Skip to main content
Top
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

High body mass index is not associated with atopy in schoolchildren living in rural and urban areas of Ghana

Authors: Irene A Larbi, Kerstin Klipstein-Grobusch, Abena S Amoah, Benedicta B Obeng, Michael D Wilson, Maria Yazdanbakhsh, Daniel A Boakye

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

Factors which determine the development of atopy and the observed rural-urban gradient in its prevalence are not fully understood. High body mass index (BMI) has been associated with asthma and potentially atopy in industrialized countries. In developing countries, the transition from rural to urban areas has been associated with lifestyle changes and an increased prevalence of high BMI; however, the effect of high BMI on atopy remains unknown in this population. We therefore investigated the association between high BMI and atopy among schoolchildren living in rural and urban areas of Ghana.

Methods

Data on skin prick testing, anthropometric, parasitological, demographic and lifestyle information for 1,482 schoolchildren aged 6-15 years was collected. Atopy was defined as sensitization to at least one tested allergen whilst the Centres for Disease Control and Prevention (CDC, Atlanta) growth reference charts were used in defining high BMI as BMI ≥ the 85th percentile. Logistic regression was performed to investigate the association between high BMI and atopy whilst adjusting for potential confounding factors.

Results

The following prevalences were observed for high BMI [Rural: 16%, Urban: 10.8%, p < 0.001] and atopy [Rural: 25.1%, Urban: 17.8%, p < 0.001]. High BMI was not associated with atopy; but an inverse association was observed between underweight and atopy [OR: 0.57, 95% CI: 0.33-0.99]. Significant associations were also observed with male sex [Rural: OR: 1.49, 95% CI: 1.06-2.08; Urban: OR: 1.90, 95% CI: 1.30-2.79], and in the urban site with older age [OR: 1.76, 95% CI: 1.00-3.07], family history of asthma [OR: 1.58, 95% CI: 1.01-2.47] and occupational status of parent [OR: 0.33, 95% CI: 0.12-0.93]; whilst co-infection with intestinal parasites [OR: 2.47, 95% CI: 1.01-6.04] was associated with atopy in the rural site. After multivariate adjustment, male sex, older age and family history of asthma remained significant.

