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Nishiyama H, Tajiri T, Kurokawa R, Suzuki T, Ito K, Mori Y, Fukumitsu K, Fukuda S, Kanemitsu Y, Uemura T, Ohkubo H, Maeno K, Ito Y, Oguri T, Takemura M, Niimi A. Prevalence and clinical relevance of comorbid pertussis infection in adult patients with asthma: A prospective, cross-sectional study. Respir Investig 2024; 62:811-816. [PMID: 39018657 DOI: 10.1016/j.resinv.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/06/2024] [Accepted: 07/03/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Viral or atypical bacterial respiratory infections are involved in the new development and the pathogenesis of asthma. Though an association between pertussis and asthma has been expected, few studies have reported it consistently. We assessed the prevalence and clinical relevance of pertussis infection in adult patients with asthma. METHODS In this prospective, cross-sectional study, newly referred, adult patients with asthma (n = 107) and with non-asthmatic subacute/chronic cough (n = 31) were enrolled. The prevalence of pertussis in patients with asthma and in those with non-asthmatic subacute/chronic cough was assessed. Next, the prevalence of newly diagnosed asthma was compared between asthmatic patients with and without pertussis. Finally, demographic characteristics of patients, blood test results, pulmonary function test results, and questionnaire scores were compared between the two patient groups. RESULTS The prevalence of pertussis infection was significantly higher in patients with asthma than in those with non-asthmatic subacute/chronic cough (36% vs 10%; P = 0.004). The prevalence of newly diagnosed asthma was significantly higher in asthmatic patients with pertussis than in those without (74.4% vs 50.0%; P = 0.014). The physical, psychological, and total scores of the Leicester Cough Questionnaire were significantly lower in asthmatic patients with pertussis than in those without (all P < 0.05). The acid-reflux, dyspeptic, and total scores of the Frequency Scale for Symptoms of Gastroesophageal Reflux Disease (GERD) (FSSG) were significantly higher in asthmatic patients with pertussis than in those without (all P ≤ 0.05). The FSSG acid-reflux score was negatively correlated with the cough-specific quality of life (QOL) score only in asthmatic patients with pertussis (rho = -0.68, P = 0.01). CONCLUSIONS The prevalence of pertussis infection was significantly higher in adult patients with asthma than in those with non-asthmatic subacute/chronic cough. In patients with asthma, comorbid pertussis infection may play a role in newly diagnosed asthma and may contribute to impaired cough-specific QOL partly due to worsening acid-reflux symptoms of GERD.
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Affiliation(s)
- Hirono Nishiyama
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Tomoko Tajiri
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Ryota Kurokawa
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Tatsuro Suzuki
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Keima Ito
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Yuta Mori
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Kensuke Fukumitsu
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Satoshi Fukuda
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Yoshihiro Kanemitsu
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Takehiro Uemura
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Hirotsugu Ohkubo
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Ken Maeno
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Yutaka Ito
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Tetsuya Oguri
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Masaya Takemura
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Akio Niimi
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
