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. 1994 Dec;49(12):1205–1210. doi: 10.1136/thx.49.12.1205

Asthma, allergy, and atopy in three south-east Asian populations.

R Leung 1, P Ho 1
PMCID: PMC475324  PMID: 7878553

Abstract

BACKGROUND--Whilst many recent reports have suggested a rise in the prevalence of asthma and allergic disease in Western countries, little is known about the epidemiology of these common conditions in south-east Asia. This study compared the prevalence of asthma and allergic disease amongst secondary school students in three south-east Asian populations--Hong Kong, Kota Kinabalu in Malaysia, and San Bu in China--and investigated the associations with atopy and family history. METHODS--Secondary school students were given standard questionnaires on respiratory and allergic symptoms for completion by parents with response rates of 89.2% in Hong Kong (611 male, 451 female; mean (SD) age = 13.9 (1.8 years), 87.6% in Kota Kinabalu (134 male, 275 female; 15.5 (2.1) years), and 98.6% in San Bu (492 male, 245 female; 16.4 (1.8) years). Skin tests were performed in a subsample of students to determine atopic status. RESULTS--The respective prevalence (and 95% CI) for hayfever, eczema, and wheeze or asthma were 15.7% (13.5, 17.9), 20.1% (17.7, 22.5), 11.6% (9.3, 13.9) in Hong Kong, 11.2% (8.2, 14.3), 7.6% (5.0, 10.1), 8.2% (5.5, 10.9) in Kota Kinabalu, and 2.1% (1.2, 3.1), 7.2% (5.4, 9.1), 1.9% (0.7, 3.1) in San Bu. Atopy was common and was present in 49.0-63.9% of subjects in the three populations. Dust mite and cockroach were the commonest allergens that gave positive reactions in 42.8-60.5% and 25.7-35.9% of students respectively. A higher proportion of students in Hong Kong had severe degree of reactivity on skin test than the other two populations. Family history was associated with asthma and allergic symptoms in the three populations conferring a 3-80-fold increase in risk to family members and was a stronger predictor for asthma and allergy than atopy. CONCLUSIONS--Prevalence of asthma and allergic disease is low compared with Western countries, but considerable differences exist between the three south-east Asian populations despite similar rates of atopy. Asthma and allergic disease are more strongly associated with family history than atopy, which suggests that genetic and environmental factors common to the family, other than aeroallergen sensitisation, are important in the pathogenesis of asthma and allergy in the region.

