title: Cultural adaptation is associated with atopy and wheezing among children of Turkish origin living in Germany.
abstract: BACKGROUND
  Turkish children have been found to suffer less from atopic diseases than their German peers. The underlying causes are unknown.
  
  
  OBJECTIVE
  To evaluate rates of sensitization and atopic disease among children in Germany with German or Turkish ethnicity and different degrees of cultural adaptation.
  
  
  METHODS
  This was a cross-sectional study. The setting was screening for school eligibility in an inner-city district of Berlin/Germany. The participants were preschool children born in Germany with double German or double Turkish parental citizenship. Cultural adaptation of Turkish children was assessed by the language parents used to communicate with their child: only Turkish (n = 60, group A); Turkish and German (n = 269, group B); and only German (n = 103, group C). Group D contained children from German parents (n = 383). The main outcome measures were specific sensitization to common aeroallergens (CAP-System, Pharmacia Phadiatop >or= 0.35 kU/L), and lifetime and 1-year prevalences of allergic disease symptoms (ISAAC questionnaire in German and Turkish, Mantel-Haenszel test for trend).
  
  
  RESULTS
  Sensitization rates for groups A, B, C and D were 8.0%, 6.8%, 18.9% and 18.3%, respectively (P = 0.004). The corresponding prevalence rates for wheeze ever were 6.7%, 9.3%, 12.6% and 21.3% (P < 0.001), wheeze in the past year 3.3%, 3.7%, 9.7% and 10.2% (P = 0.001), itchy rash ever 3.3%, 6.3%, 8.7% and 13.7% (P < 0.001), itchy rash in the past year 1.7%, 3.7%, 4.9% and 9.5% (P < 0.001), respectively. No significant differences were found for hay fever symptoms.
  
  
  CONCLUSIONS
  Higher cultural adaptation is correlated with higher rates of allergic sensitization and disease among children of Turkish origin living in Berlin. This correlation suggests that environmental rather than genetic differences are responsible for the differences observed.
authors.affiliation: Department of Paediatric Pneumology and Immunology, Charité - Humboldt University, Berlin, Germany. christoph.grueber@charite.de
authors.forename: C
authors.initials: C
authors.lastname: Grüber
authors.forename: S
authors.initials: S
authors.lastname: Illi
authors.forename: A
authors.initials: A
authors.lastname: Plieth
authors.forename: C
authors.initials: C
authors.lastname: Sommerfeld
authors.forename: U
authors.initials: U
authors.lastname: Wahn
mesh_terms: D000069:Acculturation; D002648:Child; D003430:Cross-Sectional Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D007239:Infections / Q000150:complications; D015995:Prevalence; D012135:Respiratory Sounds / Q000175:diagnosis; D012307:Risk Factors; D012959:Socioeconomic Factors; D014421:Turkey / Q000208:ethnology