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Howard Ludlam A, Paynter J, Goodyear-Smith F, Petousis-Harris H. Pertussis epidemiology in adults: Retrospective analysis of pertussis incidence and association with comorbidities among adult populations in Aotearoa New Zealand, using national administrative datasets. Vaccine 2024:S0264-410X(24)00675-3. [PMID: 38910093 DOI: 10.1016/j.vaccine.2024.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 04/15/2024] [Accepted: 06/04/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND In New Zealand, approximately half reported pertussis cases are adult. Studies indicate underestimated pertussis burden in this population and probable reservoir for childhood pertussis. Pertussis is linked to chronic obstructive pulmonary disease (COPD) development and increased risk with pre-existing COPD. While acellular pertussis vaccines are available for adults, data on pertussis disease burden in adults and association with COPD remain limited. AIM To estimate pertussis incidence in New Zealand adult health service user (HSU) population aged ≥ 18 between 2008-2019 and inform adult pertussis vaccination strategies by assessing disease burden and risk factors in different adult populations. METHODS Retrospective observational cohort study using an HSU cohort, formed by linking administrative health data using unique National Health Index identifier. For primary analysis, annual incidence rates were calculated using pertussis hospitalisations and notifications. In secondary analysis, Cox proportional hazards survival analyses explored association between pertussis in adults and chronic comorbidities. RESULTS The cohort had 2,907,258 participants in 2008 and grew to 3,513,327 by 2019, with 11,139 pertussis cases reported. Highest annual incidence rate of 84.77 per 100,000 PYRS in 2012, notably affecting females, those aged 30-49 years, and European or Māori ethnicity. Adjusting for sociodemographic variables found no significant risk of prior pertussis notification leading to comorbidity diagnosis (Adjusted-HR: 0.972). However, individuals with prior comorbidity diagnosis had 16 % greater risk of receiving pertussis notification or diagnosis (Adjusted-HR: 1.162). CONCLUSIONS Study found significant pertussis burden among the HSU adult cohort and highlighted higher risk of pertussis for those with recent comorbidity diagnoses. Vaccination for pertussis should be recommended for individuals with comorbidities to reduce infection risk and disease severity. GPs must have capability to test for pertussis, given it is notifiable disease with implications for individuals, their families, and broader population. High-quality disease surveillance is crucial for informing policy decisions.
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Affiliation(s)
- Adrian Howard Ludlam
- Department of General Practice and Primary Health Care, School of Population Health, The University of Auckland, 22-30 Park Avenue, Grafton, Auckland 1023, New Zealand.
| | - Janine Paynter
- Department of General Practice and Primary Health Care, School of Population Health, The University of Auckland, 22-30 Park Avenue, Grafton, Auckland 1023, New Zealand.
| | - Felicity Goodyear-Smith
- Department of General Practice and Primary Health Care, School of Population Health, The University of Auckland, 22-30 Park Avenue, Grafton, Auckland 1023, New Zealand.
| | - Helen Petousis-Harris
- Department of General Practice and Primary Health Care, School of Population Health, The University of Auckland, 22-30 Park Avenue, Grafton, Auckland 1023, New Zealand.
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Ataei Y, Sun Y, Liu W, S. Ellie A, Dong H, Ahmad UM. Health Effects of Exposure to Indoor Semi-Volatile Organic Compounds in Chinese Building Environment: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:678. [PMID: 36613006 PMCID: PMC9819628 DOI: 10.3390/ijerph20010678] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
People spend a considerable portion of their lives indoors; thus, the quality of the indoor environment is crucial. Semi-volatile organic compounds (SVOCs) are among the primary indoor pollutants responsible for various health risks. This paper systematically reviews the impact of SVOC exposure on human health in Chinese built environments. Based on a set of criteria, we judged 12 publications as providing sufficient information on both SVOC exposure and health effects to inform the relationship. Out of six studies on polycyclic aromatic hydrocarbons (PAHs), three observed a positive association between PAH exposure and lung cancer. Out of six studies of phthalate exposure, two studies reported a significant positive association between DEP and DiBP and asthma, between DEP and DEHP and dry cough among children, and between DBP and rhinitis among younger adults. The results of this review suggest that there might be a link between phthalate exposure and asthma and allergies, as well as a link between PAH exposure and lung cancer. However, due to the limited number of studies conducted, more evidence is necessary to definitively guide the establishment of standards for SVOC control in China.
