title: Prevalence and associated factors of atopic dermatitis symptoms in rural and urban Ethiopia.
abstract: BACKGROUND
  Allergic diseases, including atopic dermatitis (AD), are increasingly becoming a clinical problem in developing countries.
  
  
  OBJECTIVE
  We investigated the prevalence of AD symptoms and the effects of potential environmental aetiologies in rural and urban areas of Jimma in southwestern Ethiopia.
  
  
  METHODS
  Information on allergic disease symptoms and lifestyle factors was gathered in an interviewer-led cross-sectional questionnaire-based population survey of 9844 urban and 3032 rural participants of all ages. A one-in-four subsample underwent skin prick testing for hypersensitivity to Dermatophagoides pteronyssinus, mixed threshings, and aspergillus.
  
  
  RESULTS
  Around 95% of those eligible took part in the survey. Lifetime cumulative prevalence of AD symptoms was generally low with an overall prevalence of 1.2%, but was higher in the urban (1.5%) than in the rural area (0.3%; odds ratio (OR)=4.45 [95% CI 2.34-8.47]). AD symptoms were strongly associated with wheeze (adjusted OR=22.03 [15.45-31.42]) and rhinitis symptoms (61.94 [42.66-89.95]). Of several environmental exposures assessed, residence in a house made of brick (rather than mud) walls with wooden (rather than clay) floor, exposure to cigarette smoke as a child, having lived outside of Jimma in the past, and being of the Tigrean ethnic group were associated with an increased risk of AD symptoms.
  
  
  CONCLUSIONS
  Although the overall prevalence of AD symptoms was low in this Ethiopian population, a marked urban-rural gradient was evident. Lifestyle factors linked to urbanization were associated with an increased risk of AD symptoms.
authors.affiliation: Jimma University, Jimma, Ethiopia.
authors.forename: H
authors.initials: H
authors.lastname: Yemaneberhan
authors.forename: C
authors.initials: C
authors.lastname: Flohr
authors.forename: S A
authors.initials: SA
authors.lastname: Lewis
authors.forename: Z
authors.initials: Z
authors.lastname: Bekele
authors.forename: E
authors.initials: E
authors.lastname: Parry
authors.forename: H C
authors.initials: HC
authors.lastname: Williams
authors.forename: J
authors.initials: J
authors.lastname: Britton
authors.forename: A
authors.initials: A
authors.lastname: Venn
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D004777:Environment; D005002:Ethiopia / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D006798:Housing; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population; D012882:Skin Tests; D014028:Tobacco Smoke Pollution; D014505:Urban Population; D014934:Wood
chemical_list: D014028:Tobacco Smoke Pollution