Risk factors for eczema in infants born in Cuba: a population-based cross-sectional study

BMC Family Practice

Andrew W Fogarty³  John Britton³  Andrea Venn³  Hermes Fundora-Hernández¹  Dania Fabré-Ortiz²  Liem Gómez-Marrero¹  Ileana del Valle-Infante¹  Gladys García-García¹  Esperanza de la Mora-Faife¹  Silvia Josefina Venero-Fernández¹  Ramón Suárez-Medina¹ 

[1]Instituto Nacional de Higiene, Epidemiología y Microbiología, Infanta No 1158 e/ Llinásy Clavel, Código Postal 10300 La Habana, Cuba

[2]Hospital Pediátrico Docente “Juan Manuel Márquez”, La Habana, Cuba

[3]Nottingham Biomedical Research Unit, Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, City Hospital, NG5 1 PB Nottingham, UK

关键词: Paracetamol;    Cuba;    Risk factor;    Infants;    Eczema;   

Others  :  854579
DOI  :  10.1186/1471-5945-14-6

 received in 2013-11-26, accepted in 2014-03-19,  发布年份 2014

【 摘 要 】

Background

There is a concern that allergic disease in childhood is higher than expected in Cuba. The aim of this study was to determine the risk factors for eczema of infants aged 12–15 months living in Havana.

Methods

We used a cross-sectional epidemiological study design. Data on eczema symptoms and a wide range of lifestyle factors were collected by researcher administered questionnaires.

Results

Data were collected on 1956 children (96% response rate), of whom 672 (34%) were reported as having had eczema. Independent risk factors for eczema included young maternal age (adjusted odds ratio (OR) 0.98 per additional year of age; 95% confidence interval (CI) 0.97-0.99), child’s weight (OR 1.13 per additional kg; 95% CI: 1.03-1.25), insect sting allergy (OR 2.11; 95% CI: 1.33-3.35), rodents in the home (OR 1.39; 95% CI: 1.10-1.76), attendance at childcare facilities (OR 1.34: 95% CI: 1.05-1.70) and self-reported mould in the home (OR 1.23; 95% CI: 1.07-1.41). Infant exposure to paracetamol was associated with an increased risk of eczema even after adjustment for wheeze (OR 1.22; 95% CI: 1.03-1.46).

Conclusion

Despite a very different culture and environment, the consistency of these findings with those from more economically developed countries suggests potential causal associations. The association with paracetamol, even after adjustment for wheeze, suggests that intervention studies are required in young infants, to ascertain if this commonly used anti-pyretic medication increases allergic disease.