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Affiliation(s)
- Yeganeh Ataei
- Tianjin Key Laboratory of Indoor Air Environmental Quality Control, School of Environmental Science and Engineering, Tianjin University, Tianjin 300350, China
| | - Yuexia Sun
- Tianjin Key Laboratory of Indoor Air Environmental Quality Control, School of Environmental Science and Engineering, Tianjin University, Tianjin 300350, China
| | - Wei Liu
- Tianjin Key Laboratory of Indoor Air Environmental Quality Control, School of Environmental Science and Engineering, Tianjin University, Tianjin 300350, China
| | - Agnes S. Ellie
- Tianjin Key Laboratory of Indoor Air Environmental Quality Control, School of Environmental Science and Engineering, Tianjin University, Tianjin 300350, China
| | - Hui Dong
- Centre for Environmental Policy, Imperial College London, South Kensington, London SW7 2AZ, UK
| | - Umme Marium Ahmad
- Tianjin Key Laboratory of Indoor Air Environmental Quality Control, School of Environmental Science and Engineering, Tianjin University, Tianjin 300350, China
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Sio YY, Chew FT. Risk factors of asthma in the Asian population: a systematic review and meta-analysis. J Physiol Anthropol 2021; 40:22. [PMID: 34886907 PMCID: PMC8662898 DOI: 10.1186/s40101-021-00273-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Background and objective An increasing trend of asthma prevalence was observed in Asia; however, contributions of environmental and host-related risk factors to the development of this disease remain uncertain. This study aimed to perform a systematic review and meta-analysis for asthma-associated risk factors reported in Asia. Methods We systematically searched three public databases (Web of Science, PubMed, and Scopus) in Feb 2021. We only included articles that reported environmental and host-related risk factors associated with asthma in the Asian population. Random-effect meta-analyses were conducted for frequently reported asthma-associated risk factors to provide an overall risk estimate of asthma development. Results Of 4030 records obtained from public databases, 289 articles were selected for review. The most frequently reported asthma-associated risk factor was the family history of allergy-related conditions. The random-effect asthma risk estimates (pooled odds ratio, OR) were 4.66 (95% confidence interval (CI): 3.73–5.82) for the family history of asthma, 3.50 (95% CI: 2.62–4.67) for the family history of atopy, 3.57 (95% CI: 3.03–4.22) for the family history of any allergic diseases, 1.96 (95% CI: 1.47–2.61) for the family history of allergic rhinitis, and 2.75 (95% CI: 1.12–6.76) for the family history of atopic dermatitis. For housing-related factors, including the presence of mold, mold spots, mold odor, cockroach, water damage, and incense burning, the random-effect pooled OR ranged from 1.43 to 1.73. Other risk factors with significant pooled OR for asthma development included male gender (1.30, 95% CI: 1.23–1.38), cigarette smoke exposure (1.44, 95% CI: 1.30–1.60), cigarette smoking (1.66, 95% CI: 1.44–1.90), body mass index (BMI)–related parameters (pooled OR ranged from 1.06 to 2.02), various types of air pollution (NO2, PM10, and O3; pooled OR ranged from 1.03 to 1.22), and pre- and perinatal factors (low birth weight, preterm birth, and cesarean section; pooled OR ranged from 1.14 to 1.32). Conclusions The family history of asthma was the most frequently reported risk factor for asthma development in Asia with the highest risk estimate for asthma development. This suggests a major role of the genetic component in asthma pathogenesis. Further study on asthma genetics is required to improve the current understanding of asthma etiology. Supplementary Information The online version contains supplementary material available at 10.1186/s40101-021-00273-x.
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Affiliation(s)
- Yang Yie Sio
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore
| | - Fook Tim Chew
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, off Lower Kent Ridge Road, 117543, Singapore, Singapore.
