动物接触和微生物暴露对印度城乡儿童特应性疾病和哮喘患病率的影响。
Effect of animal contact and microbial exposures on the prevalence of atopy and asthma in urban vs rural children in India.
作者信息
Vedanthan Pudupakkam K, Mahesh Padukudru A, Vedanthan Rajesh, Holla Amrutha D, Liu Andrew H
机构信息
University of Colorado Health Sciences Center, Denver, USA.
出版信息
Ann Allergy Asthma Immunol. 2006 Apr;96(4):571-8. doi: 10.1016/S1081-1206(10)63552-1.
BACKGROUND
Environmental factors, including microbial exposures and close animal contact, are implicated in the lower prevalence of asthma and allergy in rural vs urban children.
OBJECTIVES
To determine (1) the prevalence of asthma, rhinitis, eczema, and atopic sensitization in rural and urban children in India; (2) differences in microbial and animal exposures in these locales; and (3) whether differences in environmental exposures account for the different rates of asthma and atopy in these locales.
METHODS
One child from each of 50 urban (Mysore) and 50 rural (Vinobha) households in southern India was randomly selected for data analysis. Allergy, asthma, health, environment, and lifestyle information was obtained using a questionnaire and household inspections. Atopy was determined via skin prick testing for common allergens. Endotoxin content was measured in house dust samples.
RESULTS
Children from rural vs urban areas had lower prevalences of self-reported asthma (8% vs 30%; P = .005), rhinitis (22% vs 42%; P = .03), and atopic sensitization (36% vs 58%; P = .03). Higher median dust endotoxin loads were found in rural vs urban households (6.50 x 10(4) EU/m2 vs 1.27 x 10(4) EU/m2; P < .001). In multivariate analysis, close indoor animal contact (adjusted odds ratio [OR] 0.2; 90% confidence interval [CI], 0.05-0.9), outdoor animal contact (OR, 0.3; 90% CI, 0.1-0.8), and exclusive breastfeeding for at least 6 months (OR, 0.2; 90% CI, 0.1-0.5) were associated with lower atopic sensitization; mud flooring was associated with lower self-reported wheezing (OR, 0.1; 90% CI, 0.02-1.0).
CONCLUSION
Children in India who live with close animal contact and mud flooring and who were exclusively breastfed in infancy are less likely to develop asthma, rhinitis, and atopic sensitization.
背景
环境因素，包括微生物暴露和与动物的密切接触，与农村儿童相比城市儿童哮喘和过敏症患病率较低有关。
目的
确定（1）印度农村和城市儿童哮喘、鼻炎、湿疹和特应性致敏的患病率；（2）这些地区微生物和动物暴露的差异；（3）环境暴露的差异是否导致这些地区哮喘和特应性疾病发病率的不同。
方法
从印度南部50个城市（迈索尔）家庭和50个农村（维诺巴）家庭中各随机选取一名儿童进行数据分析。通过问卷调查和家庭检查获取过敏、哮喘、健康、环境和生活方式信息。通过对常见变应原进行皮肤点刺试验确定特应性。测量房屋灰尘样本中的内毒素含量。
结果
农村儿童与城市儿童相比，自我报告的哮喘患病率较低（8%对30%；P = 0.005）、鼻炎患病率较低（22%对42%；P = 0.03）和特应性致敏患病率较低（36%对58%；P = 0.03）。农村家庭的灰尘内毒素负荷中位数高于城市家庭（6.50×10⁴ EU/m²对1.27×10⁴ EU/m²；P < 0.001）。在多变量分析中，室内与动物密切接触（调整优势比[OR] 0.2；90%置信区间[CI]，0.05 - 0.9）、室外与动物接触（OR，0.3；90% CI，0.1 - 0.8）以及纯母乳喂养至少6个月（OR，0.2；90% CI，0.1 - 0.5）与较低的特应性致敏相关；泥土地面与较低的自我报告喘息相关（OR，0.1；90% CI，0.02 - 1.0）。
结论
在印度，与动物密切接触、居住在泥土地面且婴儿期纯母乳喂养的儿童患哮喘、鼻炎和特应性致敏的可能性较小。
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