 2081 rural children aged 5-17 years whose respiratory status was assessed using the ISAAC questionnaire. RESULTS The overall prevalence of asthma was larger in rural children than in urban children (2.8% vs. 1.8%, respectively; p = 0.01). Spastic bronchitis occurred with similar frequency in urban (7.8%) and rural children (6.5%). Compared with urban children, rural subjects had dry cough at night (13.1 vs 8.2%, p < 0.001) and attacks of dyspnea (4.7 vs 2.4%, p < 0.001) more often. The prevalence of other symptoms did not differ significantly between urban and rural subjects. Results of multivariate analyses showed that both asthma and spastic bronchitis were associated (p < 0.05) with parental history of asthma, dampness in the house, and poor financial standing of the family. In addition, asthma was related to coal/wood-based heating whereas spastic bronchitis was associated with passive smoking and lower parental education. CONCLUSIONS The findings show a low prevalence of ever-diagnosed asthma in the examined population. Nosological tradition and similar correlates of asthma and spastic bronchitis suggest that some cases of asthma might be included in the diagnostic category of spastic bronchitis.
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Affiliation(s)
- Vakhtang Beridze
- a Faculty of Natural Sciences and Health Care, Shota Rustaveli State University , Batumi , Georgia
| | - Lia Abuladze
- b Maternity and Child Health Center , Batumi , Georgia
| | | | - Tamar Bakhtadze
- a Faculty of Natural Sciences and Health Care, Shota Rustaveli State University , Batumi , Georgia
| | - Joshua Lawson
- c Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan , Saskatoon , Canada
| | - Jan E Zejda
- d Department of Epidemiology , School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
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Oluwole O, Arinola GO, Huo D, Olopade CO. Household biomass fuel use, asthma symptoms severity, and asthma underdiagnosis in rural schoolchildren in Nigeria: a cross-sectional observational study. BMC Pulm Med 2017; 17:3. [PMID: 28056916 PMCID: PMC5216579 DOI: 10.1186/s12890-016-0352-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 12/14/2016] [Indexed: 11/26/2022] Open
Abstract
Background In 2014, the International Study of Asthma and Allergies in Childhood (ISAAC) reported that the highest prevalence of symptoms of severe asthma was found in the low- and middle-income countries (LMICs), including Nigeria. While exposure to biomass fuel use may be an important risk factor in the development of asthma, its association with asthma symptoms severity has not been well-established. The aim of this study is to extend the spectrum of environmental risk factors that may be contributing towards increasing asthma morbidity, especially asthma symptoms severity in rural schoolchildren in Nigeria and to examine possible asthma underdiagnosis among this population. Methods Authors conducted a cross-sectional survey in three rural communities in Nigeria. Asthma symptoms were defined according to the ISAAC criteria. Information on the types of household fuel used for cooking was used to determine household cooking fuel status. Asthma symptoms severity was defined based on frequencies of wheeze, day- and night-time symptoms, and speech limitations. Logistic regression analyses were used to explore associations. Results A total of 1,690 Nigerian schoolchildren participated in the study. Overall, 37 (2.2%) had diagnosed asthma and 413 (24.4%) had possible asthma (asthma-related symptoms but not diagnosed asthma). Children from biomass fuel households had higher proportion of possible asthma (27.7 vs. 22.2%; p < 0.05) and symptoms of severe asthma (18.2 vs. 7.6%; p = 0.048). In adjusted analyses, biomass fuel use was associated with increased odds of severe symptoms of asthma [odds ratios (OR) = 2.37; 95% CI: 1.16–4.84], but not with possible asthma (OR = 1.22; 95% CI: 0.95–1.56). Conclusion In rural Nigerian children with asthma symptoms, the use of biomass fuel for cooking is associated with an increased risk of severe asthma symptoms. There is additional evidence that rural children might be underdiagnosed for asthma.
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Affiliation(s)
- Oluwafemi Oluwole
- Department of Community Health and Epidemiology and the Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Medicine and The Center for Global Health, University of Chicago, 5841 S Maryland Avenue, MC 6076, Chicago, IL, 60637, USA
| | - Ganiyu O Arinola
- College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Dezheng Huo
- Department of Public Health Science, University of Chicago, Chicago, IL, USA
| | - Christopher O Olopade
- Department of Medicine and The Center for Global Health, University of Chicago, 5841 S Maryland Avenue, MC 6076, Chicago, IL, 60637, USA.
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