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Respiratory symptoms, bronchial responsiveness, and atopy in Fijian and Indian children
1Department of Medicine, Fiji School of Medicine, Suva.
Insights
Fiji Indian children have more severe asthma, indicated by higher rates of bronchial hyperresponsiveness. Fijian children experience more respiratory infections, shown by higher rates of productive cough.
Area of Science:
- Environmental Health
- Epidemiology
- Respiratory Medicine
Background:
- Hospital admission rates for asthma are significantly higher in Fiji Indian children compared to Melanesian Fijian children.
- Conversely, Melanesian Fijian children exhibit higher hospital admission rates for pneumonia than Fiji Indian children.
Purpose of the Study:
- To investigate the prevalence of respiratory symptoms, bronchial hyperresponsiveness, and atopy in school children of different ethnic groups in Suva City.
- To explore potential ethnic disparities in asthma severity and respiratory infection burden.
Main Methods:
- A cross-sectional study involving 2,173 Suva City school children (mean age 9.6 years) using a multilingual questionnaire.
- Histamine inhalation challenges and skin-prick allergen tests were performed on a subset of participants.
- Data analysis compared prevalence of symptoms, bronchial hyperresponsiveness, and atopy between ethnic groups.
Main Results:
- Wheezing prevalence was similar (20.6%) between ethnic groups, but productive cough was more frequent in Fijians (29%) than Indians (17%).
- Bronchial hyperresponsiveness was twice as common in Indian children (30%) compared to Fijian children (15%).
- The combination of wheezing and bronchial hyperresponsiveness was nearly three times more prevalent in Indian children.
Conclusions:
- Indian children may experience more severe asthma, potentially due to genetic or environmental factors independent of atopy.
- Higher rates of productive cough in Fijian children suggest a greater burden of respiratory infections, possibly linked to domestic crowding.
- Ethnic differences in respiratory health outcomes warrant further investigation into underlying causes.
Abstract:
Hospital admission rates for asthma in the 5 to 14 yr age group are three times higher in Fiji Indians than in Melanesian Fijians. Conversely, admission rates for pneumonia are three times higher for Fijians than Indians. To determine the prevalence of respiratory symptoms, bronchial hyperresponsiveness, and atopy, a questionnaire in three languages was distributed to 2,173 Suva City school children (mean age 9.6 yr), half of whom were sampled for histamine inhalation and skin-prick allergen tests. Prevalence of wheeze in the previous 12 mo was identical in both ethnic groups (20.6%). Productive cough was more common in Fijians (29%) than Indians (17%, p < 0.0001). Bronchial hyperresponsiveness was twice as common in Indians (30%) as Fijians (15%), relative risk 2.1 (95% confidence interval [CI]: 1.5 to 2.8), p < 0.0001. The combination of current wheeze and bronchial hyperresponsiveness was found in nearly three times as many Indian children (11.3%) as Fijians (4.0%), and the mean bronchial dose-response slope to histamine was steeper in Indians than Fijians. Prevalence of atopy was similar in Fijians (36%) and Indians (38%). Wheeze was significantly associated with atopy and a steeper dose-response slope to histamine, but productive cough was not. Indians may have more severe asthma than Fijians due to genetic or environmental factors acting independently of atopy. The higher prevalence of productive cough in Fijians is consistent with a greater burden of respiratory infection, and is associated with domestic crowding.