Hygiene, atopy and wheeze-eczema-rhinitis symptoms in schoolchildren from urban and rural Ecuador.

Content Provider	Europe PMC
Author	Cooper, Philip J Vaca, Maritza Rodriguez, Alejandro Chico, Martha E Santos, Darci N Rodrigues, Laura C Barreto, Mauricio L
Copyright Year	2014
Abstract	BackgroundRural residence is protective against atopy and wheeze–rhinitis–eczema symptoms in developed countries, an effect attributed to farming and poor hygiene exposures. There are few data from developing countries addressing this question. We compared atopy and wheeze–rhinitis–eczema symptoms between urban and rural Ecuador, and explored the effects of farming and poor hygiene exposures.MethodsWe performed cross sectional studies of schoolchildren living in rural and urban Ecuador. Data on symptoms and farming/hygiene exposures were collected by parental questionnaire, atopy by allergen skin prick test reactivity and geohelminth infections by stool examinations.ResultsAmong 2526 urban and 4295 rural schoolchildren, prevalence was: atopy (10.0% vs 12.5%, p=0.06), wheeze (9.4% vs 10.1%, p=0.05), rhinitis (8.1% vs 6.4%, p=0.02) and eczema (5.9% vs 4.7%, p=0.06). A small proportion of symptoms were attributable to atopy (range 3.9–10.7%) with greater attributable fractions for respiratory symptoms observed in urban schoolchildren. Respiratory symptoms were associated with poor hygiene/farming exposures: wheeze with lack of access to potable water; and rhinitis with household pets, no bathroom facilities and contact with large farm animals. Birth order was inversely associated with respiratory symptoms. Area of residence and atopy had few effects on these associations.ConclusionsUrban schoolchildren living in Ecuador have a similar prevalence of atopy, eczema and wheeze but a higher prevalence of rhinitis compared with rural children. Some farming and poor hygiene exposures were associated with an increase in the prevalence of wheeze or rhinitis while birth order was inversely associated with these symptoms.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC3932750&blobtype=pdf
ISSN	00406376
Journal	Thorax
Volume Number	69
DOI	10.1136/thoraxjnl-2013-203818
PubMed Central reference number	PMC3932750
Issue Number	3
PubMed reference number	24105783
e-ISSN	14683296
Language	English
Publisher	BMJ Publishing Group
Publisher Date	2013-10-08
Publisher Place	BMA House, Tavistock Square, London, WC1H 9JR
Access Restriction	Open
Rights License	This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/3.0/ Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
Subject Keyword	Wheeze-Rhinitis-Eczema Atopy Hygiene Farming Urban-Rural
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine