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Solis Soto, Maria Teresa (2013): Prevalence, severity and risk factors of asthma, rhinitis and eczema symptoms in school-aged children from Oropeza Province – Bolivia, Prevalencia, severidad y factores de riesgo de síntomas de asma, rinitis y eczema en niños de edad escolar en la provincia Oropeza - Bolivia. Dissertation, LMU München: Medizinische Fakultät



Background: Asthma and allergies are world-wide common chronic diseases among children and young people. Little is known about prevalence and environmental and dietary risk factors of asthma and allergies among rural and urban school children in Bolivia. The aim of this study was to describe the prevalence, severity and risk factors associated with asthma, rhinoconjunctivitis, and eczema symptoms in children of school age in Oropeza Province – Bolivia. Methods: Overall, 2584 children (response 91%) attending fifth elementary grade in Oropeza province answered the written and the video questionnaire of the International Study on Asthma and Allergies in Childhood. Lifetime, 12 months and severity prevalence were determined for asthma, rhinoconjunctivitis and eczema symptoms. The associations between: environmental and dietary factors and symptoms of asthma, rhinoconjuctivitis and eczema symptoms were analysed using logistic regression analysis with adjustment for age, sex and place of living. Results: Median age of children was 11 years, 52% were female and 26% lived in rural areas. The prevalence of asthma symptoms was higher in the written (18%) than in the video questionnaire (6%). 22% of children reported symptoms of rhinoconjunctivitis and 9% eczema symptoms. Overall, rural children reported more frequently symptoms of asthma and allergies than urban children. Parental smoking (adjusted OR 1.3; 95%IC 1.0-1.6), presence of disease vectors at home (fourth quartile vs. first quartile: 1.5; 1.1-2.2) and farm animals (1.3; 1.0-1.6) were statistically significant predictors of asthma symptoms detected by the written questionnaire. The associations were similar for symptoms of rhinoconjunctivitis and eczema. A greater adherence to the Mediterranean Diet (MD) was inversely related with asthma symptoms in the video questionnaire (reference category: 1st quartile; second quartile 0.6; 0.3-0.9, third quartile 0.7; 0.4-1.2, fourth quartile 0.6; 0.3-1.0) Conclusion: Our results suggest that promoting a healthy diet and reducing exposure to modifiable risk factors like environmental tobacco smoke, precarious housing conditions and certain disease vectors would have a significant positive impact on asthma and allergies morbidity in children in this region.