Lily Irsa

Body mass index, atopy, and allergic diseases

Background Prevalence of atopy, allergic diseases, and obesity are increasing. Atopy is an individu and/or familial tendency to sensitization in response to ordinary exposure to allergens. Studies on association of BM I with atopy and allergic diseases in children were limited, with inconclusive results. Objective To assess associations of BM I with atopy and allergic diseases in chidren. Methods A cross-sectional was conducted in school children aged 6-12 years in Lhokseumawe City, Aceh, June 2012. Children were assessed for BMI, skin prick test, and International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Statistical analyses included Chi-square, Fisher exact, and logistic regression. Results The subjects consisted of 137 (85.6%) normoweight, 12 (7.5%) overweight, and 11 (6.9%) obesity. Skin prick test results were positive in 44 (27.5%) and negative in 116 (72.5%) subjects. Allergic manifestations were allergic rhinitis (AR) 17 (10.6%), bronchial asthma 6 (3.8%), and atopic dermatitis (AD) 3 (1.9%). There was significant association of obesity with atopy, compared with normoweight (OR=3.78; 95%CI 1.08 to 13.19; P=0.037), but no significant association found when family history of atopy also assesed. There was significant association of obesity with bronchial asthma (OR=9.92; 95%CI 1.46 to 67.18; P=0.004) and AR (OR=6.49; 95%CI 1.64 to 25.66; P=0.015), compared with normoweight children. Significant association of overweight with atopy and allergic disease were not found. Conclusion Obese children are more likely to have atopy, bronchial asthma, and allergic rhinitis, but overweight and normoweight children are not.

Nutritional status and malaria infection in primary school-aged children

Background The most common nutritional problem affecting the pediatric population in developing countries is protein energy malnutrition (PEM). The nutritional problem may be caused by a variety of factors, most of which are related inadequate food intake and infection. One of the highest causes of morbidity and mortality in endemic areas is malaria. Malaria infection and nutritional status have been suggested to be interrelated. Objective To assess for a relationship between nutritional status and malaria infection in children. Methods This cross-sectional study was conducted in October and November 2010 in primary school children at Panyabungan City, North Sumatera Province. Peripheral thick and thin blood smear examinations were done to confirm the diagnosis of malaria. Participants were divided in two groups (malaria-infected and uninfected) by consecutive sampling. Nutritional status was determined by body weight and height measurements based on the 2000 Centers for Disease Control and Prevention (CDC) chart. The mild and moderate malnutrition classification was further sub-divided into stunted and wasted, based on the 2007 NCHS/WHO chart. Chi-square test was used to analyze the relationship between nutritional status and malaria infection. Results There were 126 children in each group. Significant differences in mild-moderate malnutrition were found between the malaria-infected and uninfected groups (23.8% vs. 46.8%, respectively; P= 0.011). There were also significant differences between the malaria-infected and uninfected groups with regards to chronic malnutrition type: stunted (20.0% vs. 37.3%, respectively; P=0.042) and stunted-wasted (6.7% vs. 28.8%, respectively; P= 0.008) in both groups of the children with mild-moderate malnutrition. Conclusion There are significantly more children with mild-moderate malnutrition in the uninfected group than in the malaria-infected group, furthermore, of those with mild-moderate malnutrition, there are significantly more stunted and stunted-wasted children who were uninfected than malaria-infected.

Total serum IgE levels in soil-transmitted helminth infected children with atopy symptoms

Background High total serum immunoglobulin E (IgE) levels and eosinophilia are markers for atopy, but other factors may also play a key role in affecting atopy, such as intestinal parasitic infection. Helminthiasis has been associated with a reduced risk of atopy and asthma symptoms in areas with high prevalence of parasitic infections. Objective To assess for associations between total serum IgE level and soil-transmitted helminthiasis (STH) infection, as well as between STH infection and allergy symptoms. Methods We conducted a cross-sectional stu dy on 84 consecutively-enrolled children , aged 7- 13 years, in the Secanggang Subdistrict, Langkat District, North Sumatera Province. Subjects were enrolled into one of two groups, with or without STH infection. Total serum IgE measurements and stool STH examinations were performed in all subjects. Data on atopy or allergy symptoms were obtained by parental interview. Results The 42 subjects with STH infection had significantly higher mean total serum lg E levels than the 42 subjects without infec tion, 1,13 1.26 IU/mL and 744.76 IU/mL, respectiv ely (P = 0.029). We also fo und significant positive association s between STH infection and asthma symptoms (P= 0.049), as well as eczema symptoms (P=0.044). Conclusion Mean total serum IgE level is higher in STHinfected subjects than in those without infection. In addition, STH infection is positively associated with asthma and eczema symptoms.

Comparison of skin prick allergy test in urban and rural children

Background Children who grow up in rural areas have a lower incidence of atopy and other allergic manifestations than children in urban areas. Several recent studies have suggested that agricultural exposure may protect children from developing asthma and atopy, but these findings are inconsistent. Objective To examine an association between living in rural or urban areas and skin prick allergy test results in children and to detennine associated risk factors for atopy. Methods We conducted a cross-sectional study in Karo district (rural) and Medan (urban) in October-December 2009. We enrolled primary school children who had a history of atopy in their families. Skin prick testing was done on the volar side of the forearm and included eight aero-allergens: house dust mites, house dust, cotton, chicken feathers, cat dander, cockroaches, mould, and pollen. We analyzed the folloMng risk factors for association Mth atopy: tobacco smoke, pets, livestock exposure, and having older sibling(s). Results We recruited 49 children from the Karo district and 52 children from the city of Medan. There were significant associations between living in an urban area and positive skin prick test results for house dust mites and house dust compared to living in a rural area (P=0.04, 95% CI: 1.11 to 5.91; P=0.04, 95% CI: 1.13 to 12.45, respectively). The reverse was true for cockroach allergens (P=0.02, 95% CI: 0.16 to 0.81). Tobacco smoke and livestock exposure were associated Mth negative skin prick test results in rural children (P=O.03, 95% CI: 0.03 to 0.81 and P=0.002, 95% CI: 0.02 to 0.42, respectively). Multivariate analysis revealed that lack of livestock exposure was the major risk factor associated Mth any positive skin prick test results in rural children (P=0.004; 95% CI ; 0.02 to 0.49). Conclusion There were differing associations between living in rural and urban areas to various skin prick test results in children. Lack of livestock exposure was the risk factor associated with positive skin prick test results in rural children.