Prevalence and risk factors for allergic rhinitis in two resource-limited settings in Peru with disparate degrees of urbanization

L. M. Baumann, K. M. Romero, C. L. Robinson, Nadia Hansel, Robert H Gilman, Robert G Hamilton, J. J. Lima, R. A. Wise, William Checkley, Juan M. Combe, Alfonso Gomez, Guillermo Gonzalvez, Lilia Cabrera, Kathleen Barnes, Patrick N Breysse, D'Ann Williams, Robert A Wise, Ed Mougey

Research output: Contribution to journalArticle

Abstract

Background: Allergic rhinitis is a disease with a high global disease burden, but risk factors that contribute to this condition are not well understood. Objective: To assess the prevalence and risk factors of allergic rhinitis in two Peruvian populations with disparate degrees of urbanization. Methods: We conducted a population-based, cross-sectional study on 1441 children aged 13-15 years at enrollment (mean age 14.9 years, 51% boys) to investigate the prevalence of allergic disease. We used a standardized, Spanish validated questionnaire to determine the prevalence of allergic rhinitis and asked about sociodemographics and family history of allergies. Children also underwent spirometry, exhaled nitric oxide, allergy skin testing to 10 common household allergens and provided a blood sample for measurement of 25OH vitamin D and total serum IgE. Results: Overall prevalence of allergic rhinitis was 18% (95% CI 16% to 20%). When stratified by site, the prevalence of allergic rhinitis was 23% Lima vs. 13% in Tumbes (P <0.001); however, this difference was no longer significant after controlling for subject-specific factors (P = 0.95). There was a strong association with other allergic diseases: 53% of children with asthma had allergic rhinitis vs. 15% in those without asthma (P <0.001) and 42% of children with eczema vs. 17% of those without eczema (P <0.001). Important risk factors for allergic rhinitis were parental rhinitis (adjusted OR = 3.0, 95% CI 1.9-4.7 for 1 parent and adjusted OR = 4.4, 95% CI 1.5-13.7 for 2 parents); allergic sensitization to common household aeroallergens (1.6, 1.1-2.3); being overweight (1.5, 1.0-2.3); exhaled nitric oxide ≥20 ppb (1.9, 1.3-2.7); and total serum IgE ≥ 95th percentile (2.4, 1.2-4.8). Population attributable risk of important factors for allergic rhinitis were 25% for high exhaled nitric oxide, 22% for allergic sensitization to common household aeroallergens, 22% for paternal rhinitis, 10% for being overweight and 7% for an elevated total serum IgE. Conclusion and Clinical Relevance: Allergic rhinitis was prevalent in both settings, and important risk factors include elevated exhaled nitric oxide, allergic sensitization to common household aeroallergens, parental rhinitis, being overweight and high total serum IgE. When considering subject-specific factors, the difference in prevalence between the urban and rural settings became non-important.

Original languageEnglish (US)
Pages (from-to)192-199
Number of pages8
JournalClinical and Experimental Allergy
Volume45
Issue number1
DOIs
StatePublished - Jan 1 2015

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Urbanization
Peru
Immunoglobulin E
Nitric Oxide
Rhinitis
Eczema
Serum
Hypersensitivity
Asthma
Population
Allergic Rhinitis
Spirometry
Vitamin D
Allergens
Cross-Sectional Studies
Parents
Skin

Keywords

  • Allergic rhinitis
  • Asthma
  • Atopy
  • Epidemiology

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

Cite this

Prevalence and risk factors for allergic rhinitis in two resource-limited settings in Peru with disparate degrees of urbanization. / Baumann, L. M.; Romero, K. M.; Robinson, C. L.; Hansel, Nadia; Gilman, Robert H; Hamilton, Robert G; Lima, J. J.; Wise, R. A.; Checkley, William; Combe, Juan M.; Gomez, Alfonso; Gonzalvez, Guillermo; Cabrera, Lilia; Barnes, Kathleen; Breysse, Patrick N; Williams, D'Ann; Wise, Robert A; Mougey, Ed.

In: Clinical and Experimental Allergy, Vol. 45, No. 1, 01.01.2015, p. 192-199.