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5
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Yang L, Sato M, Saito-Abe M, Irahara M, Nishizato M, Sasaki H, Konishi M, Ishitsuka K, Mezawa H, Yamamoto-Hanada K, Matsumoto K, Ohya Y. Hypertensive disorders of pregnancy and risk of allergic conditions in children: Findings from the Japan Environment and Children's study (JECS). World Allergy Organ J 2021; 14:100581. [PMID: 34567349 PMCID: PMC8436168 DOI: 10.1016/j.waojou.2021.100581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/22/2021] [Accepted: 08/16/2021] [Indexed: 10/26/2022] Open
Abstract
Background Hypertensive disorders of pregnancy (HDP) are one of the most common medical conditions that women encounter during pregnancy. Whether or not hypertensive disorders of pregnancy (HDP) are associated with allergic conditions in the offspring is unclear. This study used data from a large Japanese birth cohort to investigate whether HDP contributes to the development of allergic conditions in the offspring at 3 years. We also assessed the effect of blood pressure at different pregnancy trimesters on children's allergies. Methods We obtained data from the Japan Environment and Children's Study (JECS), which included 104 062 fetal records. After data selection, we analyzed 77 505 mother-child pairs, using logistic regression models to examine the relationships between HDP or the mother's blood pressure and their children's allergic conditions. In addition, we also evaluated the effect of HDP during pregnancy on allergies with a propensity score matched dataset, using a logistic regression model that predicts the conditional probability of whether a mother belonged to the HDP or non-HDP group. Results Among the 77 505 mothers eligible for analysis, 2334 (3.0%) had HDP. Percentages of women with hypertension were 1.7% in early gestation, 1.0% in mid-gestation, and 1.6% in late gestation. After adjusting for multiple potential confounders, HDP contributed nothing to allergy development in offspring. Children born to women with hypertension were no more likely than those without to have allergic conditions at 3 years of age. The propensity score matched dataset showed similar findings. Conclusion HDP and high blood pressure during pregnancy are apparently not risk factors for developing allergy in offspring. This information may help clinicians in counseling women who suffered HDP during pregnancy.
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Affiliation(s)
- Limin Yang
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Miori Sato
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Mayako Saito-Abe
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Makoto Irahara
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Minaho Nishizato
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hatoko Sasaki
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Mizuho Konishi
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Kazue Ishitsuka
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hidetoshi Mezawa
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Kiwako Yamamoto-Hanada
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Kenji Matsumoto
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan.,Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
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Akiki Z, Saadeh D, Farah R, Hallit S, Sacre H, Hosseini H, Salameh P. Asthma prevalence and associated factors among lebanese adults: the first national survey. BMC Pulm Med 2021; 21:162. [PMID: 33985479 PMCID: PMC8120928 DOI: 10.1186/s12890-021-01529-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 05/06/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND No national research has yet explored the prevalence of asthma among adults in Lebanon. This study aims to evaluate the prevalence of physician-diagnosed asthma and current asthma, and their determinants among Lebanese adults 16 years old or above. METHODS A cross-sectional study was carried out using a multistage cluster sampling. The questionnaire used collected information on asthma, respiratory symptoms, and risk factors. RESULTS The prevalence of physician-diagnosed asthma was 6.7% (95% CI 5-8.7%), and that of current asthma was 5% (95% CI 3.6-6.9%). Chronic symptoms such as cough, wheezing, and shortness of breath were worst at night. Factors positively associated with physician-diagnosed asthma were a secondary educational level (adjusted OR, aOR = 4.45), a family history of chronic respiratory diseases (aOR = 2.78), lung problems during childhood (15.9), and allergic rhinitis (4.19). Additionally, consuming fruits and vegetables less than once per week (3.36), a family history of chronic respiratory diseases (3.92), lung problems during childhood (9.43), and allergic rhinitis (8.12) were positively associated with current asthma. CONCLUSIONS The prevalence of asthma was within the range reported from surrounding countries. However, repeated cross-sectional studies are necessary to evaluate trends in asthma prevalence in the Lebanese population.
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Affiliation(s)
- Zeina Akiki
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Danielle Saadeh
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.
- Faculty of Public Health, Lebanese University, Fanar, Lebanon.
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon.
