The low prevalence of allergic disease in Eastern Europe
- 7 April 2009
- journal article
- research article
- Published by Wiley in Clinical and Experimental Allergy
- Vol. 39 (5), 708-716
- https://doi.org/10.1111/j.1365-2222.2009.03205.x
Abstract
Background The prevalence of allergic disease is known to be low in Eastern Europe. Objective To assess the association of suspected risk factors, including several closely linked to the hygiene hypothesis, with allergic symptoms and atopic sensitization in young school‐aged children. Methods Observational study of 13 889 Belarusian children followed up at age 6.5 years in the Promotion of Breastfeeding Intervention Trial (PROBIT). Allergic symptoms and diseases were based on parental responses to the International Study of Asthma and Allergy in Childhood questionnaire, and prick tests to five common inhalant allergens were performed using standard methods. Results Significantly increased risks of wheezing and hayfever symptoms in the past 12 months, and of recurrent itchy rash were observed in boys, children with a positive first‐degree family atopic history, and those who had received probiotics (especially as prophylaxis with antibiotic use). Pet ownership, contact with farm animals, the presence and number of younger and (especially) older siblings, and residency in rural areas of Western Belarus were associated with reduced risks. Maternal postnatal smoking was associated with wheezing and hayfever symptoms, while the duration of exclusive breastfeeding was not protective against any of the studied outcomes. The risk factors for allergic symptoms were similar in children with positive skin‐prick tests to those in the overall cohort. Conclusion Many of the risk and protective factors we identified are consistent with those reported in Western countries and with the hygiene hypothesis. Further research on dietary and other environmental and genetic factors is necessary to understand the low prevalence of allergic disease in Belarus and other Eastern European countries.Keywords
This publication has 51 references indexed in Scilit:
- A Regulatory B Cell Subset with a Unique CD1dhiCD5+ Phenotype Controls T Cell-Dependent Inflammatory ResponsesImmunity, 2008
- Effect of prolonged and exclusive breast feeding on risk of allergy and asthma: cluster randomised trialBMJ, 2007
- Cytokine responses to allergens during the first 2 years of life in Estonian and Swedish childrenClinical and Experimental Allergy, 2006
- Role of toll-like receptor 4 in protection by bacterial lipopolysaccharide in the nasal mucosa of atopic children but not adultsThe Lancet, 2004
- Siblings, Day-Care Attendance, and the Risk of Asthma and Wheezing during ChildhoodThe New England Journal of Medicine, 2000
- Sibship size, birth order, and atopy in 11,371 Italian young menJournal of Allergy and Clinical Immunology, 1998
- Risk factors for respiratory symptoms and atopic sensitisation in the Baltic area.Archives of Disease in Childhood, 1995
- Role of viral infections in the inception of asthma and allergies during childhood: could they be protective?Thorax, 1994
- Immediate skin test reactivity to Food and Drug Administration-approved standardized extractsJournal of Allergy and Clinical Immunology, 1990
- Prognosis of positive allergy skin tests in an asymptomatic population: A three year follow-up of college studentsJournal of Allergy and Clinical Immunology, 1971