Published ahead of print on January 24, 2003, doi:10.1164/rccm.200210-1204OC
Am. J. Respir. Crit. Care Med., Volume 167, Number 10, May 2003, 1369-1373
A more recent version of this article appeared on May 15, 2003
Submitted on October 22, 2002
Accepted on January 21, 2003
Wheezing, allergy and parasite infection in children in urban and rural Ethiopia
Damtew Dagoye1, Zegaye Bekele2, Kifle Woldemichael2, Hailu Nida2, Meselech Yimam2, Andy Hall, Andrea J Venn3, John R Britton3, Richard Hubbard3, and Sarah A Lewis3*
1 Paediatrics, Jimma University, Jimma, Ethiopia; Division of Respiratory Medicine, University of Nottingham, Nottingham, United Kingdom,
2 Paediatrics, Jimma University, Jimma, Ethiopia,
3 Division of Respiratory Medicine, University of Nottingham, Nottingham, United Kingdom
* To whom correspondence should be addressed. E-mail: Sarah.lewis{at}nottingham.ac.uk.
Epidemiological studies in developing countries suggest that intestinal parasite infection may reduce the risk of asthma. Since this evidence is all derived from adults and older children, we have investigated the relation between parasite infection, wheezing and allergen skin sensitisation in nested case-control studies drawn from a survey of 7155 children aged 1 to 4 years living in urban and rural areas of Jimma, Ethiopia. Infection with parasites was common, predominantly with Trichuris (54%),Ascaris(38%), and hookworm (10%). Wheezing in the past year was significantly more prevalent in urban (4.4%) than rural children (2.0%), and was less prevalent in those infected with Ascaris (age, sex and urban/rural adjusted odds ratio (OR)=0.5, 95% CI 0.3 to 0.9), particularly in relation to high intensity infection. Similar though non-significant associations were found for hookworm (adjusted OR=0.6, 95% CI 0.2 to 1.8), but there was no suggestion of any relation to Trichuris infection. D pteronyssinus and cockroach (Blattella germanica) skin sensitisation was more prevalent in rural than urban children, and was unrelated to wheeze. We conclude that Ascaris and possibly hookworm infection protects against wheeze in young Ethiopian children, and that this effect is not mediated by inhibition of allergen sensitisation.
Key words: wheeze, parasites, atopy
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