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Selected References

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  1. Abramson M., Kutin J., Bowes G. The prevalence of asthma in Victorian adults. Aust N Z J Med. 1992 Aug;22(4):358–363. doi: 10.1111/j.1445-5994.1992.tb02148.x. [DOI] [PubMed] [Google Scholar]
  2. Abramson M., Voigt T. Ambient air pollution and respiratory disease. Med J Aust. 1991 Apr 15;154(8):543–553. doi: 10.5694/j.1326-5377.1991.tb119453.x. [DOI] [PubMed] [Google Scholar]
  3. Burney P., Chinn S. Developing a new questionnaire for measuring the prevalence and distribution of asthma. Chest. 1987 Jun;91(6 Suppl):79S–83S. doi: 10.1378/chest.91.6_supplement.79s. [DOI] [PubMed] [Google Scholar]
  4. Burr M. L., Butland B. K., King S., Vaughan-Williams E. Changes in asthma prevalence: two surveys 15 years apart. Arch Dis Child. 1989 Oct;64(10):1452–1456. doi: 10.1136/adc.64.10.1452. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Chien Y. K., Yang W. P., Xue Z. L., Massey D. G. House dust mite asthma in China: a review. Ann Allergy. 1987 Aug;59(2):147–148. [PubMed] [Google Scholar]
  6. Clifford R. D., Howell J. B., Radford M., Holgate S. T. Associations between respiratory symptoms, bronchial response to methacholine, and atopy in two age groups of schoolchildren. Arch Dis Child. 1989 Aug;64(8):1133–1139. doi: 10.1136/adc.64.8.1133. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cookson W. O., Sharp P. A., Faux J. A., Hopkin J. M. Linkage between immunoglobulin E responses underlying asthma and rhinitis and chromosome 11q. Lancet. 1989 Jun 10;1(8650):1292–1295. doi: 10.1016/s0140-6736(89)92687-1. [DOI] [PubMed] [Google Scholar]
  8. Duffy D. L., Martin N. G., Battistutta D., Hopper J. L., Mathews J. D. Genetics of asthma and hay fever in Australian twins. Am Rev Respir Dis. 1990 Dec;142(6 Pt 1):1351–1358. doi: 10.1164/ajrccm/142.6_Pt_1.1351. [DOI] [PubMed] [Google Scholar]
  9. Elfert H., Anderson J. M., Lai M. Parents' perceptions of children with chronic illness: a study of immigrant Chinese families. J Pediatr Nurs. 1991 Apr;6(2):114–120. [PubMed] [Google Scholar]
  10. Evans D., Levison M. J., Feldman C. H., Clark N. M., Wasilewski Y., Levin B., Mellins R. B. The impact of passive smoking on emergency room visits of urban children with asthma. Am Rev Respir Dis. 1987 Mar;135(3):567–572. doi: 10.1164/arrd.1987.135.3.567. [DOI] [PubMed] [Google Scholar]
  11. Gabriel M., Cunnington A. M., Allan W. G., Pickering C. A., Wraith D. G. Mite allergy in Hong Kong. Clin Allergy. 1982 Mar;12(2):157–171. doi: 10.1111/j.1365-2222.1982.tb01635.x. [DOI] [PubMed] [Google Scholar]
  12. Gelber L. E., Seltzer L. H., Bouzoukis J. K., Pollart S. M., Chapman M. D., Platts-Mills T. A. Sensitization and exposure to indoor allergens as risk factors for asthma among patients presenting to hospital. Am Rev Respir Dis. 1993 Mar;147(3):573–578. doi: 10.1164/ajrccm/147.3.573. [DOI] [PubMed] [Google Scholar]
  13. Gerrard J. W., Cockcroft D. W., Mink J. T., Cotton D. J., Poonawala R., Dosman J. A. Increased nonspecific bronchial reactivity in cigarette smokers with normal lung function. Am Rev Respir Dis. 1980 Oct;122(4):577–581. doi: 10.1164/arrd.1980.122.4.577. [DOI] [PubMed] [Google Scholar]
  14. Hsieh K. H. A study of intracutaneous skin tests and radioallergosorbent tests on 1,000 asthmatic children in Taiwan. Asian Pac J Allergy Immunol. 1984 Jun;2(1):56–60. [PubMed] [Google Scholar]
  15. Hsieh K. H., Shen J. J. Prevalence of childhood asthma in Taipei, Taiwan, and other Asian Pacific countries. J Asthma. 1988;25(2):73–82. doi: 10.3109/02770908809071357. [DOI] [PubMed] [Google Scholar]
  16. Huston D. P., Kavanaugh A. F., Rohane P. W., Huston M. M. Immunoglobulin deficiency syndromes and therapy. J Allergy Clin Immunol. 1991 Jan;87(1 Pt 1):1–17. doi: 10.1016/0091-6749(91)90203-z. [DOI] [PubMed] [Google Scholar]
  17. Johnston S. L., Clough J. B., Pattemore P. K., Smith S., Holgate S. T. Longitudinal changes in skin-prick test reactivity over 2 years in a population of schoolchildren with respiratory symptoms. Clin Exp Allergy. 1992 Oct;22(10):948–957. doi: 10.1111/j.1365-2222.1992.tb02069.x. [DOI] [PubMed] [Google Scholar]
  18. Jones D. T., Sears M. R., Holdaway M. D., Hewitt C. J., Flannery E. M., Herbison G. P., Silva P. A. Childhood asthma in New Zealand. Br J Dis Chest. 1987 Oct;81(4):332–340. doi: 10.1016/0007-0971(87)90181-1. [DOI] [PubMed] [Google Scholar]
  19. Josephs L. K., Gregg I., Mullee M. A., Holgate S. T. Nonspecific bronchial reactivity and its relationship to the clinical expression of asthma. A longitudinal study. Am Rev Respir Dis. 1989 Aug;140(2):350–357. doi: 10.1164/ajrccm/140.2.350. [DOI] [PubMed] [Google Scholar]