| | - Rita Farah
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Souheil Hallit
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Hassan Hosseini
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Life Sciences and Health Department, Paris-Est University, Paris, France
- Henri Mondor Hospital, Paris, France
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
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Ng YT, Chew FT. A systematic review and meta-analysis of risk factors associated with atopic dermatitis in Asia. World Allergy Organ J 2020; 13:100477. [PMID: 33204388 PMCID: PMC7645284 DOI: 10.1016/j.waojou.2020.100477] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/01/2020] [Accepted: 10/01/2020] [Indexed: 12/18/2022] Open
Abstract
Background Atopic dermatitis (AD) is a chronic, inflammatory skin disorder characterised by intense itch and eczematous lesions. Rising prevalence of AD has been observed worldwide including in Asia. Understanding the risk factors associated with AD may explain its pathogenicity and identify new preventive strategies and treatments. However, AD-associated risk factors and comorbidities specific to Asia have not been systematically reviewed. Methods We performed a systematic review in accordance with the Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines and summarised epidemiological studies investigating personal, family, and environmental factors and comorbidities associated with AD in Asia. Significant factors were assessed if they can be altered through lifestyle practices and further classified into non-modifiable and modifiable factors. Meta-analysis using the random-effect model was also conducted to provide an overall estimate for several significant factors. Results We identified a total of 162 epidemiological studies conducted in Asia. Among non-modifiable factors, a family history of atopic diseases was the most reported, suggesting the involvement of genetics in AD pathogenesis. Among modifiable factors, the results of meta-analyses revealed maternal smoking as the strongest risk factor with a pooled odds ratio (OR) of 2.95 (95% CI, 2.43-3.60), followed by active smoking (pooled OR, 1.91, 95% CI, 1.41-2.59). Conclusion While a family history may aid clinicians in identifying high-risk individuals, literature has long suggested the importance of gene-environment interaction. This review identified several modifiable factors including medical treatments, indoor and outdoor environmental exposure, and personal and family lifestyle specific to Asia. Based on the meta-analyses performed, prevention strategies against AD may start from changing personal and family lifestyle choices, especially smoking habits.
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Key Words
- AD, atopic dermatitis
- Asia
- Atopic dermatitis
- CI, Confidence interval
- Eczema
- FLG, Filaggrin
- HR, Hazard ratio
- I2, Inconsistency index
- ISAAC, International Study of Asthma and Allergies in Childhood
- NO2, nitrogen dioxide
- OR, Odds ratio
- PR, Prevalence ratio
- PRISMA, Preferred Reporting Item for Systematic Review and Meta-Analyses
- PUFAs, polyunsaturated fatty acids
- RR, Relative risk
- Risk factors
- TCM, traditional chinese medicine
- Th, T helper cell
- VOCs, Volatile organic compounds
- p, p-value
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Affiliation(s)
- Yu Ting Ng
- Department of Biological Sciences, National University of Singapore, Singapore
| | - Fook Tim Chew
- Department of Biological Sciences, National University of Singapore, Singapore
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8
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Malaeb D, Hallit S, Sacre H, Hallit R, Salameh P. Factors associated with wheezing among Lebanese children: Results of a cross-sectional study. Allergol Immunopathol (Madr) 2020; 48:523-529. [PMID: 32402625 DOI: 10.1016/j.aller.2020.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND In Lebanon, asthma is underdiagnosed due to low access to healthcare, particularly in rural areas, although asthma diagnosis in children is based mainly on clinical symptoms. Thus, wheezing might be more suggestive of undiagnosed respiratory diseases including asthma in Lebanese children. This study aimed to determine the factors associated with wheezing in Lebanese children without asthma diagnosis. METHODS This cross-sectional study was conducted between December 2015 and April 2016, enrolling a total of 1203 schoolchildren. RESULTS Out of 1500 prepared questionnaires, 1380 questionnaires were distributed in schools, and 1203 (87.17%) were collected back from the parents of children aged between 4-17 years old. The sample included 42 (3.5%) [95% CI 0.025-0.045] children with reported chronic wheezing. A multivariable analysis was performed taking the presence versus absence of wheezing in children as the dependent variable. The results showed that spraying pesticides at home (aOR=1.91), presence of humidity at home (aOR=2.21) and child reflux (aOR=2.60) were significantly associated with the presence of wheezing in children. CONCLUSION The findings of the study suggest that certain environmental factors, such as pesticides, humidity at home and reflux disease, might be associated with wheezing episodes in children. Those factors can be prevented through raising awareness by health care professionals.