Conclusions

In Ghanaian schoolchildren, high BMI was not associated with atopy. Further studies are warranted to clarify the relationship between body weight and atopy in children subjected to rapid life-style changes associated with urbanization of their environments.
Appendix
Available only for authorised users
Literature
2.
go back to reference Ait-Khaled N, Odhiambo J, Pearce N, Adjoh KS, Maesano IA, Benhabyles B, et al: Prevalence of symptoms of asthma, rhinitis and eczema in 13 to 14-year-old children in Africa: the International Study of Asthma and Allergies in Childhood Phase III. Allergy. 2007, 62: 247-258. 10.1111/j.1398-9995.2007.01325.x.CrossRefPubMed Ait-Khaled N, Odhiambo J, Pearce N, Adjoh KS, Maesano IA, Benhabyles B, et al: Prevalence of symptoms of asthma, rhinitis and eczema in 13 to 14-year-old children in Africa: the International Study of Asthma and Allergies in Childhood Phase III. Allergy. 2007, 62: 247-258. 10.1111/j.1398-9995.2007.01325.x.CrossRefPubMed
3.
go back to reference Addo-Yobo E, Woodcock A, Allotey A, Baffoe-Bonnie B, Strachan D, Custovic A: Exercise-induced bronchospasm and atopy in Ghana: two surveys ten years apart. PLoS Medicine. 2007, 4 (2): 355-360. 10.1371/journal.pmed.0040355.CrossRef Addo-Yobo E, Woodcock A, Allotey A, Baffoe-Bonnie B, Strachan D, Custovic A: Exercise-induced bronchospasm and atopy in Ghana: two surveys ten years apart. PLoS Medicine. 2007, 4 (2): 355-360. 10.1371/journal.pmed.0040355.CrossRef
5.
go back to reference Weinberg EG: Urbanization and childhood asthma: An African perspective. Journal of Allergy and Clinical Immunology. 2000, 105: 224-231. 10.1016/S0091-6749(00)90069-1.CrossRefPubMed Weinberg EG: Urbanization and childhood asthma: An African perspective. Journal of Allergy and Clinical Immunology. 2000, 105: 224-231. 10.1016/S0091-6749(00)90069-1.CrossRefPubMed
6.
go back to reference van Ree R, Yazdanbakhsh M: Allergic disorders in African countries: linking immunology to accurate phenotype. Allergy. 2007, 62: 237-246. 10.1111/j.1398-9995.2007.01336.x.CrossRefPubMed van Ree R, Yazdanbakhsh M: Allergic disorders in African countries: linking immunology to accurate phenotype. Allergy. 2007, 62: 237-246. 10.1111/j.1398-9995.2007.01336.x.CrossRefPubMed
7.
go back to reference Arshad SA, Tariq SM, Matthews S, Hakim E: Sensitization to common allergens and its association with allergic disorders at age 4 years: A whole population birth cohort study. Pediatrics. 2001, 108: e33-10.1542/peds.108.2.e33.CrossRefPubMed Arshad SA, Tariq SM, Matthews S, Hakim E: Sensitization to common allergens and its association with allergic disorders at age 4 years: A whole population birth cohort study. Pediatrics. 2001, 108: e33-10.1542/peds.108.2.e33.CrossRefPubMed
8.
go back to reference Stevenson MD, Sellins S, Grube E, Schroer K, Gupta J, Wang N, et al: Aeroallergen sensitization in healthy children: Racial and socioeconomic correlates. J Pediatr. 2007, 151 (2): 187-191. 10.1016/j.jpeds.2007.03.001.CrossRefPubMedPubMedCentral Stevenson MD, Sellins S, Grube E, Schroer K, Gupta J, Wang N, et al: Aeroallergen sensitization in healthy children: Racial and socioeconomic correlates. J Pediatr. 2007, 151 (2): 187-191. 10.1016/j.jpeds.2007.03.001.CrossRefPubMedPubMedCentral
9.
go back to reference Pearce N, Douwes J: The global epidemiology of asthma in children. Int Journal of Tuberculosis & Lung Diseases. 2006, 10 (2): 125-132. Pearce N, Douwes J: The global epidemiology of asthma in children. Int Journal of Tuberculosis & Lung Diseases. 2006, 10 (2): 125-132.
10.
11.
go back to reference Zacharasiewicz A, Douwes J, Pearce N: What proportion of rhinitis symptoms is attributable to atopy?. Journal of Clinical Epidemiology. 2003, 56 (4): 385-390. 10.1016/S0895-4356(03)00043-X.CrossRefPubMed Zacharasiewicz A, Douwes J, Pearce N: What proportion of rhinitis symptoms is attributable to atopy?. Journal of Clinical Epidemiology. 2003, 56 (4): 385-390. 10.1016/S0895-4356(03)00043-X.CrossRefPubMed
12.
