Asthma and sensitization in a community with low indoor allergen levels and low pet-keeping frequency.
BACKGROUND
Little is known about causes of asthma and sensitization in desert countries.


OBJECTIVE
To investigate risk factors associated with asthma and sensitization in Kuwait.


METHODS
One hundred sixty children (9-16 years) with physician-diagnosed asthma were recruited and matched (age, sex) with 303 healthy controls. Risk factors were assessed by questionnaires, determination of sensitization status (skin tests and IgE), and home allergen exposure (mite, cat, dog, cockroach; ELISA).


RESULTS
Home allergen levels and frequency of pet ownership were very low (cat, 4.1%; dog, 1.5%). The risk of cat sensitization increased significantly among cat owners (odds ratio [OR], 3.53; 95% CI, 1.33-9.41; P = .01), and in children with reported contact with cats during the first year of life (OR, 2.60; 95% CI, 1.17-5.80; P = .019). In the multivariate analysis, maternal atopy (OR, 1.77; 95% CI, 1.13-2.75; P = .01) and cat ownership (OR, 3.32; 95% CI, 1.19-9.25; P = .02) remained significant associates of cat sensitization. Current dog ownership significantly increased the risk of sensitization to dog (OR, 6.05; 95% CI, 1.33-27.54; P = .02). In the multivariate analysis, dog ownership remained the only significant associate of dog sensitization (OR, 6.02; 95% CI, 1.30-27.96; P = .02). Sensitization to Alternaria was the strongest independent associate of the asthma group. Family history of asthma, history of whooping cough, current cat ownership, and breast-feeding <2 months were other significant and independent risk factors for asthma.


CONCLUSIONS
Pet ownership markedly increased the risk of sensitization to pets. Despite low allergen exposure, the pattern of childhood asthma in Kuwait follows that described in Western communities (strong association with sensitization).
Al-Mousawi
Mahdi Sayed Hassan
MS
North West Lung Centre, Wytenshawe Hospital, Manchester, UK.
Lovel
Hermione
H
Behbehani
Nasser
N
Arifhodzic
Nermina
N
Woodcock
Ashley
A
Custovic
Adnan
A
D000293:Adolescent; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D000485:Allergens / Q000032:analysis*; D000818:Animals; D000829:Animals, Domestic; D001249:Asthma / Q000209:etiology*; D002648:Child; D004285:Dogs; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors
D000485:Allergens; D007073:Immunoglobulin E