Research output: Contribution to journalArticle

Baumann, LM, Romero, KM, Robinson, CL, Hansel, N, Gilman, RH, Hamilton, RG, Lima, JJ, Wise, RA, Checkley, W, Combe, JM, Gomez, A, Gonzalvez, G, Cabrera, L, Barnes, K, Breysse, PN, Williams, DA, Wise, RA & Mougey, E 2015, 'Prevalence and risk factors for allergic rhinitis in two resource-limited settings in Peru with disparate degrees of urbanization', Clinical and Experimental Allergy, vol. 45, no. 1, pp. 192-199. https://doi.org/10.1111/cea.12379
Baumann, L. M. ; Romero, K. M. ; Robinson, C. L. ; Hansel, Nadia ; Gilman, Robert H ; Hamilton, Robert G ; Lima, J. J. ; Wise, R. A. ; Checkley, William ; Combe, Juan M. ; Gomez, Alfonso ; Gonzalvez, Guillermo ; Cabrera, Lilia ; Barnes, Kathleen ; Breysse, Patrick N ; Williams, D'Ann ; Wise, Robert A ; Mougey, Ed. / Prevalence and risk factors for allergic rhinitis in two resource-limited settings in Peru with disparate degrees of urbanization. In: Clinical and Experimental Allergy. 2015 ; Vol. 45, No. 1. pp. 192-199.
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abstract = "Background: Allergic rhinitis is a disease with a high global disease burden, but risk factors that contribute to this condition are not well understood. Objective: To assess the prevalence and risk factors of allergic rhinitis in two Peruvian populations with disparate degrees of urbanization. Methods: We conducted a population-based, cross-sectional study on 1441 children aged 13-15 years at enrollment (mean age 14.9 years, 51{\%} boys) to investigate the prevalence of allergic disease. We used a standardized, Spanish validated questionnaire to determine the prevalence of allergic rhinitis and asked about sociodemographics and family history of allergies. Children also underwent spirometry, exhaled nitric oxide, allergy skin testing to 10 common household allergens and provided a blood sample for measurement of 25OH vitamin D and total serum IgE. Results: Overall prevalence of allergic rhinitis was 18{\%} (95{\%} CI 16{\%} to 20{\%}). When stratified by site, the prevalence of allergic rhinitis was 23{\%} Lima vs. 13{\%} in Tumbes (P <0.001); however, this difference was no longer significant after controlling for subject-specific factors (P = 0.95). There was a strong association with other allergic diseases: 53{\%} of children with asthma had allergic rhinitis vs. 15{\%} in those without asthma (P <0.001) and 42{\%} of children with eczema vs. 17{\%} of those without eczema (P <0.001). Important risk factors for allergic rhinitis were parental rhinitis (adjusted OR = 3.0, 95{\%} CI 1.9-4.7 for 1 parent and adjusted OR = 4.4, 95{\%} CI 1.5-13.7 for 2 parents); allergic sensitization to common household aeroallergens (1.6, 1.1-2.3); being overweight (1.5, 1.0-2.3); exhaled nitric oxide ≥20 ppb (1.9, 1.3-2.7); and total serum IgE ≥ 95th percentile (2.4, 1.2-4.8). Population attributable risk of important factors for allergic rhinitis were 25{\%} for high exhaled nitric oxide, 22{\%} for allergic sensitization to common household aeroallergens, 22{\%} for paternal rhinitis, 10{\%} for being overweight and 7{\%} for an elevated total serum IgE. Conclusion and Clinical Relevance: Allergic rhinitis was prevalent in both settings, and important risk factors include elevated exhaled nitric oxide, allergic sensitization to common household aeroallergens, parental rhinitis, being overweight and high total serum IgE. When considering subject-specific factors, the difference in prevalence between the urban and rural settings became non-important.",
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T1 - Prevalence and risk factors for allergic rhinitis in two resource-limited settings in Peru with disparate degrees of urbanization

AU - Baumann, L. M.

AU - Romero, K. M.

AU - Robinson, C. L.

AU - Hansel, Nadia

AU - Gilman, Robert H

AU - Hamilton, Robert G

AU - Lima, J. J.

AU - Wise, R. A.

AU - Checkley, William

AU - Combe, Juan M.