【 授权许可】

   
2014 Suárez-Medina et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Asher M, Montefort S, Bjorksten B, Lai C, Strachan D, Weiland S, Williams H, and the ISAAC phase three study group: Worldwide trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet 2006, 368:733-743.
• [2]Williams H, Stewart A, von Mutius E, Cookson W, Anderson R, and the ISAAC phase one and phase three study groups: Is eczema really on the increase worldwide? J Allergy Clin Immunol 2008, 121:947-954.
• [3]Williams H, Robertson C, Stewart A, Ait-Khaled N, Anabwani G, Anderson R, Asher I, Beasley R, Bjorksten B, Burr M, Clayton T, Crane J, Ellwood P, Keil U, Mallol J, Martinez F, Mitchell E, Montefort S, Pearce N, Shah J, Sibbald B, Strachan D, von Mutius E, Weiland S: Worldwide variations in the prevalence of symptoms of atopic eczema in the international study of asthma and allergies in childhood. J Allergy Clin Immunol 1999, 103:125-138.
• [4]Cohet C, Cheng S, MacDonald C, Baker M, Foliaki S, Huntington N, Douwes J, Pearce N: Infections, medication use, and the prevalence of symptoms of asthma, rhinitis, and eczema in childhood. J Epidemiol Community Health 2004, 58:852-857.
• [5]Davey G, Berhane Y, Duncan P, Aref-Adib G, Britton J, Venn A: Use of acetaminophen and the risk of self-reported allergic symptoms and skin sensitisation in Butajira, Ethiopia. J Allergy Clin Immunol 2005, 116:863-868.
• [6]Beasley R, Clayton T, Crane J, Von Mutius E, Lai C, Monetfort S, Stewart A, Monetfort S, Stewart A, and ISAAC phase three study group: Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6–7 years: analysis from phase three of the ISAAC progranmme. Lancet 2008, 372:1039-1048.
• [7]Beasley R, Clayton T, Crane J, Lai C, Montefort S, von Mutius E, Stewart A, and ISAAC phase three study group: Acetaminophen use and risk of asthma, rhinoconjunctivitis, and eczema in adolescents. Am J Respir Crit Care Med 2011, 183:171-178.
• [8]Cooper R, Kennelly J, Ordunez-Garcia P: Health in Cuba. Int J Epidemiol 2006, 35:817-824.
• [9]Sole D, Mallol J, Wandalsen G, Aguirre V, Group LAIPS: Prevalence of symptoms of eczema in Latin America: results of the international study of asthma and allergies in childhood (ISAAC) phase 3. J Investig Allergol Clin Immunol 2010, 20:311-323.
• [10]Venero-Fernandez S, Suarez Medina R, Mora Faife E, García García G, del Valle II, Gomez-Marrero L, Abreu-Suarez G, Gonzalez-Valdez J, Fabro-Ortiz D, Fundora-Hernadez H, Venn A, Britton J, Fogarty AW: Risk factors for wheezing in infants born in Cuba. Q J Med 2013, 106:1023-1029.
• [11]Wordemann M, Polman K, Diaz R, Heredia L, Madurga A-M, Sague K, Gryseels B, Gordea M: The challenge of diagnosing atopic diseases: outcomes in Cuban children depend on definition and methodology. Allergy 2006, 61:1125-1131.
• [12]Amberbir A, Medhin G, Alem A, Britton J, Davey G, Venn A: The role of acetaminophen and geohelminth infection on the incidence of wheeze and eczema. Am J Respir Crit Care Med 2011, 183:165-170.
• [13]Belyhun Y, Amberbir A, Medhin G, Erko B, Hanlon C, Venn A, Britton J, Davey G: Prevalence of risk factors of wheeze and eczema in 1-year-old children: the Butajira birth cohort, Ethiopia. Clin Exp Allergy 2010, 40:619-626.
• [14]Newson R, Shaheen S, Chinn S, Burney P: Paracetamol sales and atopic disease in children and adults: an ecological analysis. Eur Respir J 2000, 16:817-823.
• [15]Holgate S: The acetaminophen enigma in asthma. Am J Respir Crit Care Med 2011, 183:147-151.
• [16]Tattersfield A, Knox A, Britton J, Hall I: Asthma. Lancet 2002, 360:1313-1322.
• [17]Mendell M, Mirer A, Cheung K, Tong M, Douwes J: Respiratory and allergic health effects of dampness, mold, and dampness-related agents: a review of the epidemiological evidence. Environ Health Perspect 2011, 119:748-756.
• [18]Graif Y, Romano-Zelekha O, Livne I, Green M, Shohat T: Increased rate and greater severity of allergic reactions to insect sting among schoolchildren with atopic diseases. Pediatr Allergy Immunol 2009, 20:757-762.
• [19]Yocum M, Butterfield J, Klein J, Volcheck G, Schroeder D, Silverstein M: Epidemiology of anaphyaxis in Olmsted country: a population-based study. J Allergy Clin Immunol 1999, 104:452-456.
• [20]Martinez F, Wright A, Holberg C, Morgan W, Taussig L: Maternal age as a risk factor for wheezing lower respiratory illnesses in the first year of life. Am J Epidemiol 1992, 136:1258-1268.
• [21]Taylor B, Wadsworth J, Golding J, Butler N: Breast feeding, eczema, asthma, and hayfever. J Epidemiol Community Health 1983, 37:95-99.
• [22]Sariachvili M, Droste J, Dom S, Wieringa M, Hagendorens M, Stevens W, van Sprundel M, Desager K, Weyler J: Early exposure to solid foods and the development of eczema in children up to 4 years of age. Pediatr Allergy Immunol 2010, 21:74-81.
• [23]Butland B, Strachan D, Lewis S, Bynner J, Butler N, Britton J: Investigation into the increase in hay fever and eczema at age 16 observed between the 1958 and 1970 British birth cohorts. Brit Med J 1997, 315:717-721.
• [24]Strachan D: Family size, infection and atopy: the first decade of the “hygiene hypothesis”. Thorax 2000, 55:S2-S10.
• [25]Scirirca C, Gold D, Ryan L, Abulkerim H, Celedon J, Platts-Mills T, Naccara L, Weiss S, Litonjua A: Predictors of cord blood IgE levels in children at risk of asthma and atopy. J Allergy Clin Immunol 2007, 119:81-88.