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. 2021 Jan;51(1):108-119.
doi: 10.1111/cea.13769. Epub 2020 Nov 8.

Risk factors associated with rhinitis, allergic conjunctivitis and eczema among schoolchildren in Uganda

Harriet Mpairwe  1   2 , Gyaviira Nkurunungi  1 , Pius Tumwesige  1 , Hellen Akurut  1 , Milly Namutebi  1 , Irene Nambuya  1 , Marble Nnaluwooza  1 , Barbara Apule  1 , Caroline Onen  1 , Tonny Katongole  1 , Emmanuel Niwagaba  1 , Mike Mukasa  1 , Emily L Webb  1   2 , Alison M Elliott  1   2 , Neil Pearce  1   2
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Risk factors associated with rhinitis, allergic conjunctivitis and eczema among schoolchildren in Uganda

Harriet Mpairwe et al. Clin Exp Allergy. 2021 Jan.

Abstract

Background: The prevalence of allergy-related diseases (ARDs), including rhinitis, allergic conjunctivitis and eczema, is on the increase globally. The causes of this increase are not well established.

Objectives: To investigate the risk factors associated with ARDs among schoolchildren in Uganda.

Methods: We conducted a secondary data analysis of a large asthma case-control study involving 1700 schoolchildren, 5-17 years, in urban Uganda. ARDs were defined according to the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Skin prick testing (SPT) was conducted using standard procedures and allergen-specific IgE (asIgE) using ImmunoCAP® . We employed inverse probability weighted analysis to generate estimated prevalence data and weighted odds ratios.

Results: The lifetime estimated weighted prevalence of reported rhinitis, allergic conjunctivitis and eczema was 43.3%, 39.5% and 13.5%; weighted prevalence in 12 months was 10.1%, 9.1% and 2.3%, respectively. There was overlap of ARDs, with 66.3% of 1193 schoolchildren who reported having ever an ARDs (including asthma) reporting two or more. Risk factors associated with reported rhinitis in the last 12 months were city residence at birth [adjusted odds ratio (95% confidence interval) 2.66 (1.42-4.99) compared to rural]; father's [2.62 (1.79-3.83)] and mother's history of allergic disease [2.12 (1.48-3.02)]; frequent de-worming in the last 12 months [2.01 (1.30-3.11), ≥2 versus none]; current high frequency of 'trucks passing on the street near home' [2.59 (1.48-4.52), 'almost all the time' versus rarely] and positive SPT [1.54 (1.09-2.18)] but not asIgE [1.38 (0.60-3.15)]. The same pattern of risk factors was observed for allergic conjunctivitis and eczema.

Conclusion: We found extensive multi-morbidity of, and overlap in the risk factors for, rhinitis, conjunctivitis and eczema-similar to asthma risk factors-among schoolchildren in urban Uganda. This suggests a similar underlying cause for all ARDs, associated with exposure to urban lifestyles and environment in Uganda.

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Conflict of interest statement

Conflict Of Interest

None of the authors had any conflict of interest to declare.

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