Familial and environmental determinants for wheezing and asthma in a case-control study of school children in Palestine

Summary Background Our prevalence study on Palestinian school children aged 6–12 years showed lower rates for asthma and asthma symptoms than economically developed and industrialized countries. Reasons for such differences are largely unknown, and could possibly be related to different environmenta...

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Bibliographic Details
Published in:Clinical and experimental allergy 2003-02, Vol.33 (2), p.176-186
Main Authors: El-Sharif, N., Abdeen, Z., Barghuthy, F., Nemery, B.
Format: Article
Language:English
Subjects:
Air Pollution, Indoor - adverse effects
Allergens - immunology
Allergic diseases
Animals
Animals, Domestic - immunology
asthma
Asthma - etiology
Asthma - genetics
Asthma - immunology
Biological and medical sciences
Case-Control Studies
Child
children
Dust - immunology
Environment
epidemiology
family
Female
Humans
Immunoglobulin E - blood
Immunopathology
Logistic Models
Male
Medical sciences
Mites - immunology
Palestine
Respiratory and ent allergic diseases
Respiratory Sounds - etiology
Respiratory Sounds - genetics
Respiratory Sounds - immunology
Risk Factors
Skin Tests - methods
Tropical medicine
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Summary:Summary Background Our prevalence study on Palestinian school children aged 6–12 years showed lower rates for asthma and asthma symptoms than economically developed and industrialized countries. Reasons for such differences are largely unknown, and could possibly be related to different environmental and lifestyle factors. Objective To investigate familial, early life exposures and indoor environmental determinants for asthma in children in Palestine. Methods From the population of our previous study, a group of 273 children with wheeze in the past 12 months (of whom 99 children had physician‐diagnosed asthma) were matched with an equal number of non‐wheezing controls. This case‐control study involved a parental questionnaire; skin prick testing (SPT) with mixed house dust mites, cat and dog dander, mixed grass, mixed trees pollen, Alternaria tenuis, olive tree and cockroach extracts; and serum for total and specific IgE for the same eight allergens. Results Paternal asthma and maternal hayfever significantly tripled the risk for their children to have wheezing. Previous diagnoses of bronchial allergy, bronchitis, pneumonia, or whooping cough, and positive SPT for house dust mites and cockroaches were significantly more likely among wheezing and asthmatic children than controls. Specific IgE levels for house dust mites and cat allergens showed significantly higher risk for reported wheezing. After adjustment for several environmental and sociodemographic factors using multivariate logistic regression analysis, paternal asthma, maternal hayfever, damp houses, cat and cockroach SPT positivity proved to be strong predictors for wheezing symptoms. Conclusion Our study confirmed that familial ‘atopic’ diseases are significant predictors of childhood asthma in Palestinian children. Moreover, indoor environment such as presence of cats and domestic moulds also appear to play a role. Our findings are consistent with studies in Canada, New Zealand, Estonia and Sweden, and show promise to explore further gene–environment interaction in the genesis of asthma.
ISSN:0954-7894
1365-2222
DOI:10.1046/j.1365-2222.2003.01598.x