go back to reference Schafer T: The impact of allergy on atopic eczema from data from epidemiological studies. Current Opinion in Allergy and Clinical Immunology. 2008, 8: 418-422. 10.1097/ACI.0b013e32830e71a7.CrossRefPubMed Schafer T: The impact of allergy on atopic eczema from data from epidemiological studies. Current Opinion in Allergy and Clinical Immunology. 2008, 8: 418-422. 10.1097/ACI.0b013e32830e71a7.CrossRefPubMed
13.
go back to reference Huang SL, Shiao GM, Chou P: Association between body mass index and allergy in teenage girls in Taiwan. Clinical and Experimental Allergy. 1999, 29: 323-329. 10.1046/j.1365-2222.1999.00455.x.CrossRefPubMed Huang SL, Shiao GM, Chou P: Association between body mass index and allergy in teenage girls in Taiwan. Clinical and Experimental Allergy. 1999, 29: 323-329. 10.1046/j.1365-2222.1999.00455.x.CrossRefPubMed
14.
go back to reference Ford ES: The epidemiology of obesity and asthma. Journal of Clinical Immunology. 2005, 115: 897-907. 10.1016/j.jaci.2004.11.050.CrossRef Ford ES: The epidemiology of obesity and asthma. Journal of Clinical Immunology. 2005, 115: 897-907. 10.1016/j.jaci.2004.11.050.CrossRef
15.
go back to reference Hersoug LG, Linneberg A: The link between the epidemics of obesity and allergic diseases: does obesity induce decreased immune tolerance? Allergy. 2007, 62: 1205-1213. Hersoug LG, Linneberg A: The link between the epidemics of obesity and allergic diseases: does obesity induce decreased immune tolerance? Allergy. 2007, 62: 1205-1213.
16.
go back to reference Ebbing CB, Pawlak DB, Ludwig DS: Childhood obesity: public-health crisis, common sense cure. Lancet. 2002, 360: 473-482. 10.1016/S0140-6736(02)09678-2.CrossRef Ebbing CB, Pawlak DB, Ludwig DS: Childhood obesity: public-health crisis, common sense cure. Lancet. 2002, 360: 473-482. 10.1016/S0140-6736(02)09678-2.CrossRef
18.
go back to reference Perzanowski MS, Nganga LW, Carter MC, Odhiambo J, Ngari P, Vaughan JW, et al: Atopy, asthma and antibodies to Ascaris among rural and urban children in Kenya. J Pediatr. 2002, 140: 582-588. 10.1067/mpd.2002.122937.CrossRefPubMed Perzanowski MS, Nganga LW, Carter MC, Odhiambo J, Ngari P, Vaughan JW, et al: Atopy, asthma and antibodies to Ascaris among rural and urban children in Kenya. J Pediatr. 2002, 140: 582-588. 10.1067/mpd.2002.122937.CrossRefPubMed
19.
go back to reference Calvert J, Burney P: Effect of body mass on exercise-induced bronchospasm and atopy in African children. Journal Allergy and Clinical Immunology. 2005, 116: 773-779. 10.1016/j.jaci.2005.05.025.CrossRef Calvert J, Burney P: Effect of body mass on exercise-induced bronchospasm and atopy in African children. Journal Allergy and Clinical Immunology. 2005, 116: 773-779. 10.1016/j.jaci.2005.05.025.CrossRef
21.
go back to reference Canoy D, Buchan I: Challenges in obesity epidemiology. Obesity Review. 2007, 8 (1): 1-11. 10.1111/j.1467-789X.2007.00308.x.CrossRef Canoy D, Buchan I: Challenges in obesity epidemiology. Obesity Review. 2007, 8 (1): 1-11. 10.1111/j.1467-789X.2007.00308.x.CrossRef
23.
go back to reference Gyorkos TW, Ramsan M, Foun A, Khamis IS: Efficacy of new-cost filtration device for recovering schistosoma haematobium eggs from urine. J Clin Microbiol. 2001, 39 (7): 2681-2. 10.1128/JCM.39.7.2681-2682.2001.CrossRefPubMedPubMedCentral Gyorkos TW, Ramsan M, Foun A, Khamis IS: Efficacy of new-cost filtration device for recovering schistosoma haematobium eggs from urine. J Clin Microbiol. 2001, 39 (7): 2681-2. 10.1128/JCM.39.7.2681-2682.2001.CrossRefPubMedPubMedCentral
25.
go back to reference Wang Y, Lobstein T: Worldwide trends in childhood overweight and obesity. International Journal of Pediatric Obesity. 2006, 1: 11-25. 10.1080/17477160600586747.CrossRefPubMed Wang Y, Lobstein T: Worldwide trends in childhood overweight and obesity. International Journal of Pediatric Obesity. 2006, 1: 11-25. 10.1080/17477160600586747.CrossRefPubMed
26.