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9
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Hallit S, Raherison C, Malaeb D, Hallit R, Waked M, Kheir N, Salameh P. Development of an asthma risk factors scale (ARFS) for risk assessment asthma screening in children. Pediatr Neonatol 2019; 60:156-165. [PMID: 29983338 DOI: 10.1016/j.pedneo.2018.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/16/2018] [Accepted: 05/30/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The study objective was to create asthma risk factors scale (ARFS) score that would be correlated with the increased risk of asthma in Lebanese children. This scale would eventually be used both to identify children at risk and assess early diagnosis of asthma. METHODS A case-control study (study 1) of 1276 children (976 controls and 300 cases) and a cross-sectional study (study 2) of 1000 children were conducted using a parental questionnaire. Children aged between 3 and 16 years were screened for possible enrollment. The ARFS was created by combining the following risk factors: child's exposure to pesticides, detergent mixing, alcohol, smoking and drug intake during pregnancy and breastfeeding, the actual paternal and maternal smoking status and history of asthma, and the types of food the child consumes. RESULTS There was a significant increase in the risk assessment screening for asthma per 15 points increments of ARFS (p < 0.001 for trend). The score category 0-14.99 best-represented control individuals (88.8% controls), while a score higher than 45 represented asthmatic children best (98.4% asthmatics). The positive predictive value (disease positive/all positive by scale) came out as 94.02%, whereas the negative predictive value (disease negative/all negative by scale) was found to be 90.47%. These results were confirmed in the second study sample. CONCLUSION The ARFS is a simple and easy-to-use tool, composed of 15 questions, for the clinician risk assessment of asthma in children, taking into account the environmental exposure, parental history of asthma and dietary habits of the child. Its value for asthma diagnosis remains to be confirmed in future prospective studies, especially in children with chronic respiratory symptoms.
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Affiliation(s)
- Souheil Hallit
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon; Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon; Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon; Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center, Inserm - Université de Bordeaux, Bordeaux, France; INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon.
| | - Chantal Raherison
- Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center, Inserm - Université de Bordeaux, Bordeaux, France; Department of Pneumology, University Hospital, Bordeaux, France
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
| | - Mirna Waked
- Faculty of Medicine, Balamand University, Koura, Lebanon
| | - Nelly Kheir
- Faculty of Science II, Lebanese University, Fanar, Lebanon
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon; Faculty of Medicine, Lebanese University, Beirut, Lebanon
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Hallit S, Raherison C, Malaeb D, Hallit R, Kheir N, Salameh P. The AAA Risk Factors Scale: A New Model to Screen for the Risk of Asthma, Allergic Rhinitis and Atopic Dermatitis in Children. Med Princ Pract 2018; 27:472-480. [PMID: 29879703 PMCID: PMC6243911 DOI: 10.1159/000490704] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 06/07/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To create an allergic disease risk factors scale score that would screen for the risk assessment of asthma, allergic rhinitis and atopic dermatitis (AD) in children from 3 to 17 years. METHODS This case-control study, conducted between December 2015 and April 2016, enrolled 1,274 children. The allergic disease risk factors scale was created by combining environmental, exposure to toxics during pregnancy and breastfeeding and parental history of allergic diseases. RESULTS Playing on carpets, male gender, child's respiratory problems or history of eczema before the age of 2 years, and humidity significantly increased the odds of allergies in the child. Maternal waterpipe smoking, maternal history of rhinitis, history of asthma in the mother or the father, along with the maternal drug intake or alcohol consumption during pregnancy significantly increased the odds of allergies in the child. There was a significant increase in allergy diseases per category of the allergic disease risk factors scale (p < 0.001 for trend). Scores ≤2.60 best represented control individuals, while scores > 5.31 best represented children with allergic diseases. CONCLUSION Allergic diseases seem to be linked to several risk factors in our population of school children. Many environmental factors might be incriminated in these allergic diseases.
