Article Text
Statistics from Altmetric.com
- Asthma
- asthma epidemiology
- asthma guidelines
- bronchiectasis
- inhaler devices
- paediatric asthma
- paediatric lung disease
- paediatric physician
Differences in asthma in urban and rural environments were first reported from Germany in 1965,1 followed by many reports of higher rates of asthma symptoms in urban than rural environments around the world including Africa,2 Asia3–5 and Papua New Guinea.6 Authors have suggested that wealth, lifestyle, housing and urban environmental exposures may contribute to increasing asthma prevalence. In relation to possible protective factors in the rural environment, studies have emerged on farming lifestyles in Westernised high-income countries, showing an inverse relationship between farm exposures early in life and asthma and rhinitis, but not eczema symptoms.7 8 The potential protective effect of microbial exposures from animals or unpasteurised milk on these diseases was highlighted. A recent review of these and other potential factors suggested a ‘package’ of factors may influence the lower prevalence in rural areas.9
In this issue of Thorax, two articles10 11 present new findings related to urbanisation in Latin America. Most of the readers of Thorax will not have visited the locations studied in these papers, as they are not on popular travel routes. However, they may represent the living circumstances of many of the world's children in low- and middle-income countries where the prevalence of asthma, rhinitis and eczema is mainly increasing.12
Rodríguez et al11 undertook an ecological study in 59 communities in Esmeraldas Province, a humid, tropical, coastal region in Ecuador. This is one of the poorest and remotest areas of the country undergoing changes related to urbanisation over the last 20 years. From 2005 to 2008 all the 7–15-year-olds were studied within the communities using parent completed questionnaires and reported community infrastructure. This study is robust with a high number of participants (n=4183) and a 95% response rate. Asthma was defined as a positive response to …
Linked Articles
- Asthma and the environment
- Asthma and the environment