Prevalence and associated factors of atopic dermatitis symptoms in rural and urban Ethiopia

TY - JOUR

T1 - Prevalence and associated factors of atopic dermatitis symptoms in rural and urban Ethiopia

AU - Yemaneberhan, H.

AU - Flohr, C.

AU - Lewis, S. A.

AU - Bekele, Z.

AU - Parry, E.

AU - Williams, H. C.

AU - Britton, J.

AU - Venn, A.

PY - 2004/5

Y1 - 2004/5

N2 - Background: Allergic diseases, including atopic dermatitis (AD), are increasingly becoming a clinical problem in developing countries. Objective: We investigated the prevalence of AD symptoms and the effects of potential environmental aetiologies in rural and urban areas of Jimma in southwestern Ethiopia. Methods: Information on allergic disease symptoms and lifestyle factors was gathered in an interviewer-led cross-sectional questionnaire-based population survey of 9844 urban and 3032 rural participants of all ages. A one-in-four subsample underwent skin prick testing for hypersensitivity to Dermatophagoides pteronyssinus, mixed threshings, and aspergillus. Results: Around 95% of those eligible took part in the survey. Lifetime cumulative prevalence of AD symptoms was generally low with an overall prevalence of 1.2%, but was higher in the urban (1.5%) than in the rural area (0.3%; odds ratio (OR) = 4.45 [95% CI 2.34-8.47]). AD symptoms were strongly associated with wheeze (adjusted OR = 22.03 [15.45-31.42]) and rhinitis symptoms (61.94 [42.66-89.95]). Of several environmental exposures assessed, residence in a house made of brick (rather than mud) walls with wooden (rather than clay) floor, exposure to cigarette smoke as a child, having lived outside of Jimma in the past, and being of the Tigrean ethnic group were associated with an increased risk of AD symptoms. Conclusion: Although the overall prevalence of AD symptoms was low in this Ethiopian population, a marked urban-rural gradient was evident. Lifestyle factors linked to urbanization were associated with an increased risk of AD symptoms.

AB - Background: Allergic diseases, including atopic dermatitis (AD), are increasingly becoming a clinical problem in developing countries. Objective: We investigated the prevalence of AD symptoms and the effects of potential environmental aetiologies in rural and urban areas of Jimma in southwestern Ethiopia. Methods: Information on allergic disease symptoms and lifestyle factors was gathered in an interviewer-led cross-sectional questionnaire-based population survey of 9844 urban and 3032 rural participants of all ages. A one-in-four subsample underwent skin prick testing for hypersensitivity to Dermatophagoides pteronyssinus, mixed threshings, and aspergillus. Results: Around 95% of those eligible took part in the survey. Lifetime cumulative prevalence of AD symptoms was generally low with an overall prevalence of 1.2%, but was higher in the urban (1.5%) than in the rural area (0.3%; odds ratio (OR) = 4.45 [95% CI 2.34-8.47]). AD symptoms were strongly associated with wheeze (adjusted OR = 22.03 [15.45-31.42]) and rhinitis symptoms (61.94 [42.66-89.95]). Of several environmental exposures assessed, residence in a house made of brick (rather than mud) walls with wooden (rather than clay) floor, exposure to cigarette smoke as a child, having lived outside of Jimma in the past, and being of the Tigrean ethnic group were associated with an increased risk of AD symptoms. Conclusion: Although the overall prevalence of AD symptoms was low in this Ethiopian population, a marked urban-rural gradient was evident. Lifestyle factors linked to urbanization were associated with an increased risk of AD symptoms.

KW - Allergic diseases

KW - Allergy

KW - Atopic dermatitis

KW - Atopy

KW - Hygiene hypothesis

UR - http://www.scopus.com/inward/record.url?scp=2942601650&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2222.2004.1946.x

DO - 10.1111/j.1365-2222.2004.1946.x

M3 - Article

C2 - 15144471

AN - SCOPUS:2942601650

SN - 0954-7894

VL - 34

SP - 779

EP - 785

JO - Clinical and Experimental Allergy

JF - Clinical and Experimental Allergy

IS - 5

ER -