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Published ahead of print on April 24, 2003, doi:10.1164/rccm.200211-1320OC

Am. J. Respir. Crit. Care Med., Volume 168, Number 3, August 2003, 313-317

A more recent version of this article appeared on August 1, 2003
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Submitted on November 12, 2002
Accepted on April 23, 2003

Allergic Symptoms, Atopy, and Geohelminth Infections in a Rural Area of Ecuador

Philip J Cooper1*, Martha E Chico2, Martin Bland3, George E Griffin4, and Thomas B Nutman5

1 Laboratorio de Investigaciones, Hospital Pedro Vicente Maldonado, Pedro Vicente Maldonado, Pichincha, Ecuador; Laboratory of Parasitic Diseases, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA; Infectious Diseases, St George's Hospital Medical School, London, United Kingdom, 2 Laboratorio de Investigaciones, Hospital Pedro Vicente Maldonado, Pedro Vicente Maldonado, Pichincha, Ecuador, 3 Public Health Sciences, St George's Hospital Medical School, London, United Kingdom, 4 Infectious Diseases, St George's Hospital Medical School, London, United Kingdom, 5 Laboratory of Parasitic Diseases, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

* To whom correspondence should be addressed. E-mail: pcooper{at}ecnet.ec.

Geohelminth infections may affect the expression of allergic disease. To investigate the relationship between geohelminth infections, atopy, and symptoms of allergic disease, we studied 4,433 schoolchildren from 71 schools in a rural tropical area in Ecuador. Information was collected on allergic symptoms, allergen skin test reactivity, and presence of geohelminth infections. Allergic symptoms were of low prevalence (2.1% had recent wheeze), but prevalence of skin test reactivity was relatively high (18.2%). The presence of geohelminth infections was protective against allergen skin test reactivity (OR 0.62, 95% CI 0.50-0.76, P < 0.001) and symptoms of exercise-induced wheeze (OR 0.59, 95% CI 0.40-0.87, P = 0.008) but not against other wheeze symptoms or symptoms of allergic rhinitis or atopic eczema. Infection intensity with Ascaris lumbricoides or Trichuris trichiura was associated with a reduction in the prevalence of allergen skin test reactivity but not allergic symptoms. There was no evidence of interactions between geohelminth infection and allergen skin test reactivity on the risks of allergic symptoms. The results suggest that geohelminth infections do not explain the low prevalence of allergic symptoms in the study population.
Key words: Allergy, Atopy, Geohelminths, School-children




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