Independent effects of intestinal parasites infection and domestic allergen exposure on risk of wheeze in Ethiopia: a nested case-control study
Independent effects of intestinal parasites infection and domestic allergen exposure on risk of wheeze in Ethiopia: a nested case-control study
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DOI：
10.1016/s0140-6736(01)06579-5
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发表时间：
2001-11-03
期刊：
影响因子：
168.9
通讯作者：
Britton, J
中科院分区：
文献类型：
--
作者：
Scrivener, S;Yemaneberhan, H;Britton, J
背景为什么哮喘在农村自给自足的社会中很少见还不清楚。我们测试的假设，即哮喘的风险降低肠道寄生虫或甲型肝炎感染，并增加暴露于尘螨过敏原或有机磷杀虫剂在城市和农村地区的Jimma，Ethiopia.Methods从12876个人谁参加了在城市和农村Jimma的哮喘和特应性研究在1996年，我们确定了所有谁在过去的12个月内报告喘息，和随机的控制子样本。1999年，我们评估了205例和399例年龄在16岁以上的对照者的粪便样本中的寄生虫、床上用品中的Der p 1水平、甲型肝炎抗体、血清胆碱酯酶（有机磷暴露的标志物）、血清总IgE和特异性IgE以及对屋尘螨的皮肤致敏性。寄生虫病、Der p 1水平、甲型肝炎血清阳性和胆碱酯酶浓度对喘息风险的影响，以及IgE和皮肤致敏在这些关联中的作用，通过多元logistic回归进行分析。（95% CI 0.24-0.93，p=0.03），与Der p 1水平相关（每四分位数比值比1.26 [1.00-1.59]，p=0.05），与甲型肝炎血清阳性或胆碱酯酶浓度无关。在城市人群中，屋尘螨皮肤敏感性与喘鸣更密切相关（9.45 [5.03-17.75]）（1.95 [0.58-6.61]，相互作用p =0.017），其中屋尘螨致敏常见，但在高强度寄生虫感染的情况下与喘息无关。解释高度寄生虫感染可能预防特应性个体的哮喘症状。
Background Why asthma is rare in rural subsistence societies is not clear. We tested the hypotheses that the risk of asthma is reduced by intestinal parasites or hepatitis A infection, and increased by exposure to dust-mite allergen or organophosphorus insecticides in urban and rural areas of Jimma, Ethiopia.Methods From 12876 individuals who took part in a study of asthma and atopy in urban and rural Jimma in 1996, we identified all who reported wheeze in the previous 12 months, and a random subsample of controls. In 1999, we assessed parasites in faecal samples, Der p 1 levels in bedding, hepatitis A antibodies, serum cholinesterase (a marker of organophosphorus exposure), total and specific serum IgE, and skin sensitisation to Dermatophagoides pteronyssinus in 205 cases and 399 controls aged over 16 years. The effects of parasitosis, Der p 1 level, hepatitis A seropositivity, and cholinesterase concentration on risk of wheeze, and the role of IgE and skin sensitisation in these associations, were analysed by multiple logistic regression.Findings The risk of wheeze was independently reduced by hookworm infection by an odds ratio of 0.48 (95% CI 0.24-0.93, p=0.03), increased in relation to Der p 1 level (odds ratio per quartile 1.26 [1.00-1.59], p=0.05), and was unrelated to hepatitis A seropositivity or cholinesterase concentration. In the urban population, D pteronyssinus skin sensitisation was more strongly related to wheeze (9.45 [5.03-17.75]) than in the rural areas (1.95 [0.58-6.61], p for interaction=0.017), where D pteronyssinus sensitisation was common, but unrelated to wheeze in the presence of high-intensity parasite infection.Interpretation High degrees of parasite infection might prevent asthma symptoms in atopic individuals.