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. 2020 Nov 4;10(11):e042380.
doi: 10.1136/bmjopen-2020-042380.

Prevalence of atopic dermatitis, asthma and rhinitis from infancy through adulthood in rural Bangladesh: a population-based, cross-sectional survey

Courtney J Pedersen  1 , Mohammad J Uddin  2 , Samir K Saha  2 , Gary L Darmstadt  3
Affiliations

Prevalence of atopic dermatitis, asthma and rhinitis from infancy through adulthood in rural Bangladesh: a population-based, cross-sectional survey

Courtney J Pedersen et al. BMJ Open. .

Abstract

Objective: Describe the pattern of atopic disease prevalence from infancy to adulthood.

Design: Cross-sectional household survey.

Setting: Community-based demographic surveillance site, Mirzapur, Bangladesh.

Participants: 7275 individuals in randomly selected clusters within 156 villages.

Primary and secondary outcome measures: The 12-month prevalence of atopic dermatitis (by UK Working Party Criteria (UK criteria) and International Study of Asthma and Allergies in Childhood (ISAAC)), asthma and rhinitis (by ISAAC); disease severity (by ISAAC); history of ever receiving a medical diagnosis.

Results: Children aged 2 years had the highest prevalence of atopic dermatitis-18.8% (95% CI 15.2% to 22.4%) by UK criteria and 14.9% (95% CI 11.6% to 18.1%) by ISAAC- and asthma (20.1%, 95% CI 16.4% to 23.8%). Prevalence of rhinitis was highest among 25-29 year olds (6.0%, (95% CI% 4.5 to 7.4%). History of a medical diagnosis was lowest for atopic dermatitis (4.0%) and highest for rhinitis (27.3%) and was significantly associated with severe disease compared with those without severe disease for all three conditions (atopic dermatitis: 30.0% vs 11.7%, p=0.015; asthma; 85.0% vs 60.4%, p<0.001; rhinitis: 34.2% vs 7.3%, p<0.001) and having a higher asset-based wealth score for asthma (29.7% (highest quintile) vs 7.5% (lowest quintile), p<0.001) and rhinitis (39.8% vs 12.5%, p=0.003). Prevalence of having >1 condition was highest (36.2%) at 2 years and decreased with age. Having atopic dermatitis (ISAAC) was associated with significantly increased odds ratios (OR) for comorbid asthma (OR 5.56 (95% CI 4.26 to 7.26)] and rhinitis (3.68 (95% CI 2.73 to 4.96)). Asthma and rhinitis were also strongly associated with each other (OR 8.39 (95% CI 6.48 to 10.86)).

Conclusions: Atopic disease burden was high in this rural Bangladeshi population. Having one atopic condition was significantly associated with the presence of another. Low incidence of ever obtaining a medical diagnosis highlights an important opportunity to increase availability of affordable diagnosis and treatment options for all age groups.

Keywords: allergy; asthma; community child health; dermatological epidemiology; eczema; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
The 12-month prevalence of atopic dermatitis and proportion of severe cases by age group of subjects in Mirzapur, Bangladesh. ISAAC, International Study of Asthma and Allergies in Childhood.
Figure 2
Figure 2
The 12-month prevalence of asthma and proportion of severe cases by age group of subjects in Mirzapur, Bangladesh.
Figure 3
Figure 3
The 12- month prevalence of rhinitis and proportion of severe cases by age group of subjects in Mirzapur, Bangladesh.
Figure 4
Figure 4
Proportions of comorbid atopic conditions by age group of subjects in Mirzapur, Bangladesh.
See this image and copyright information in PMC

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