Allergic diseases and respiratory symptoms in urban and rural children in Grodno Region (Belarus).

BACKGROUND

Because of the unknown frequency of asthma and other common allergic diseases in children living in Belarus, we conducted a population-based respiratory health survey. The objective of the study was to estimate the prevalence of allergic diseases and major allergic symptoms in children of the Grodno Region (Western Belarus) and to examine their familial and environmental correlates.

METHODS

The cross-sectional study was conducted in 2010 and included 2606 urban and 2422 rural children aged 6-16 years. Physician-diagnosed respiratory diseases and symptoms were ascertained using the ISAAC questionnaire completed by the parents. Both family and environmental factors were examined for their association with respiratory health outcomes including asthma and spastic bronchitis. Descriptive statistics and multiple logistic regression analysis were used to test associations.

RESULTS

The prevalence of asthma, atopic eczema and allergic rhinitis was 1.39%, 10.25%, and 3.84%, respectively. Spastic bronchitis was reported for 6.74% of children. Chronic respiratory symptoms occurring in the past 12 months and suggestive of asthma included chest wheeze (9.71%) attacks of dyspnea at rest (1.77%), symptoms of hay fever (2.45%) attacks of sneezing and nasal congestion without a cold (6.78%), and recurrent itchy rash (13.48%). All diseases except for asthma and spastic bronchitis as well as symptoms of hay fever, congested nose and itchy rash were more frequent in urban than in rural children (p < 0.05). Results of multivariate logistic analysis confirmed associations (p < 0.05) between asthma and parental asthma (OR = 4.82) and dampness in home (OR = 2.12) after adjustment for age, gender and place of residence. Spastic bronchitis in children who did not have a concurrent diagnosis of asthma was related (p < 0.05) to parental asthma (OR = 2.18), dampness in the home (OR = 1.68) and less use of coal-based heating (OR = 0.64). Allergic rhinitis and atopic eczema were associated (p < 0.05) with parental asthma (OR = 5.07 and OR = 1.91, respectively), dampness (OR = 2.33 and OR = 1.51, respectively), lower parental education (OR = 0.74 and OR = 0.68, respectively) and household density (OR = 0.84 and OR = 0.92), respectively.

CONCLUSIONS

The findings show a low prevalence of allergic diseases and symptoms in children of Western Belarus, following similar East-West gradients described in the literature. All allergic disorders except asthma were less frequent in the rural population. A very low prevalence of childhood asthma and the possibility of underdiagosis of the disease in the surveyed population deserve further investigation.