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Bottle feeding and exposure to Toxocara as risk factors for wheezing illness among under-five Amazonian children: a
Marcelo Urbano Ferreira1, Guita Rubinsky-Elefant, Teresa Gontijo de Castro
1Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, Av Prof. Lineu Prestes 1374, São Paulo, SP, Brazil. muferrei@usp.br
Insights
In Amazonian children, early bottle feeding and Toxocara infection increased asthma risk. These findings highlight key targets for public health interventions to reduce childhood asthma prevalence.
Area of Science:
- Pediatric respiratory health
- Environmental and infectious disease epidemiology
Background:
- Wheezing and asthma are significant health concerns in young children.
- Understanding risk factors in diverse populations like the Amazon is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of wheezing and asthma in young children in Northwestern Brazil.
- To identify demographic, socioeconomic, environmental, maternal, nutritional, and infectious risk factors associated with wheezing and asthma.
Main Methods:
- A population-based cross-sectional survey of 606 children aged 6-59 months was conducted.
- Data collected via maternal interviews; parasitic infections and Toxocara antibodies diagnosed via laboratory tests.
- Logistic regression models analyzed associations between independent variables and asthma/wheezing outcomes.
Main Results:
- Prevalence of recent wheezing was 42.6%; asthma prevalence was 8.5%.
- 21.5% of children had antibodies to Toxocara (seropositivity).
- Independent risk factors for asthma included early bottle feeding (<4 months exclusive breastfeeding) and Toxocara seropositivity.
Conclusions:
- Early bottle feeding and Toxocara infection are significant risk factors for childhood asthma in this Amazonian population.
- These factors represent potential targets for public health strategies to mitigate asthma development.
- Further research into the mechanisms linking Toxocara and asthma is warranted.
Abstract:
We investigated the prevalence and risk factors for wheezing and asthma in young Amazonian children. A population-based cross-sectional survey of 606 children aged 6-59 months was performed in two small towns in Acre State, Northwestern Brazil. Information on outcome variables (recent wheezing and medical diagnosis of asthma) and demographic, socioeconomic, environmental, maternal and nutritional variables was obtained by interviewing children's mothers or guardians. Infections with intestinal parasites and antibodies to the zoonotic nematode Toxocara were diagnosed using standard laboratory techniques. Multiple unconditional logistic regression models were used to describe associations between independent variables and outcomes. The prevalence of recent wheezing (one or more reported episodes in the past 12 months) was 42.6%, but only 19.8% of wheezing children were also reported to have a medical diagnosis of asthma (prevalence, 8.5%); 21.5% of the children examined had antibodies to Toxocara. Increased risk of asthma was independently associated with early introduction of bottle feeding, defined as <4 months of exclusive breastfeeding [adjusted odds ratio (aOR) = 2.21, 95% confidence interval (95% CI), 1.07-4.59, P = 0.033], and seropositivity to Toxocara (aOR = 2.37, 95% CI 1.17-4.77, P = 0.016), suggesting two potential targets for public health interventions.
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