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Affiliation(s)
- Souheil Hallit
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Beirut, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center, Inserm, Université de Bordeaux, Bordeaux, France
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon
- *Souheil Hallit, Street 8, Building 560, 1st floor, Biakout (Lebanon), E-Mail
| | - Chantal Raherison
- Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center, Inserm, Université de Bordeaux, Bordeaux, France
- Department of Pneumology, University Hospital, Bordeaux, France
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Beirut, Lebanon
| | - Nelly Kheir
- Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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Hallit S, Salameh P. Exposure to toxics during pregnancy and childhood and asthma in children: A pilot study. J Epidemiol Glob Health 2017; 7:147-154. [PMID: 28756822 PMCID: PMC7320455 DOI: 10.1016/j.jegh.2017.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 04/21/2017] [Indexed: 11/24/2022] Open
Abstract
Environmental factors, pesticides, alcohol and smoking are linked to asthma in children. The association of toxic substances exposure with asthma has not been evaluated. Our objective is to assess such associations among children aged less than 16 years old. This is a cross-sectional study, conducted between January and May 2015, using a sample of Lebanese students from private schools in Beirut and Mount Lebanon. Out of 700 distributed questionnaires, 527 (75.2%) were returned to us. Verbal informed consent was also obtained from all parents prior to participating in the study. A significant association was found between waterpipe smoking and diagnosed asthma (p = 0.003; ORa = 13.25; 95% CI 2.472–71.026). Alcohol during pregnancy, waterpipe smoking during pregnancy and parents respiratory problems significantly increased the risk of respiratory problems by approximately 5 times, 6 times and 2 times respectively (p = 0.016; ORa = 4.889; 95% CI 1.339–17.844, p = 0.021; ORa = 6.083; 95% CI 1.314–28.172, p = 0.004; ORa = 1.748; 95% CI 1.197–2.554 respectively). Waterpipe smoking, alcohol during pregnancy, recurrent otitis and humidity at home seem to be significantly correlated with asthma in children. Spreading awareness by health care professionals is needed to permit a reduction of the prevalence of these allergic diseases, especially asthma, in children.
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Affiliation(s)
- Souheil Hallit
- Lebanese University, School of Pharmacy, Hadath, Lebanon; Universite Saint Joseph, Faculty of Pharmacy, Beirut, Lebanon; Universite Saint-Esprit Kaslik, Faculty of Medicine, Kaslik, Lebanon; Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon; Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center Inserm - Université de Bordeaux, France.
| | - Pascale Salameh
- Lebanese University, School of Pharmacy, Hadath, Lebanon; Lebanese University, Faculty of Medicine, Hadath, Lebanon
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Mirzaei M, Karimi M, Beheshti S, Mohammadi M. Prevalence of asthma among Middle Eastern children: A systematic review. Med J Islam Repub Iran 2016. [PMID: 28638816 PMCID: PMC5473014 DOI: 10.18869/mjiri.31.9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background: The prevalence of asthma and allergy has increased during the last decades, especially in children. However, little is known about it in the Middle East region. This systematic review is aimed to estimate the prevalence of asthma among the Middle Eastern children.
Methods: Local and international scientific databases including SID, Iranmedex, Medline and Science Direct were systematically searched for relevant keywords including; asthma, prevalence, children, International Study of Asthma and Allergies in Childhood (ISACC) and the names of Middle Eastern countries for the period of 1996-2011. Papers in Persian and English which met the defined criteria were included into the study. Bibliographies of the extracted articles were also searched. After extraction of data, heterogeneity between studies and publication bias were measured using Egger's-test. Effect size was pooled by the random-effect model. Since significant heterogeneity was found between studies, univariate meta-regression analyses were done to assess the association of variables with the overall results.
Results: Fifty studies in the Middle East examined the prevalence of asthma and allergy in children under the age of 18 years according to the ISAAC criteria and were included. A total number of 289,717 children were examined in the included studies and the prevalence varied from 0.7 % in Isfahan to 22.3 % in Bagdad. The total prevalence of diagnosed asthma was calculated 7.53 % (95% Cl: 6.38-8.75). Prevalence of asthma in the 13-14 years age group was 7.57% (95% Cl: 5.78-9.29) and in 6-7 years age group was 7.43% (95% Cl: 5.75-9.10). The prevalence of asthma among girls, based on random effect model, was 6.30% (95% Cl: 4.97-7.61) and among boys, it was 8.91% (95% Cl: 6.80-11.04).
