Association of atopy, asthma, allergic rhinoconjunctivitis, atopic dermatitis and intestinal helminth infections in Cuban children.
OBJECTIVE
To examine the relationship of past and current intestinal helminth infections with asthma, allergic rhinoconjunctivitis, atopic dermatitis and atopy.


METHODS
Cross-sectional study of 1320 children aged 4-14 years from two Cuban municipalities. Helminth infections were determined by stool examination and parental questionnaire. Asthma, rhinoconjunctivitis and atopic dermatitis were diagnosed by International Study of Asthma and Allergies in Childhood questionnaire, asthma additionally by spirometry, atopy by skin prick testing.


RESULTS
Questionnaire-based frequencies were 21% for asthma, 14% for allergic rhinoconjunctivitis and 8% for atopic dermatitis. According to spirometry, 4% had asthma; 20% had a positive skin prick test. A history of infection for Enterobius vermicularis was associated with increased risk of atopic dermatitis (OR 1.88, P = 0.001) and allergic rhinoconjunctivitis (OR 1.34, P = 0.046), and hookworm with increased risk of allergic rhinoconjunctivitis (OR 2.77, P = 0.021). A positive stool examination for Ascaris lumbricoides infection was negatively associated with atopic dermatitis (OR 0.22, P = 0.007). Asthma and atopy were unrelated to helminth infections.


CONCLUSIONS
Current A. lumbricoides infection protects against atopic dermatitis in Cuban children, while past infection with E. vermicularis and hookworm are risk factors for allergic rhinoconjunctivitis and/or atopic dermatitis. Apparently, interactions differ depending on the type of helminth and atopic disease and on the time of helminth infestation.
Wördemann
Meike
M
Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium. mwoerdemann@itg.be
Diaz
Raquel Junco
RJ
Heredia
Lenina Menocal
LM
Collado Madurga
Ana Maria
AM
Ruiz Espinosa
Aniran
A
Prado
Raul Cordovi
RC
Millan
Irai Atencio
IA
Escobedo
Angel
A
Rojas Rivero
Lazara
L
Gryseels
Bruno
B
Gorbea
Mariano Bonet
MB
Polman
Katja
K
D000293:Adolescent; D000818:Animals; D001196:Ascariasis / Q000276:immunology; D017164:Ascaris lumbricoides / Q000276:immunology; D001249:Asthma / Q000150:complications* / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D003233:Conjunctivitis, Allergic / Q000150:complications / Q000175:diagnosis; D003462:Cuba; D003876:Dermatitis, Atopic / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D005260:Female; D006373:Helminthiasis / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D007411:Intestinal Diseases, Parasitic / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D008297:Male; D012220:Rhinitis / Q000150:complications / Q000175:diagnosis; D012307:Risk Factors