Am. J. Respir. Crit. Care Med., Vol 150, No. 2, 08 1994, 415-420.
Respiratory symptoms, bronchial responsiveness, and atopy in Fijian and Indian children
MG Flynn
Department of Medicine, Fiji School of Medicine, Suva.
Hospital admission rates for asthma in the 5 to 14 yr age group are three
times higher in Fiji Indians than in Melanesian Fijians. Conversely,
admission rates for pneumonia are three times higher for Fijians than
Indians. To determine the prevalence of respiratory symptoms, bronchial
hyperresponsiveness, and atopy, a questionnaire in three languages was
distributed to 2,173 Suva City school children (mean age 9.6 yr), half of
whom were sampled for histamine inhalation and skin-prick allergen tests.
Prevalence of wheeze in the previous 12 mo was identical in both ethnic
groups (20.6%). Productive cough was more common in Fijians (29%) than
Indians (17%, p < 0.0001). Bronchial hyperresponsiveness was twice as
common in Indians (30%) as Fijians (15%), relative risk 2.1 (95% confidence
interval [CI]: 1.5 to 2.8), p < 0.0001. The combination of current
wheeze and bronchial hyperresponsiveness was found in nearly three times as
many Indian children (11.3%) as Fijians (4.0%), and the mean bronchial
dose- response slope to histamine was steeper in Indians than Fijians.
Prevalence of atopy was similar in Fijians (36%) and Indians (38%). Wheeze
was significantly associated with atopy and a steeper dose- response slope
to histamine, but productive cough was not. Indians may have more severe
asthma than Fijians due to genetic or environmental factors acting
independently of atopy. The higher prevalence of productive cough in
Fijians is consistent with a greater burden of respiratory infection, and
is associated with domestic crowding.
