BACKGROUND: Higher rates of exercise induced bronchospasm (EIB) have been reported for urban than for rural African schoolchildren. The change from a traditional to a westernized lifestyle has been implicated. This study was undertaken to examine the impact of various features of urban living on the prevalence of EIB in Kenyan school children. METHODS: A total of 1226 children aged 8-17 years attending grade 4 at five randomly selected schools in Nairobi (urban) and five in Muranga district (rural) underwent an exercise challenge test. A respiratory health and home environment questionnaire was also administered to parents/guardians. This report is limited to 1071 children aged < or = 12 years. Prevalence rates of EIB for the two areas were compared and the differences analysed to model the respective contributions of personal characteristics, host and environmental factors implicated in childhood asthma. RESULTS: A fall in forced expiratory volume in one second (FEV1) after exercise of > or = 10% occurred in 22.9% of urban children and 13.2% of rural children (OR 1.96, 95% CI 1.41 to 2.71). The OR decreased to 1.65 (95% CI 1.10 to 2.47) after accounting for age, sex, and host factors (a family history of asthma and breast feeding for less than six months), and to 1.21 (95% CI 0.69 to 2.11) after further adjustment for environmental factors (parental education, use of biomass fuel and kerosene for cooking, and exposure to motor vehicle fumes). CONCLUSIONS: The EIB rates in this study are higher than any other reported for African children, even using more rigorous criteria for EIB. The study findings support a view which is gaining increasing credence that the increase in prevalence of childhood asthma associated with urbanisation is the consequence of various harmful environmental exposures acting on increasingly susceptible populations.
BACKGROUND: Higher rates of exercise induced bronchospasm (EIB) have been reported for urban than for rural African schoolchildren. The change from a traditional to a westernized lifestyle has been implicated. This study was undertaken to examine the impact of various features of urban living on the prevalence of EIB in Kenyan school children. METHODS: A total of 1226 children aged 8-17 years attending grade 4 at five randomly selected schools in Nairobi (urban) and five in Muranga district (rural) underwent an exercise challenge test. A respiratory health and home environment questionnaire was also administered to parents/guardians. This report is limited to 1071 children aged < or = 12 years. Prevalence rates of EIB for the two areas were compared and the differences analysed to model the respective contributions of personal characteristics, host and environmental factors implicated in childhood asthma. RESULTS: A fall in forced expiratory volume in one second (FEV1) after exercise of > or = 10% occurred in 22.9% of urban children and 13.2% of rural children (OR 1.96, 95% CI 1.41 to 2.71). The OR decreased to 1.65 (95% CI 1.10 to 2.47) after accounting for age, sex, and host factors (a family history of asthma and breast feeding for less than six months), and to 1.21 (95% CI 0.69 to 2.11) after further adjustment for environmental factors (parental education, use of biomass fuel and kerosene for cooking, and exposure to motor vehicle fumes). CONCLUSIONS: The EIB rates in this study are higher than any other reported for African children, even using more rigorous criteria for EIB. The study findings support a view which is gaining increasing credence that the increase in prevalence of childhood asthma associated with urbanisation is the consequence of various harmful environmental exposures acting on increasingly susceptible populations.
Authors: M R Becklake; S Freeman; C Goldsmith; P A Hessel; R Mkhwelo; K Mokoetle; G Reid; F Sitas Journal: Int J Epidemiol Date: 1987-12 Impact factor: 7.196
Authors: Scott P Commins; Libby A Kelly; Eva Rönmark; Hayley R James; Shawna L Pochan; Edward J Peters; Bo Lundbäck; Lucy W Nganga; Philip J Cooper; Janelle M Hoskins; Saju S Eapen; Luis A Matos; Dane C McBride; Peter W Heymann; Judith A Woodfolk; Matthew S Perzanowski; Thomas A E Platts-Mills Journal: Am J Respir Crit Care Med Date: 2012-01-26 Impact factor: 21.405
Authors: Colin L Robinson; Lauren M Baumann; Karina Romero; Juan M Combe; Alfonso Gomez; Robert H Gilman; Lilia Cabrera; Guillermo Gonzalvez; Nadia N Hansel; Robert A Wise; Kathleen C Barnes; Patrick N Breysse; William Checkley Journal: Thorax Date: 2011-07-05 Impact factor: 9.139
Authors: Tina V Hartert; Xinqing Deng; Terryl J Hartman; Wanqing Wen; Gong Yang; Yu-Tang Gao; Meiling Jin; Chunxue Bai; Myron Gross; L Jackson Roberts; James R Sheller; John Christman; William Dupont; Marie Griffin; Xiao Ou Shu Journal: Am J Epidemiol Date: 2008-04-07 Impact factor: 4.897
Authors: Harriet Mpairwe; Lawrence Muhangi; Juliet Ndibazza; Josephine Tumusiime; Moses Muwanga; Laura C Rodrigues; Alison M Elliott Journal: Trans R Soc Trop Med Hyg Date: 2008-03-05 Impact factor: 2.184