go back to reference Addo-Yobo E, Custovic A, Taggart S, Craven M, Bonnie B, Woodcock A: Risk factors for asthma in urban Ghana. Journal Allergy and Clinical Immunology. 2001, 108: 363-368. 10.1067/mai.2001.117464.CrossRef Addo-Yobo E, Custovic A, Taggart S, Craven M, Bonnie B, Woodcock A: Risk factors for asthma in urban Ghana. Journal Allergy and Clinical Immunology. 2001, 108: 363-368. 10.1067/mai.2001.117464.CrossRef
27.
go back to reference Nganga L, Odhiambo J, Mungai M, Gicheha C, Nderitu P, Maingi B, et al: Prevalence of exercise induced bronchospasm in Kenyan schoolchildren: an urban-rural comparison. Thorax. 1998, 53: 919-926. 10.1136/thx.53.11.919.CrossRef Nganga L, Odhiambo J, Mungai M, Gicheha C, Nderitu P, Maingi B, et al: Prevalence of exercise induced bronchospasm in Kenyan schoolchildren: an urban-rural comparison. Thorax. 1998, 53: 919-926. 10.1136/thx.53.11.919.CrossRef
28.
go back to reference Lopata AL, Jeebhay MF, Groenewald M, Manjra A, du Toit G, Sibanda EN, et al: Sensitization to three cockroach species in Southern Africa. Current Allergy & Clinical Immunology. 2005, 2 (18): 62-66. Lopata AL, Jeebhay MF, Groenewald M, Manjra A, du Toit G, Sibanda EN, et al: Sensitization to three cockroach species in Southern Africa. Current Allergy & Clinical Immunology. 2005, 2 (18): 62-66.
29.
go back to reference Shapiro GG, Stout JW: Childhood asthma in the United States: urban issues. Pediatr Pulmonol. 2002, 33: 47-55. 10.1002/ppul.10029.CrossRefPubMed Shapiro GG, Stout JW: Childhood asthma in the United States: urban issues. Pediatr Pulmonol. 2002, 33: 47-55. 10.1002/ppul.10029.CrossRefPubMed
30.
go back to reference von Mutius E, Schwartz J, Neas L, Dockery D, Weiss S: Relation of body mass index to asthma and atopy in children: the national health and nutrition examination study III. Thorax. 2001, 56: 835-838. 10.1136/thorax.56.11.835.CrossRefPubMedPubMedCentral von Mutius E, Schwartz J, Neas L, Dockery D, Weiss S: Relation of body mass index to asthma and atopy in children: the national health and nutrition examination study III. Thorax. 2001, 56: 835-838. 10.1136/thorax.56.11.835.CrossRefPubMedPubMedCentral
31.
go back to reference Van Gysel D, Govaere E, Verhmme K, Doli E, D Baets F: Body mass index in Belgian schoolchildren and its relationship with sensitization and allergic symptoms. Pediatr Allergy Immunol. 2009, 2: 246-253.CrossRef Van Gysel D, Govaere E, Verhmme K, Doli E, D Baets F: Body mass index in Belgian schoolchildren and its relationship with sensitization and allergic symptoms. Pediatr Allergy Immunol. 2009, 2: 246-253.CrossRef
33.
go back to reference Mai XM, Nilsson L, Axelson O, Braback L, Sandin A, Kjellman NI, et al: High body mass index, asthma and allergy in Swedish schoolchildren participating in the International Study of Asthma and Allergies in Childhood: Phase II. Acta Paediatr. 2003, 92: 1144-1148. 10.1111/j.1651-2227.2003.tb02474.x.CrossRefPubMed Mai XM, Nilsson L, Axelson O, Braback L, Sandin A, Kjellman NI, et al: High body mass index, asthma and allergy in Swedish schoolchildren participating in the International Study of Asthma and Allergies in Childhood: Phase II. Acta Paediatr. 2003, 92: 1144-1148. 10.1111/j.1651-2227.2003.tb02474.x.CrossRefPubMed
34.
go back to reference Hancox RJ, Milne BJ, Poulton R, Taylor DR, Greene JM, McLachlan CR, et al: Sex differences in the relation between body mass index and asthma and atopy in a birth cohort. Am J Respir Crit Care Med. 2005, 171: 440-5.CrossRefPubMed Hancox RJ, Milne BJ, Poulton R, Taylor DR, Greene JM, McLachlan CR, et al: Sex differences in the relation between body mass index and asthma and atopy in a birth cohort. Am J Respir Crit Care Med. 2005, 171: 440-5.CrossRefPubMed
35.
go back to reference Leung TF, Klong APS, Chan IHS, Choi KC, Ho CS, Chan MHM, et al: Assocation between obesity and atopy in Chinese school children. Int Arch Allergy Immunol. 2009, 149: 133-140. 10.1159/000189196.CrossRefPubMed Leung TF, Klong APS, Chan IHS, Choi KC, Ho CS, Chan MHM, et al: Assocation between obesity and atopy in Chinese school children. Int Arch Allergy Immunol. 2009, 149: 133-140. 10.1159/000189196.CrossRefPubMed
