Background Allergic rhinitis is one of the most common chronic

Background Allergic rhinitis represents a global health problemaffecting 10% to more than 40% of the population worldwide.Several studies in recent years have described the efficacy ofsecond-generation antihistamines in younger children. It isnot well established whether cetirizine is more effective thanloratadine in reducing symptoms of allergic rhinitis.Objective The objective of this study was to compare the efficacyof loratadine with cetirizine for treatment of allergic rhinitis.Methods We conducted a randomized, double-blind, controlledtrial of 100 children, aged 13 to 16 years, from October toNovember 2009 at two junior high schools in Medan. GroupI received 10 mg of cetirizine and group II received 10 mg ofloratadine, each once daily in the morning for 14 days. Drugefficacy was assessed by changes from baseline symptom scoresand evaluation of therapeutic responses after 3 days, 7 days and14 days of treatment.Results The efficacy of cetirizine compared to that of loratadinewas not statistically significant in diminishing nasal symptomsafter 3 days, 7 days and 14 days of treatment (P=0.40, P=0.07,and P=0.057, respectively). Evaluation of side effects, however,revealed significantly fewer headaches in the cetirizine group after3 days and 7 days of treatment (P=0.01 and P=0.03, respectively)than in the loratidine group. In addition, the loratadine grouphad significantly more instances of palpitations after 7 days oftreatment (P=0.04) compared to the cetirizine group.Conclusion There was no significant difference in cetirizine andloratadine treatment effectiveness on allergic rhinitis. However,loratadine was found to cause more headaches and palpitationsthan cetirizine. [Paediatr lndones. 2012;52:61-6].

Background Allergic rhinitis represents a global health problem

Background Children who grow up in rural areas have a lower incidence of atopy and other allergic manifestations than children in urban areas. Several recent studies have suggested that agricultural exposure may protect children from developing asthma and atopy, but these findings are inconsistent.Objective To examine an association between living in rural or urban areas and skin prick allergy test results in children and to detennine associated risk factors for atopy.Methods We conducted a cross-sectional study in Karo district (rural) and Medan (urban) in October-December 2009. We enrolled primary school children who had a history of atopy in their families. Skin prick testing was done on the volar side of the forearm and included eight aero-allergens: house dust mites, house dust, cotton, chicken feathers, cat dander, cockroaches, mould, and pollen. We analyzed the folloMng risk factors forassociation Mth atopy: tobacco smoke, pets, livestock exposure, and having older sibling(s).Results We recruited 49 children from the Karo district and 52 children from the city of Medan. There were significant associations between living in an urban area and positive skin prick test results for house dust mites and house dust compared to living in a rural area (P=0.04, 95% CI: 1.11 to 5.91; P=0.04, 95% CI: 1.13 to 12.45, respectively). The reverse was true for cockroach allergens (P=0.02, 95% CI: 0.16 to 0.81). Tobacco smoke and livestock exposure were associated Mth negative skin prick test results in rural children (P=O.03, 95% CI: 0.03 to 0.81 and P=0.002, 95% CI: 0.02 to 0.42, respectively). Multivariate analysis revealed that lack of livestock exposure was the major risk factor associated Mth any positive skin prick test results in rural children (P=0.004; 95% CI ; 0.02 to 0.49).Conclusion There were differing associations between living in rural and urban areas to various skin prick test results in children. Lack of livestock exposure was the risk factor associated with positive skin prick test results in rural children.