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Risk factors for acute asthma in tropical America: a case-control study in the City of Esmeraldas, Ecuador

ArduraGarcia, Cristina, Vaca, Maritza, Oviedo, Gisela, Sandoval, Carlos, Workman, Lisa, Schuyler, Alexander J, Perzanowski, Matthew S, Platts-Mills, Thomas AE and Cooper, Phil (2015) 'Risk factors for acute asthma in tropical America: a case-control study in the City of Esmeraldas, Ecuador'. Pediatric Allergy and Immunology, Vol 26, Issue 5, pp. 423-430.

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Despite the high asthma rates described in Latin America, asthma risk factors in poor urban settings are not well established. We investigated risk factors for acute asthma among Ecuadorian children.


A matched case-control study was done in a public hospital serving a coastal city. Children with acute asthma were age- and sex-matched to non-asthmatics. A questionnaire was administered and blood, as well as stool, and nasopharyngeal swabs were collected.


60 cases and 119 controls aged 5-15 years were evaluated. High proportions of cases were atopic with population attributable fractions for atopy of 68.5% for sIgE and 57.2% for SPT. Acute asthma risk increased with greater titers of mite IgE (3.51-50 kU/L vs. <0.70kU/L - OR 4.56, 95% CI 1.48-14.06, P=0.008; >50kU/L vs. <0.70kU/L - OR 41.98, 95% CI: 8.97-196.39, P<0.001). Asthma risk was significantly independently associated with bronchiolitis (adj. OR: 38.9, 95%CI 3.26-465), parental educational level (adj. OR 1.26, 95%CI: 1.08-1.46), and presence of sIgE (adj. OR: 36.7, 95% CI: 4.00-337 while a reduced risk was associated with current contact with pets (adj. OR: 0.07, 95% CI: 0.01- 0.56). Rhinovirus infection was more frequent in cases (cases 35.6% vs. controls 7.8%, P=0.002). None of the cases were on maintenance therapy with inhaled corticosteroids and most relied on emergency department for control.


A high proportion of children presenting to a public hospital with acute asthma were allergic to mite, particularly at high IgE titer. Poor asthma control resulted in overuse of emergency care.

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WF Respiratory System > WF 140 Diseases of the respiratory system (General)
WF Respiratory System > WF 20 Research (General)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):
Depositing User: Lynn Roberts-Maloney
Date Deposited: 29 Jun 2015 08:35
Last Modified: 06 Feb 2018 13:10


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