Medicine

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    Association between serum total IgE, allergic diseases and geohelminth infections in Sri Lankan children
    (BioMed Central, 2007) Amarasekera, N.D.D.M.; Gunawardena, N.K.; de Silva, N.R.; Douglass, J.; O’Hehir, R.E.; Weerasinghe, A.
    BACKGROUND: Elevated levels of total IgE (tIgE) in serum are characteristic of allergic diseases. Levels of tIgE are influenced by genetic predisposition, age, sex and helminth infections. However, the association between tIgE and allergic diseases in children living in areas endemic for helminth infections is not clear. The aim of our study was to assess the relationship between tIgE, allergic diseases and geohelminth infections in children. METHODS: A total of 640 schoolchildren 9Y11 years of age was selected by stratified random sampling. Data regarding allergic diseases (asthma, rhinitis and eczema) were collected by a standard questionnaire given to the parent or guardian. Screening for helminth infections was done by examining their fresh stool samples by modified Kato-Katz technique. Serum tIgE was measured by Fluoroenzymeimmunoassay in 67 geohelminth-positive subjects and in a comparable group of geohelminth-negative subjects. RESULTS: The mean age in the study population was 10 years (SDT0.3). The prevalence of geohelminth infection was 15.5%. Trichuris trichiura (14.3%) was the most common followed by Ascaris lumbricoides (4.2%) and hookworm (0.2%). Mixed infection was detected in 20.3% of infected children. Infection intensity was light in 68.9% of infected children while 28.4% and 2.7% showed moderate and heavy infection respectively. The cumulative prevalence of allergic diseases was 33.7%. Prevalence of asthma, rhinitis and eczema was 17%, 21.4% and 5% respectively. Serum tIgE concentrations showed a positively skewed distribution. Geometric mean (GM) for tIgE for the geohelminth infected group (1039.9kU/L) was significantly higher than that of the non-infected group (575.4kU/L) (p = 0.004). It was also higher in the allergic group (933.3kU/L) than in the non-allergic group (639.7kU/L) but the difference was not statistically significant (p = 0.068). The GM for tIgE for non-allergic children in the study population was much higher than that seen in non-allergic children in developed countries. CONCLUSION: Serum tIgE concentration was strongly associated with the presence of geohelminth infections in children. Serum tIgE may not be a useful marker for allergic diseases in children living in areas endemic for geohelminth infections. © 2007 World Allergy Organization
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    Prevalence of atopic diseases among school children in Western Province
    (University of Kelaniya, 2007) Amarasekera, N.D.D.M.; Gunawardena, N.K.; de Silva, N.R.; Weerasinghe, A.
    Background : Atopic diseases such as asthma, rhinitis and eczema in children are major public health problems in developed, industrialized countries as well as in some developing countries. Our objective was to assess the prevalence of atopic diseases in schoolchildren in grade 5 in the Western Province of Sri Lanka. Method : Schoolchildren in grade 5 were selected by stratified - random sampling frbm 17 schools in the Western Province. Internationally validated ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire, filled by the parent or guardian was used to collect details regarding atopic diseases. Results : A total of 640 schoolchildren were recruited. Five hundred ~nd eleven (79.8%) returned the completed questionnaire. The mean age was I 0 years (SD ± 0.3) and 55.9% of the study population was boys. Prevalence of asthma, rhinitis and eczema was 17%, 21.4% and 5% respectively, while 33.7% had one or more diseases, Thirty three (21.4%) of the children with an atopic disease was on long term treatment. Only the prevalence of allergic rhinitis showed a statistically significant difference between the two sexes, being more common in boys. Less than 30% of affected children's parents recognized that their child had either asthma or rhinitis, whereas a higher number of parents (54.2%) recognized that their child had eczema. Among children with asthma, 44.4% had rhinitis and wheezing was severe enough to disturb their sleep in 52.4% of children. Conclusion: One in 3 children in grade 5 had either asthma or rhinitis or eczema, but parental recognition of these conditions was poor. Atopic diseases are a significant health problem among schoolchildren in the Western Province.
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