Prevalence of atopy, asthma symptoms and diagnosis, and the management of asthma: comparison of an affluent and a non-affluent country

摘要

BACKGROUND—Theprevalence of childhood asthma and of atopy varies widely betweencountries. However, few studies have compared the pattern of diagnosisand management of asthma, or the role of atopy in predisposing toasthma between a less affluent country and a more affluent country. Theaim of this study was to compare the prevalence of symptoms, diagnosis,and management of asthma, and the prevalence of atopy as measured byskin prick tests in Nigeria and Australia using a standardised methodology.
METHODS—Respiratoryhistory was collected using a validated questionnaire administered toparents, and atopy was measured with skin prick tests in 654 Australianand 566 Nigerian children aged 8-11 years (70% consent rate inAustralia, 60% in Nigeria).
RESULTS—Wheeze andpersistent cough were less prevalent in Nigeria (10.2% and 5.1%,respectively) than in Australia (21.9% and 9.6%, respectively),caused less morbidity, and were less likely to be labelled or treatedas asthma than in Australia. There was no significant difference in theoverall prevalence of atopy between the two countries (Australia32.5%, Nigeria 28.2%). Atopy was a strong risk for wheeze in bothcountries (odds ratio (OR) 3.4(95% CI 2.3 to 5.1) in Australia, 1.8 (95% CI 1.0 to 3.3) in Nigeria), especially atopy to house dust mites(OR 3.1 (95% CI 2.1 to 4.7) in Australia, 2.4 (95% CI 1.3 to 4.3) in Nigeria).
CONCLUSION—Althoughthere was a similar prevalence of atopy in both countries, Australianchildren had a higher prevalence of asthma symptoms. Further studiesare needed to determine why atopic children in Australia are more atrisk of developing asthma. Such studies will have importantimplications for the prevention of asthma.