title: Allergic characteristics of urban schoolchildren with atopic eczema in Ghana.
abstract: BACKGROUND
  Atopic eczema is an increasing clinical problem in Africa.
  
  
  OBJECTIVE
  To determine allergic characteristics and to identify possible risk factors for eczema among schoolchildren in an urbanized area in Ghana.
  
  
  METHODS
  Schoolchildren aged 3-16 years with eczema were recruited. For each patient, one to three age- and sex-matched controls were selected. All children completed a questionnaire and were skin prick tested with a panel of allergens. Blood was drawn to determine the total and allergen-specific IgE. Conditional logistic regression models with the matching factors included in the model were used to calculate the odds ratios and to adjust for possible confounders.
  
  
  RESULTS
  A total of 52 children with eczema (27 boys and 25 girls) and 99 controls were included. Levels of total IgE were found to be 9.1 (1.1; 78.4) times more often elevated in children with eczema. This association was mainly driven by elevated IgE levels against cockroach antigen. Children with eczema were found to have 2.0 (0.87; 4.7) times more often positive skin prick tests (SPT), but this association diminished to 1.2 (0.40; 3.6) after adjustment for total IgE levels. Frequent washing with soap was identified as a risk factor for the development of eczema among these children.
  
  
  CONCLUSIONS
  Schoolchildren with eczema in Ghana were characterized by elevated IgE levels especially against cockroach antigen. The association between eczema and positive SPT was much weaker suggesting immune hyporesponsiveness of the skin. After adjustment for IgE level, SPT were less suitable to distinguish children with and without eczema.
authors.affiliation: Dermatology, University of Ghana Medical School, Korle-Bu Teaching Hospital, Accra, Ghana.
authors.forename: A A
authors.initials: AA
authors.lastname: Hogewoning
authors.forename: I A
authors.initials: IA
authors.lastname: Larbi
authors.forename: H A
authors.initials: HA
authors.lastname: Addo
authors.forename: A S
authors.initials: AS
authors.lastname: Amoah
authors.forename: D
authors.initials: D
authors.lastname: Boakye
authors.forename: F
authors.initials: F
authors.lastname: Hartgers
authors.forename: M
authors.initials: M
authors.lastname: Yazdanbakhsh
authors.forename: R
authors.initials: R
authors.lastname: Van Ree
authors.forename: J N
authors.initials: JN
authors.lastname: Bouwes Bavinck
authors.forename: A P M
authors.initials: AP
authors.lastname: Lavrijsen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000150:complications / Q000276:immunology*; D005260:Female; D005869:Ghana; D006373:Helminthiasis / Q000150:complications; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008288:Malaria / Q000150:complications; D008297:Male; D012882:Skin Tests; D011795:Surveys and Questionnaires
chemical_list: D007073:Immunoglobulin E