title: Prevalence of asthma, rhinitis and eczema symptoms in rural and urban school-aged children from Oropeza Province - Bolivia: a cross-sectional study.
abstract: BACKGROUND
  Asthma and allergies are world-wide common chronic diseases among children and young people. Little information is available about the prevalence of these diseases in rural areas of Latin America. This study assesses the prevalence of symptoms of asthma and allergies among children in urban and rural areas at Oropeza Province in Bolivia.
  
  
  METHODS
  The Spanish version of the ISAAC standardized questionnaire and the ISAAC video questionnaire were implemented to 2584 children attending the fifth elementary grade in 36 schools in Oropeza province (response 91%). Lifetime, 12 months and severity prevalence were determined for asthma, rhinitis and eczema symptoms. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated adjusting for age using generalized linear mixed-effects models.
  
  
  RESULTS
  Median age of children was 11 years, 74.8% attended public schools, and 52.1% were female. While children attending urban schools had lower prevalence of self-reported wheeze in the written questionnaire (adjusted OR 0.6; 95% CI 0.4-1.9), they were more likely than children attending rural schools to report wheeze in the video questionnaire (aOR 2.1; 95% CI 1.0-2.6). They also reported more frequently severe rhinoconjunctivitis (aOR 2.8; 95% CI 1.2-6.6) and severe eczema symptoms (aOR 3.3; 95% CI 1.0-11.0).
  
  
  CONCLUSIONS
  Overall in accordance with the hygiene hypothesis, children living in urban areas of Bolivia seem to have a higher prevalence of symptoms of asthma and allergies compared to children living in the country side. In order to develop primary prevention strategies, environmental factors need to be identified in future studies.
authors.affiliation: Center for International Health, Ludwig-Maximilians-University, Ziemssenstr, 1, 80336 Munich, Germany. maritesolissoto@gmail.com.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Solis Soto
authors.forename: Armando
authors.initials: A
authors.lastname: Patiño
authors.forename: Dennis
authors.initials: D
authors.lastname: Nowak
authors.forename: Katja
authors.initials: K
authors.lastname: Radon
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D001838:Bolivia / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D004485:Eczema / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012220:Rhinitis / Q000175:diagnosis / Q000453:epidemiology*; D012423:Rural Health; D011795:Surveys and Questionnaires; D014504:Urban Health