Conclusion: The prevalence of asthma in the Middle East is lower than most developed countries. However, there is not enough longitudinal data to estimate the trend over time. In order to have more accurate estimates and to provide evidence for proper planning, standard epidemiologic studies should be conducted in countries of the region.
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Affiliation(s)
- Masoud Mirzaei
- Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mehran Karimi
- Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Shima Beheshti
- Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Masoud Mohammadi
- Department of Social Medicine, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Salameh P, Karaki C, Awada S, Rachidi S, Al Hajje A, Bawab W, Saleh N, Waked M. [Asthma, indoor and outdoor air pollution: A pilot study in Lebanese school teenagers]. Rev Mal Respir 2015; 32:692-704. [PMID: 26071127 DOI: 10.1016/j.rmr.2014.11.073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Accepted: 11/18/2014] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Many studies have demonstrated that outdoor pollution might exacerbate respiratory symptoms and childhood asthma. Our objective was to evaluate the relationship between asthma and outdoor and indoor pollution. METHODS We undertook a survey in May-June 2012 about schoolchildren aged 12-19 years in six Lebanese schools. This combined the International Study of Asthma and Allergies in Childhood (ISAAC) standardized questionnaire with other questions addressing outdoor and indoor exposure. RESULTS Among 717 subjects (response rate 71.7%), 4.5% had physician-diagnosed asthma, 34.7% had probable asthma and 60.8% were asymptomatic. Exposure to indoor contaminants was positively associated to asthma. The risk for asthma was higher in those residing near heavy road traffic (ORa=4.30 [95% CI 1.45-12.71], P<0.05), those previously exposed to fire (ORa=1.84 [95% CI 1.01-3.36]), and those exposed to smog (ORa=4.15 [95% CI 1.42-12.12]). Airing the house in the morning or in case of indoor smoking had a protective effect against asthma. CONCLUSION These results suggest that the risks of asthma or having respiratory symptoms are not only related to indoor pollution but also to outdoor pollution especially from road traffic.
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Affiliation(s)
- P Salameh
- Laboratoire de recherche clinique et épidémiologique, faculté de pharmacie, campus Rafic Hariri, université libanaise, Hadath, Beyrouth, Liban; Section II, faculté de santé publique, université libanaise, Beyrouth, Liban.
| | - C Karaki
- École doctorale des sciences et technologie, université libanaise, Beyrouth, Liban
| | - S Awada
- Laboratoire de recherche clinique et épidémiologique, faculté de pharmacie, campus Rafic Hariri, université libanaise, Hadath, Beyrouth, Liban; École doctorale des sciences et technologie, université libanaise, Beyrouth, Liban
| | - S Rachidi
- Laboratoire de recherche clinique et épidémiologique, faculté de pharmacie, campus Rafic Hariri, université libanaise, Hadath, Beyrouth, Liban; École doctorale des sciences et technologie, université libanaise, Beyrouth, Liban
| | - A Al Hajje
- Laboratoire de recherche clinique et épidémiologique, faculté de pharmacie, campus Rafic Hariri, université libanaise, Hadath, Beyrouth, Liban; École doctorale des sciences et technologie, université libanaise, Beyrouth, Liban
| | - W Bawab
- Laboratoire de recherche clinique et épidémiologique, faculté de pharmacie, campus Rafic Hariri, université libanaise, Hadath, Beyrouth, Liban; École doctorale des sciences et technologie, université libanaise, Beyrouth, Liban
| | - N Saleh
- Section II, faculté de santé publique, université libanaise, Beyrouth, Liban; École doctorale des sciences et technologie, université libanaise, Beyrouth, Liban
| | - M Waked
- Hôpital Saint-Georges, faculté de médecine, université de Balamand, Beyrouth, Liban
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Bos A, Beemsterboer P, Wolfs T, Versteegh F, Arets H. Bordetella species in children with cystic fibrosis: What do we know? J Cyst Fibros 2011; 10:307-12. [DOI: 10.1016/j.jcf.2011.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 05/26/2011] [Accepted: 06/06/2011] [Indexed: 10/18/2022]
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