36.
go back to reference Ing R, Su Z, Scott ME, Koski KG: Suppressed T helper 2 immunity and prolonged survival of a nematode parasite in protein-malnourished mice. Proc Natl Acad Sci USA. 2000, 97 (13): 7078-83. 10.1073/pnas.97.13.7078.CrossRefPubMedPubMedCentral Ing R, Su Z, Scott ME, Koski KG: Suppressed T helper 2 immunity and prolonged survival of a nematode parasite in protein-malnourished mice. Proc Natl Acad Sci USA. 2000, 97 (13): 7078-83. 10.1073/pnas.97.13.7078.CrossRefPubMedPubMedCentral
37.
go back to reference Lusky A, Barell V, Lubin F, Kaplan G, Layani V, Schohat Z, et al: Relationship between morbidity and extreme values of body mass index in adolescents. Int J Epidemiol. 1996, 25 (4): 829-34. 10.1093/ije/25.4.829.CrossRefPubMed Lusky A, Barell V, Lubin F, Kaplan G, Layani V, Schohat Z, et al: Relationship between morbidity and extreme values of body mass index in adolescents. Int J Epidemiol. 1996, 25 (4): 829-34. 10.1093/ije/25.4.829.CrossRefPubMed
38.
go back to reference Kwon HL, Ortiz B, Swaner R, Shoemaker K, Jean-Louis B, Northridge ME, et al: Childhood asthma and extreme values of body mass index: the Harlem children's zone asthma initiative. J Urban Health. 2006, 83: 421-433. 10.1007/s11524-006-9050-9.CrossRefPubMedPubMedCentral Kwon HL, Ortiz B, Swaner R, Shoemaker K, Jean-Louis B, Northridge ME, et al: Childhood asthma and extreme values of body mass index: the Harlem children's zone asthma initiative. J Urban Health. 2006, 83: 421-433. 10.1007/s11524-006-9050-9.CrossRefPubMedPubMedCentral
39.
go back to reference Peden DB: Development of atopy and asthma: Candidate environmental influences and important periods of exposure. Environmental Health Perspectives. 2000, 108 (3): 475-482.CrossRefPubMedPubMedCentral Peden DB: Development of atopy and asthma: Candidate environmental influences and important periods of exposure. Environmental Health Perspectives. 2000, 108 (3): 475-482.CrossRefPubMedPubMedCentral
40.
go back to reference Mao XQ, Sun DJ, Miyoshi A, Feng Z, Handzel ZT, Hopkin JM, et al: The link between helminth infection and atopy. Parasitology Today. 2000, 16 (5): 186-188. 10.1016/S0169-4758(00)01642-2.CrossRefPubMed Mao XQ, Sun DJ, Miyoshi A, Feng Z, Handzel ZT, Hopkin JM, et al: The link between helminth infection and atopy. Parasitology Today. 2000, 16 (5): 186-188. 10.1016/S0169-4758(00)01642-2.CrossRefPubMed
41.
go back to reference Hunninghake GM, Soto-Quiros ME, Avila L, Ly NP, Liang C, Sylvia JS, et al: Sensitization to Ascaris lumbricoides and severity of childhood asthma in Costa Rica. Journal Allergy and Clinical Immunology. 2007, 119: 654-661. 10.1016/j.jaci.2006.12.609.CrossRef Hunninghake GM, Soto-Quiros ME, Avila L, Ly NP, Liang C, Sylvia JS, et al: Sensitization to Ascaris lumbricoides and severity of childhood asthma in Costa Rica. Journal Allergy and Clinical Immunology. 2007, 119: 654-661. 10.1016/j.jaci.2006.12.609.CrossRef
42.
go back to reference Butte NF, Garza C, de Onis M: Evaluation of the feasibility of international growth standards for school-aged children and adolescent. J Nutr. 2007, 137 (1): 153-7.PubMed Butte NF, Garza C, de Onis M: Evaluation of the feasibility of international growth standards for school-aged children and adolescent. J Nutr. 2007, 137 (1): 153-7.PubMed
43.
go back to reference Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, et al: CDC growth charts: United States. Adv Data. 2000, 8 (314): 1-27. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, et al: CDC growth charts: United States. Adv Data. 2000, 8 (314): 1-27.
Metadata
Title
High body mass index is not associated with atopy in schoolchildren living in rural and urban areas of Ghana
Authors
Irene A Larbi
Kerstin Klipstein-Grobusch
Abena S Amoah
Benedicta B Obeng
Michael D Wilson
Maria Yazdanbakhsh
Daniel A Boakye
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-469

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue