Particular characteristics of allergic symptoms in tropical environments: follow up to 24 months in the FRAAT birth cohort study

BMC Pulmonary Medicine

Luis Caraballo²  Silvia Jiménez²  Dilia Mercado³  Dalgys Martínez²  Ketty Mendoza¹  Marta Puello¹  Álvaro Alvarez¹  Carlos Quiróz³  Adriana Bornacelly²  Josefina Zakzuk²  Jorge Sánchez²  Nathalie Acevedo² 

[1] Department of Microbiology, Faculty of Medicine, University of Cartagena, Cartagena, Colombia;Foundation for the Development of Medical and Biological Sciences (Fundemeb), Cartagena, Colombia;Institute for Immunological Research, University of Cartagena, Cartagena, Colombia

关键词: Latin America;    Cartagena;    Poverty;    Parasite;    The tropics;    Atopic march;    Eczema;    Rhinitis;    Asthma;    Allergy;    Wheezing;    Birth cohort study;   

Others  :  1172484
DOI  :  10.1186/1471-2466-12-13

 received in 2011-07-06, accepted in 2012-03-22,  发布年份 2012

【 摘 要 】

Background

Early wheezing and asthma are relevant health problems in the tropics. Mite sensitization is an important risk factor, but the roles of others, inherent in poverty, are unknown. We designed a birth-cohort study in Cartagena (Colombia) to investigate genetic and environmental risk factors for asthma and atopy, considering as particular features perennial exposure to mites, parasite infections and poor living conditions.

Methods

Pregnant women representative of the low-income suburbs of the city were randomly screened for eligibility at delivery; 326 mother-infant pairs were included at baseline and biological samples were collected from birth to 24 months for immunological testing, molecular genetics and gene expression analysis. Pre and post-natal information was collected using questionnaires.

Results

94% of families were from the poorest communes of the city, 40% lacked sewage and 11% tap-water. Intestinal parasites were found as early as 3 months; by the second year, 37.9% of children have had parasites and 5.22% detectable eggs of Ascaris lumbricoides in stools (Median 3458 epg, IQR 975-9256). The prevalence of "wheezing ever" was 17.5% at 6 months, 31.1% at 12 months and 38.3% at 24 months; and recurrent wheezing (3 or more episodes) 7.1% at 12 months and 14.2% at 24 months. Maternal rhinitis [aOR 3.03 (95%CI 1.60-5.74), p = 0.001] and male gender [aOR 2.09 (95%CI 1.09 - 4.01), p = 0.026], increased risk for wheezing at 6 months. At 24 months, maternal asthma was the main predisposing factor for wheezing [aOR 3.65 (95%CI 1.23-10.8), p = 0.01]. Clinical symptoms of milk/egg allergy or other food-induced allergies were scarce (1.8%) and no case of atopic eczema was observed.

Conclusions

Wheezing is the most frequent phenotype during the first 24 months of life and is strongly associated with maternal asthma. At 24 months, the natural history of allergic symptoms is different to the "atopic march" described in some industrialized countries. This cohort is representative of socially deprived urban areas of underdeveloped tropical countries. The collection of biological samples, data on exposure and defined phenotypes, will contribute to understand the gene/environment interactions leading to allergy inception and evolution.

【 授权许可】

   
2012 Acevedo et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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