engleski

Risk factors for childhood asthma in Croatia

Little is known about risk factors for asthma in European countries in transition. We aimed to investigate the factors associated with asthma in schoolchildren in Croatia. 411 children with asthma aged 6 to 18 years (cases), were recruited into the study from the local hospital in Slavonski Brod if the following criteria were met: (1) physician-diagnosed asthma, (2) asthma symptoms within the previous 12 months, and (3) use of antiasthma medication ; 403 non-asthmatic controls were randomly selected from non-asthmatic children attending the outpatient department or local schools. We ascertained housing conditions, family history, parental smoking, pet ownership, and pet contact by validated questionnaire. Sensitization was determined by skin prick testing. Homes were visited and dust samples from the child’s mattress collected and extracted. Der p 1, Fel d 1, Can f 1 and cockroach Bla g 2 were measured using mAb-based enzyme-linked immunoassay. 90.7% cases and 17.4% controls were skin test positive to at least one allergen, with mite (45.1%) and ragweed (23.6%) being the most common sensitisations. Frequency of current pet ownership was low (cat 12.1%, dog 6.6%). Asthmatic children were exposed to lower level of Fel d 1 than controls (p<0.05) ; there was no difference between cases and controls for other allergens. In the univariate analysis, asthma was associated with specific sensitization to a range of indoor and outdoor allergens, family history of asthma and child's history of whooping cough. Significant protective factors in the univariate analysis were having two or more older siblings and current dog and cat ownership. Environmental tobacco smoke exposure, fuel used for cooking and heating, urban/rural residence and contact with farm animals were not significant associates of asthma. In the multivariate regression analysis, atopy (aOR 51.19, 95% CI 30.43-86.13, p<0.0001), maternal asthma (7.76, 1.15-52.27, p=0.035), male gender (1.56, 1.07-1.91, p=0.03) and history of whooping cough (8.14, 95%CI 4.14-16, p<0.001) were significant and independent risk factors for asthma, whereas current cat ownership was protective (0.29, 0.12-0.7, p=0.006). Atopy, maternal asthma and child’s history of whooping cough were independent predictors of asthma in Croatian schoolchildren, whereas current cat ownership was protective.

risk factors; childhood asthma

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