  20. Kennedy S. M., Elwood R. K., Wiggs B. J., Paré P. D., Hogg J. C. Increased airway mucosal permeability of smokers. Relationship to airway reactivity. Am Rev Respir Dis. 1984 Jan;129(1):143–148. doi: 10.1164/arrd.1984.129.1.143. [DOI] [PubMed] [Google Scholar]
  21. Kjellman N. I. Effect of parental smoking on IgE levels in children. Lancet. 1981 May 2;1(8227):993–994. doi: 10.1016/s0140-6736(81)91749-9. [DOI] [PubMed] [Google Scholar]
  22. Lai N. K. [Study of dust mite allergy in the Guangzhou area]. Zhonghua Yu Fang Yi Xue Za Zhi. 1988 Nov;22(6):347–349. [PubMed] [Google Scholar]
  23. Leung R., Jenkins M. Asthma, allergy and atopy in southern Chinese school students. Clin Exp Allergy. 1994 Apr;24(4):353–358. doi: 10.1111/j.1365-2222.1994.tb00246.x. [DOI] [PubMed] [Google Scholar]
  24. Morris M. J., Faux J. A., Ting A., Morris P. J., Lane D. J. HLA-A, B and C and HLA-DR antigens in intrinsic and allergic asthma. Clin Allergy. 1980 Mar;10(2):173–179. doi: 10.1111/j.1365-2222.1980.tb02094.x. [DOI] [PubMed] [Google Scholar]
  25. Ninan T. K., Russell G. Respiratory symptoms and atopy in Aberdeen schoolchildren: evidence from two surveys 25 years apart. BMJ. 1992 Apr 4;304(6831):873–875. doi: 10.1136/bmj.304.6831.873. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. O'Connor G. T., Weiss S. T., Tager I. B., Speizer F. E. The effect of passive smoking on pulmonary function and nonspecific bronchial responsiveness in a population-based sample of children and young adults. Am Rev Respir Dis. 1987 Apr;135(4):800–804. doi: 10.1164/arrd.1987.135.4.800. [DOI] [PubMed] [Google Scholar]
  27. Omar A. H. Respiratory symptoms and asthma in primary school children in Kuala Lumpur. Acta Paediatr Jpn. 1990 Apr;32(2):183–187. doi: 10.1111/j.1442-200x.1990.tb00807.x. [DOI] [PubMed] [Google Scholar]
  28. Ong S. G., Liu J., Wong C. M., Lam T. H., Tam A. Y., Daniel L., Hedley A. J. Studies on the respiratory health of primary school children in urban communities of Hong Kong. Sci Total Environ. 1991 Jul 1;106(1-2):121–135. doi: 10.1016/0048-9697(91)90025-a. [DOI] [PubMed] [Google Scholar]
  29. Peat J. K., Britton W. J., Salome C. M., Woolcock A. J. Bronchial hyperresponsiveness in two populations of Australian schoolchildren. III. Effect of exposure to environmental allergens. Clin Allergy. 1987 Jul;17(4):291–300. doi: 10.1111/j.1365-2222.1987.tb02017.x. [DOI] [PubMed] [Google Scholar]
  30. Peat J. K., Haby M., Spijker J., Berry G., Woolcock A. J. Prevalence of asthma in adults in Busselton, Western Australia. BMJ. 1992 Nov 28;305(6865):1326–1329. doi: 10.1136/bmj.305.6865.1326. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Robertson C. F., Heycock E., Bishop J., Nolan T., Olinsky A., Phelan P. D. Prevalence of asthma in Melbourne schoolchildren: changes over 26 years. BMJ. 1991 May 11;302(6785):1116–1118. doi: 10.1136/bmj.302.6785.1116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Salome C. M., Peat J. K., Britton W. J., Woolcock A. J. Bronchial hyperresponsiveness in two populations of Australian schoolchildren. I. Relation to respiratory symptoms and diagnosed asthma. Clin Allergy. 1987 Jul;17(4):271–281. doi: 10.1111/j.1365-2222.1987.tb02015.x. [DOI] [PubMed] [Google Scholar]
  33. Samet J. M. A historical and epidemiologic perspective on respiratory symptoms questionnaires. Am J Epidemiol. 1978 Dec;108(6):435–446. doi: 10.1093/oxfordjournals.aje.a112642. [DOI] [PubMed] [Google Scholar]
  34. Sherman C. B., Tosteson T. D., Tager I. B., Speizer F. E., Weiss S. T. Early childhood predictors of asthma. Am J Epidemiol. 1990 Jul;132(1):83–95. doi: 10.1093/oxfordjournals.aje.a115646. [DOI] [PubMed] [Google Scholar]
  35. Turton C. W., Morris L., Buckingham J. A., Lawler S. D., Turner-Warwick M. Histocompatibility antigens in asthma: population and family studies. Thorax. 1979 Oct;34(5):670–676. doi: 10.1136/thx.34.5.670. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Utell M. J., Samet J. M. Particulate air pollution and health. New evidence on an old problem. Am Rev Respir Dis. 1993 Jun;147(6 Pt 1):1334–1335. doi: 10.1164/ajrccm/147.6_Pt_1.1334. [DOI] [PubMed] [Google Scholar]
  37. Wang W. X., Yang S. Z., Chui X. W., Zhang H. L. Association of HLA-Bw61 with asthma in the Chinese. Tissue Antigens. 1988 Oct;32(4):215–217. doi: 10.1111/j.1399-0039.1988.tb01658.x. [DOI] [PubMed] [Google Scholar]
  38. Zhong N. S., Chen R. C., O-yang M., Wu J. Y., Fu W. X., Shi L. J. Bronchial hyperresponsiveness in young students of southern China: relation to respiratory symptoms, diagnosed asthma, and risk factors. Thorax. 1990 Nov;45(11):860–865. doi: 10.1136/thx.45.11.860. [DOI] [PMC free article] [PubMed] [Google Scholar]

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