AU - Gomez, Alfonso

AU - Gonzalvez, Guillermo

AU - Cabrera, Lilia

AU - Barnes, Kathleen

AU - Breysse, Patrick N

AU - Williams, D'Ann

AU - Wise, Robert A

AU - Mougey, Ed

PY - 2015/1/1

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N2 - Background: Allergic rhinitis is a disease with a high global disease burden, but risk factors that contribute to this condition are not well understood. Objective: To assess the prevalence and risk factors of allergic rhinitis in two Peruvian populations with disparate degrees of urbanization. Methods: We conducted a population-based, cross-sectional study on 1441 children aged 13-15 years at enrollment (mean age 14.9 years, 51% boys) to investigate the prevalence of allergic disease. We used a standardized, Spanish validated questionnaire to determine the prevalence of allergic rhinitis and asked about sociodemographics and family history of allergies. Children also underwent spirometry, exhaled nitric oxide, allergy skin testing to 10 common household allergens and provided a blood sample for measurement of 25OH vitamin D and total serum IgE. Results: Overall prevalence of allergic rhinitis was 18% (95% CI 16% to 20%). When stratified by site, the prevalence of allergic rhinitis was 23% Lima vs. 13% in Tumbes (P <0.001); however, this difference was no longer significant after controlling for subject-specific factors (P = 0.95). There was a strong association with other allergic diseases: 53% of children with asthma had allergic rhinitis vs. 15% in those without asthma (P <0.001) and 42% of children with eczema vs. 17% of those without eczema (P <0.001). Important risk factors for allergic rhinitis were parental rhinitis (adjusted OR = 3.0, 95% CI 1.9-4.7 for 1 parent and adjusted OR = 4.4, 95% CI 1.5-13.7 for 2 parents); allergic sensitization to common household aeroallergens (1.6, 1.1-2.3); being overweight (1.5, 1.0-2.3); exhaled nitric oxide ≥20 ppb (1.9, 1.3-2.7); and total serum IgE ≥ 95th percentile (2.4, 1.2-4.8). Population attributable risk of important factors for allergic rhinitis were 25% for high exhaled nitric oxide, 22% for allergic sensitization to common household aeroallergens, 22% for paternal rhinitis, 10% for being overweight and 7% for an elevated total serum IgE. Conclusion and Clinical Relevance: Allergic rhinitis was prevalent in both settings, and important risk factors include elevated exhaled nitric oxide, allergic sensitization to common household aeroallergens, parental rhinitis, being overweight and high total serum IgE. When considering subject-specific factors, the difference in prevalence between the urban and rural settings became non-important.

AB - Background: Allergic rhinitis is a disease with a high global disease burden, but risk factors that contribute to this condition are not well understood. Objective: To assess the prevalence and risk factors of allergic rhinitis in two Peruvian populations with disparate degrees of urbanization. Methods: We conducted a population-based, cross-sectional study on 1441 children aged 13-15 years at enrollment (mean age 14.9 years, 51% boys) to investigate the prevalence of allergic disease. We used a standardized, Spanish validated questionnaire to determine the prevalence of allergic rhinitis and asked about sociodemographics and family history of allergies. Children also underwent spirometry, exhaled nitric oxide, allergy skin testing to 10 common household allergens and provided a blood sample for measurement of 25OH vitamin D and total serum IgE. Results: Overall prevalence of allergic rhinitis was 18% (95% CI 16% to 20%). When stratified by site, the prevalence of allergic rhinitis was 23% Lima vs. 13% in Tumbes (P <0.001); however, this difference was no longer significant after controlling for subject-specific factors (P = 0.95). There was a strong association with other allergic diseases: 53% of children with asthma had allergic rhinitis vs. 15% in those without asthma (P <0.001) and 42% of children with eczema vs. 17% of those without eczema (P <0.001). Important risk factors for allergic rhinitis were parental rhinitis (adjusted OR = 3.0, 95% CI 1.9-4.7 for 1 parent and adjusted OR = 4.4, 95% CI 1.5-13.7 for 2 parents); allergic sensitization to common household aeroallergens (1.6, 1.1-2.3); being overweight (1.5, 1.0-2.3); exhaled nitric oxide ≥20 ppb (1.9, 1.3-2.7); and total serum IgE ≥ 95th percentile (2.4, 1.2-4.8). Population attributable risk of important factors for allergic rhinitis were 25% for high exhaled nitric oxide, 22% for allergic sensitization to common household aeroallergens, 22% for paternal rhinitis, 10% for being overweight and 7% for an elevated total serum IgE. Conclusion and Clinical Relevance: Allergic rhinitis was prevalent in both settings, and important risk factors include elevated exhaled nitric oxide, allergic sensitization to common household aeroallergens, parental rhinitis, being overweight and high total serum IgE. When considering subject-specific factors, the difference in prevalence between the urban and rural settings became non-important.

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KW - Asthma

KW - Atopy

KW - Epidemiology

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