Thorax 2000;55:449-453 ( June )

International patterns of tuberculosis and the prevalence of symptoms of asthma, rhinitis, and eczema

Erika von Mutius^a, Neil Pearce^b, Richard Beasley^b, Soo Cheng^b, Ondine von Ehrenstein^a, Bengt Björkstén^c, Stephan Weiland^d, on behalf of the ISAAC Steering Committee

^a University Children's Hospital, Klinikum Innenstadt, Munich, Germany, ^b Wellington School of Medicine, University of Otago, Wellington, New Zealand, ^c University Hospital, Linköping, Sweden, ^d Institute of Epidemiology and Social Medicine, University of Münster, Germany

Correspondence to: Dr E von Mutius, Dr von Haunersche Kinderklinik, Klinikum Innenstadt, Lindwurmstrasse 4, D-80337 München, Germany email: erika.von.mutius{at}kk-i.med.uni-muenchen.de

Received 20 May 1999; Returned to authors 8 July 1999; Revised version received 25 August 1999; Accepted for publication 7 September 1999

BACKGROUNDAn ecological analysis was conducted of the relationship between tuberculosis notification rates and the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema in 85 centres from 23 countries in which standardised data are available. These essentially comprised countries in Europe as well as the USA, Canada, Australia, and New Zealand.
METHODSTuberculosis notification rates were obtained from the World Health Organization. Data on the prevalence of symptoms of asthma, rhinitis, and eczema in 235 477 children aged 13-14 years were based on the responses to the written and video questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC). The analysis was adjusted for gross national product (GNP) as an estimate of the level of affluence.
RESULTSTuberculosis notification rates were significantly inversely associated with the lifetime prevalence of wheeze and asthma and the 12 month period prevalence of wheeze at rest as assessed by the video questionnaire. An increase in the tuberculosis notification rates of 25 per 100 000 was associated with an absolute decrease in the prevalence of wheeze ever of 4.7%. Symptoms of allergic rhinoconjunctivitis in the past 12 months were inversely associated with tuberculosis notification rates, but there were no other significant associations with other ISAAC questions on allergic rhinoconjunctivitis or atopic eczema.
CONCLUSIONSThese findings are consistent with recent experimental evidence which suggests that exposure to Mycobacterium tuberculosis may reduce the risk of developing asthma.


Keywords: tuberculosis; atopy; asthma

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© 2000 by Thorax
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