Asthma and lower airway diseaseAscaris, atopy, and exercise-induced bronchoconstriction in rural and urban South African children
Section snippets
Design
The prevalence of EIB was established in a cross-sectional survey of 18 rural schools in Kentani district of the rural Eastern Cape of South Africa and 6 urban schools in Khayelitsha, an informal urban settlement in the Western Cape. Schools in the urban area were contacted in order of construction, starting with the most recently built, and all schools approached agreed to participate in the study. In the rural area all 22 schools within an hour's drive from the study base were approached and
Description of data
The prevalence survey included 1,671 children in rural schools and 1,651 children in urban schools. EIB was identified in 8.7% (n = 146) of rural and 14.9% (n = 246) of urban children. Twelve of the children with positive exercise test results were lost to follow-up. Further examinations were undertaken in 773 children (380 cases and 393 control subjects), 754 consenting to skin prick testing and providing blood samples and 743 providing stool samples. Parents of 696 children (370/436 urban and
Discussion
Ascaris infection was associated with an increased risk of bronchial reactivity and a decreased risk of a positive skin test response. There was no significant association between titers of specific IgE to common airborne allergens and infection with Ascaris. However, Ascaris infection was associated with increased levels of total IgE after controlling for urban environment, and high levels of total IgE were positively associated with detection of specific IgE to the aeroallergens tested. There
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Supported by a Wellcome Trust Training Fellowship in Tropical Clinical Epidemiology (J.M.C.).
Disclosure of potential conflict: The authors have declared that they have no conflict of interest.