title: Allergic disorders and socio-economic status: a study of schoolchildren in an urban area of Makassar, Indonesia.
abstract: BACKGROUND
  In urban centres of developing countries, there is great variation in socio-economic status (SES) and lifestyle; however, little information is available on allergic disorders in groups with high- or low-SES within the same urban area.
  
  
  OBJECTIVE
  To determine the prevalence of allergic disorders and investigate risk factors related to them among high- and low-SES schoolchildren in Makassar, the capital city of South Sulawesi, Indonesia.
  
  
  METHODS
  This cross-sectional study was performed in 623 children originating from high- (N = 349) and low-SES (N = 274) schools. Information on reported allergic symptoms and potential factors associated with allergic disorders was obtained by questionnaire. Specific IgE and skin prick test (SPT) reactivity were determined against aeroallergens [Dermatophagoides pteronyssinus (HDM) and cockroach]. Total IgE and helminth infections were also assessed.
  
  
  RESULTS
  The prevalence of SPT to any aeroallergens was significantly higher in high-SES than in low-SES school (25% vs. 8%, P < 0.001, respectively). However, specific IgE against cockroach and total IgE were significantly lower in high- than in low-SES children. Allergic symptoms were reported more often in low- compared to high-SES children. Specific IgE to aeroallergens significantly increased the risk of SPT positivity to the same aeroallergen in the high-, but not in the low-SES children. In the high- but not in low-SES, there was a significant positive association between SPT to HDM and wheeze. Similarly, cockroach skin reactivity and elevated BMI increased the risk of eczema in the high-SES children only.
  
  
  CONCLUSIONS
  Skin prick test is higher in high-SES, whereas IgE and allergic symptoms are higher in low-SES children. Specific IgE is a risk factor for being SPT-positive, and SPT positivity is a risk factor for allergic symptoms but only in children of high- and not low-SES school. Therefore, the socio-economic status of a child might affect the diagnosis of allergic disease in a developing country.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.|Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Hamid
authors.affiliation: Department of Parasitology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
authors.forename: S
authors.initials: S
authors.lastname: Wahyuni
authors.affiliation: Department of Immunopathology, Sanquin Research, Amsterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: van Leeuwen
authors.affiliation: Department of Experimental Immunology and Department of Otorhinolaryngology, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: van Ree
authors.affiliation: Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Yazdanbakhsh
authors.affiliation: Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Sartono
mesh_terms: D000485:Allergens / Q000276:immunology; D002648:Child; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D007073:Immunoglobulin E / Q000276:immunology; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012574:Schools; D012882:Skin Tests; D012923:Social Class; D014505:Urban Population
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: IgE; allergy; atopy; helminths; risk factors; socio-economic status