Asthma and Allergic Disorders in Uganda: A Population-Based Study Across Urban and Rural Settings

Abstract

Asthma and allergic rhinitis were twice as prevalent in urban settings. Asthma was associated with greater impairment and worse lung function outcomes. We identified a high prevalence of allergic disorders in Uganda, which can be expected to increase due to urbanization and resultant exposures throughout early development.

Risk factors for asthma among schoolchildren who participated in a case-control study in urban Uganda

“…Similarly, our finding that children with asthma reported the highest frequency of 'trucks passing on the street near their home' has been reported elsewhere (34)(35)(36). We suggest that these factors are proxy measures of a higher socio-economic status of asthma cases and of urbanicity, consistent with findings from other LMICs that have found a higher prevalence of asthma among children (and adults) in urban than rural areas (7,37,38). However, our findings contradict those from HICs in which asthma is associated with lower parental education(39) and socio-economic status (40).…”

“…This is the first study in Africa to show such a strong gradient in asthma risk by place of birth. Previous studies have been mostly crosssectional and conducted in either rural or urban settings, and therefore focusing on current residence; these have shown that the prevalence of asthma is lower among rural residents compared to urban residents (6,7,10).…”

“…Asthma is estimated to affect more than 235 million people globally, and is the most common non-communicable condition among children (1). In Africa, the prevalence of asthma appears to be increasing (2)(3)(4)(5)(6), particularly in urban areas (3,7), but the causes of this increase are not fully understood. Moreover, asthma has various phenotypes which may have different aetiologies (8), and risk factors appear to vary internationally, and to differ between high-income countries (HICs) and low-and-middle income countries (LMICs) (9).…”

Environmental exposures and mechanisms in allergy and asthma development

“…The International Study of Asthma and Allergies in Childhood has demonstrated that the prevalence of these diseases can be very high in settings with low socioeconomic conditions and can vary greatly between regions, countries, and centers within a city or country, indicating the role of local environmental characteristics (7,8). Global trends of increasing urbanization and rapid population growth contribute to changes in lifestyle (diet, time indoors, physical activity) and environmental exposures (air pollution, smoking, mold, infections) that affect atopic allergic mechanisms and rising disease prevalence worldwide (1,2,(9)(10)(11). Many of these changes are associated with early-life and lifelong risk factors for the development and exacerbation of asthma and atopic allergic diseases.…”

The impact of HIV on the prevalence of asthma in Uganda: a general population survey

“…The weighted mean prevalence of asthma in Africa is 7.0% in the rural areas (2.5–11.5) and 9.6% (3.9–15.2) in urban areas. The prevalence of asthma and HIV in Uganda is 10% and 6.2% respectively [ 4 , 5 ].…”