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Asthma and sensitization in a community with low indoor allergen levels and low pet-keeping frequency.
Al-Mousawi M, Lovel HJ, Behbehani N, Arifhodzic N, Woodcock AA, Custovic A
J Allergy Clin Immunol. 2004;114( 6):1389-94.
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Abstract
BACKGROUND: Little is known about causes of asthma and sensitization in desert countries.OBJECTIVE: To investigate risk factors associated with asthma andsensitization in Kuwait. METHODS: One hundred sixty children (9-16 years)with physician-diagnosed asthma were recruited and matched (age, sex) with303 healthy controls. Risk factors were assessed by questionnaires,determination of sensitization status (skin tests and IgE), and homeallergen exposure (mite, cat, dog, cockroach; ELISA). RESULTS: Homeallergen levels and frequency of pet ownership were very low (cat, 4.1%;dog, 1.5%). The risk of cat sensitization increased significantly amongcat owners (odds ratio [OR], 3.53; 95% CI, 1.33-9.41; P = .01), and inchildren 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 ofcat sensitization. Current dog ownership significantly increased the riskof sensitization to dog (OR, 6.05; 95% CI, 1.33-27.54; P = .02). In themultivariate analysis, dog ownership remained the only significantassociate of dog sensitization (OR, 6.02; 95% CI, 1.30-27.96; P = .02).Sensitization to Alternaria was the strongest independent associate of theasthma group. Family history of asthma, history of whooping cough, currentcat ownership, and breast-feeding <2 months were other significant andindependent risk factors for asthma. CONCLUSIONS: Pet ownership markedlyincreased the risk of sensitization to pets. Despite low allergenexposure, the pattern of childhood asthma in Kuwait follows that describedin Western communities (strong association withsensitization).