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Title: Monitoring and evaluating progress towards universal health coverage in Brazil
Other Titles: PLOS Medicine
Authors: Barreto, Mauricio Lima
Rasella, Davide
Machado, Daiane B.
Pereira, Rosana Aquino Guimarães
Lima, Diana
Garcia, Leila P.
Boing, Alexandra Crispim
Santos, Jackson
Escalante, Juan
Aquino, Estela Maria Motta Lima Leão de
Travassos, Claudia Maria de Rezende
Keywords: Atopy;Geohelminths;House Dust Mite;Latin America
Issue Date: 2014
Publisher: Public Library of Science
Abstract: Background The association between atopy and asthma is attenuated in non-affluent populations, an effect that may be explained by childhood infections such as geohelminths. Objective To investigate the association between atopy and wheeze in schoolchildren living in urban and rural areas of Ecuador and examine the effects of geohelminths on this association. Methods: We performed nested case–control studies among comparable populations of schoolchildren living in rural communities and urban neighbourhoods in the Province of Esmeraldas, Ecuador. We detected geohelminths in stool samples, measured recent wheeze and environmental exposures by parental questionnaire, and atopy by specific IgE (sIgE)and skin prick test (SPT) reactivity to aeroallergens. Results Atopy, particularly sIgE to house dust mite (HDM), was more strongly associated with recent wheeze in urban than rural schoolchildren: (urban, adj. OR 5.19, 95% CI 3.37–8.00, P < 0.0001; rural, adj. OR 1.81, 95%CI 1.09–2.99, P = 0.02; interaction, P < 0.001). The population fractions of wheeze attributable to atopy were approximately two-fold greater in urban schoolchildren: SPT to any allergen (urban 23.5% vs. rural 10.1%), SPT to HDM (urban 18.5% vs. rural 9.6%), and anti-HDM IgE (urban 26.5% vs. rural 10.5%), while anti-Ascaris IgE was related to wheeze in a high proportion of rural (49.7%) and urban (35.4%) children. The association between atopy and recent wheeze was attenuated by markers of geohelminth infections. Conclusions: Our data suggest that urban residence modifies the association between HDM atopy and recent wheeze, and this effect is explained partly by geohelminth infections.
URI: http://repositorio.ufba.br/ri/handle/ri/17859
ISSN: 1932-6203
Appears in Collections:Artigos Publicados em Periódicos Estrangeiros (ISC)

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