Comparison of skin prick allergy test in urban and rural children
Abstract
Background Children who grow up in rural areas have a lower incidence of atopy and other allergic manifestations than children in urban areas. Several recent studies have suggested that agricultural exposure may protect children from developing asthma and atopy, but these findings are inconsistent.
Objective To examine an association between living in rural or urban areas and skin prick allergy test results in children and to detennine associated risk factors for atopy.
Methods We conducted a cross-sectional study in Karo district (rural) and Medan (urban) in October-December 2009. We enrolled primary school children who had a history of atopy in their families. Skin prick testing was done on the volar side of the forearm and included eight aero-allergens: house dust mites, house dust, cotton, chicken feathers, cat dander, cockroaches, mould, and pollen. We analyzed the folloMng risk factors for
association Mth atopy: tobacco smoke, pets, livestock exposure, and having older sibling(s).
Results We recruited 49 children from the Karo district and 52 children from the city of Medan. There were significant associations between living in an urban area and positive skin prick test results for house dust mites and house dust compared to living in a rural area (P=0.04, 95% CI: 1.11 to 5.91; P=0.04, 95% CI: 1.13 to 12.45, respectively). The reverse was true for cockroach allergens (P=0.02, 95% CI: 0.16 to 0.81). Tobacco smoke and livestock exposure were associated Mth negative skin prick test results in rural children (P=O.03, 95% CI: 0.03 to 0.81 and P=0.002, 95% CI: 0.02 to 0.42, respectively). Multivariate analysis revealed that lack of livestock exposure was the major risk factor associated Mth any positive skin prick test results in rural children (P=0.004; 95% CI ; 0.02 to 0.49).
Conclusion There were differing associations between living in rural and urban areas to various skin prick test results in children. Lack of livestock exposure was the risk factor associated with positive skin prick test results in rural children.
References
2. Naleway AL. Asthma and atopy in rural children: is fanning protective? Clin Med Res. 2004;2:5-12.
3. McRae WM. Asthma, allergy and the hygiene hypothesis. NZFP. 2002;29:31-7. Available from: http://www.rmcgp.org. nz/assets/documents/Publications/ Archive-NZFP ;Feb-2002-NZFP-Vol-29-N o-l/mcRae.pdf
4. Bloomfield SF. Smith or not too clean: the hygiene hy pothesis and home hy giene. Clin Exp Allergy. 2006;36:402-25.
5. Holgate ST, Lack G. Improving the management of atopic disease. Arch Dis Child. 2005;90:826-31.
6. Munasir Z. Pemeriksaan penunjang klinis: uji kulit terhadap alergen. In: Akib AAP, Munasir Z, Kurniati N, editors. Buku ajar alergi imunologi anak. 2nd Ed. Jakarta: PP IDAI; 2007.; p. 445-7.
7. Gary A, Hendra S. Clinical manifestations of allergic rhinitis in children at Denpasar hospital. Paediatr Indones. 2001;41:160-5.
S. Addo Yobo EO, Custovic A, Taggart SC, Asafo-Agyei Ap, Woodcock A. Exercise induced bronchospasm in Ghana: differences in prevalence between urban and rural schoolchildren. T horax. 1997;52:161-5.
9. Barnes M, Cullinan P, Athanasaki P, MacNeill S, Hole AM, Harris J et al. Crete: does farming explain urban and rural differences in atopy? Clin Exp Allergy. 200 1;31 :lS22-5.
10. Von Ehrenstein OS, Von Mutius E, lUi S, Baumann L, Bohm 0, Von Kries R. Reduced risk of hay fever and asthma among children of farmers. Clin Exp Allergy. 2000;30:187-193.
11. Braun-Fahrlander C, Gassner M, Grize L, N eu U, Sennhauser FH, Varonier HS, et al. Prevalence of hay fever and allergic sensitization in fanner's children and their peers living in the same rural community. SCARPOL team. Swiss Study on Childhood Allergy and Respiratory Symptoms \\lith Respect to Air Pollution. Clin Exp Allergy. 1999;29:28-34.
12. Remes ST, Pekkanen J, Soininen L, Kajosaari M, Husman T, Koivikko A. Does heredity modify the association between fanning and allergy in children? Acta Paediatr. 2002;91 :1163-9.
13. Riedler J, Eder W, Oberfeld G, Schreuer M. Austrian children living on a fann have less hay fever, asthma and allergic sensitization. Clin Exp Allergy. 2000;30: 194-200.
14. Remes ST, livanainen K, Koskela H, Pekkanen J. Which factors explain the lower prevalence of atopy amongst farmers' children? Clin Exp Allergy. 2003;33:427-34.
15. Klintberg B, Berglund N, lilja G, Wickman M, van Hage-Hamsten M. Fewer allergic respiratory disorders among fanners' children in a closed birth cohort from Sweden. Eur Respir j. 2001;17:1151-7.
16. Hansen K, Mangrio E, Lindstrom M, Rosvall M. Early exposure to secondhand tobacco smoke and the development of allergic diseases in 4 year old children in Malmo, Sweden. BMC Pediatr. 2010;10:61-8.
17. Strachan DP. Family size, infection, and atopy: the first of the "hygiene hypothesis". T horax. 2000;55 (suppl) : s2-10.
I8. Cooper PJ. Intestinal wonns and human allergy. Parasite Immunology. 2004;26;455-67.
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Accepted 2016-10-13
Published 2011-04-30
