Ahmed Ahmed, Becker Allan
1Department of Pediatrics, University of Ottawa, Ottawa, ON Canada.
2Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB Canada.
Allergy Asthma Clin Immunol. 2019 Apr 23;15:26. doi: 10.1186/s13223-019-0341-6. eCollection 2019.
Little is known about the prevalence of asthma, allergic rhinitis, eczema and allergies among Canadian Inuit children, especially those living in the arctic and subarctic areas.
A cross-sectional study among grade seven students attending schools in Iqaluit, the capital city of Nunavut, was conducted during the 2016/2017 school year. We used the International Study of Allergy and Asthma in Children (ISAAC) questionnaire with added questions relevant to the population. In addition, skin prick tests (SPT) were conducted to test for sensitization to common food and environmental allergens.
The prevalence of current asthma is 5.2%, all of them were males and 2/3 of them were Inuit and all had a previous respiratory hospitalization. Past asthma prevalence is 8.6%, 60% males and 60% Inuit. There was an inverse relationship to crowdedness possibly as a confounding factor because of getting a higher prevalence among the non-Inuit who usually live in less crowded houses. Current allergic rhinitis prevalence is 8.6%, 60% of the cases were among the mixed Inuit/Caucasian ethnicity while no cases among the non-Inuit, there was a female predominance 3:2. Past history of allergic rhinitis prevalence is 10.3%, half of the cases were among the mixed ethnicity (5.2% of that ethnicity) followed by Inuit (3.4%) and non-Inuit (1.7%), female: Male ratio 1:1. Current eczema prevalence was 27.6%, with half of the cases among the mixed ethnicity (13.8% of that group), followed by Inuit (8.6%). There was a female predominance with protective effect of exclusive breastfeeding. Past eczema prevalence 34.5%, with half of the cases were among the mixed ethnicity (17.2% of that group), followed by Inuit (10.3%). There was a female predominance. We noted a high rate of sensitization to Cat at 29.2%, most of the cases were among the mixed ethnicity, while absent sensitization to other common inhalant allergens.
While being cautious about firm conclusions due to the small sample size and power, the noticed variations in the prevalence and risk factors of asthma, allergic rhinitis and eczema among different ethnicities living at the same subarctic environment might be related to several possible explanations like genetic, gene-environment interaction and/or lifestyle factors, it was out of the scope of this study to determine the causality of such variation in prevalence, which emphasizes the need for further investigation.
对于加拿大因纽特儿童,尤其是生活在北极和亚北极地区的儿童,哮喘、过敏性鼻炎、湿疹及过敏症的患病率了解甚少。
在2016/2017学年,对努纳武特地区首府伊魁特市学校的七年级学生进行了一项横断面研究。我们使用了儿童哮喘和过敏国际研究(ISAAC)问卷,并添加了与该人群相关的问题。此外,还进行了皮肤点刺试验(SPT),以检测对常见食物和环境过敏原的致敏情况。
当前哮喘患病率为5.2%,患者均为男性,其中三分之二是因纽特人,且都曾因呼吸系统疾病住院治疗。过去哮喘患病率为8.6%,男性占60%,因纽特人占60%。拥挤程度与之呈负相关,这可能是一个混杂因素,因为通常居住在不太拥挤房屋中的非因纽特人患病率更高。当前过敏性鼻炎患病率为8.6%,60%的病例为因纽特人与高加索人混血,非因纽特人无病例,女性占比3:2。过敏性鼻炎既往史患病率为10.3%,一半病例为混血(该种族的5.2%),其次是因纽特人(3.4%)和非因纽特人(1.7%),女性与男性比例为1:1。当前湿疹患病率为27.6%,一半病例为混血(该群体的13.8%),其次是因纽特人(8.6%)。女性占主导,纯母乳喂养有保护作用。过去湿疹患病率为34.5%,一半病例为混血(该群体的17.2%),其次是因纽特人(10.3%)。女性占主导。我们注意到对猫的致敏率很高,为29.2%,大多数病例为混血,而对其他常见吸入性过敏原无致敏情况。
鉴于样本量和检验效能较小,在得出确切结论时需谨慎,但在同一亚北极环境下不同种族中,哮喘、过敏性鼻炎和湿疹的患病率及危险因素存在差异,这可能与多种因素有关,如遗传、基因 - 环境相互作用和/或生活方式因素等。确定患病率差异的因果关系超出本研究范围,这凸显了进一步调查的必要性。