The epidemiological and allergic features of asthma in the New Guinea Highlands

Abstract

Summary Asthma in the New Guinea Highlands is of interest because of its reported rarity. In the Eastern Highlands, seventy‐one cases of asthma were investigated over a 12 month period. In addition, a whole village community of 2000 people was examined for wheezing illness. In children and adolescents asthma was extremely uncommon with no case being identified in the community study and the youngest hospital case being 10 years old. The prevalence of active asthma in adults was estimated to be 0.2–0.3%. Compared with European countries, the age at onset was much later with 58% starling after the age of 30 years. The sex ratio was almost equal. Cutaneous sensitivity to allergens was assessed using the prick lest. In asthmatics, reactions to D. pteronyssinus were positive in all cases. Multiple sensitivities were common and did not diminish with increasing age at onset. In 335 unselected controls of all ages, 19% were positive to allergens, 14% of them to D. pteronyssinus. D. pteronyssinus was identified in ail house dust samples from both village and urban dwellings. Asthma occurred in both traditional and European‐influenced environments, but the importance of social change remains uncertain.

Infection: friend or foe in the development of atopy and asthma?

“…In Papua New Guinea, ANDERSON [78] observed that respiratory infections were more common among young children in the Highlands, where the asthma rate was exceedingly low as compared to the coastal regions of the country where asthma occurred more frequently. In the Fiji Islands, FLYNN [79,80] studied two groups of children, the indigenous Fijians who showed a high hospital admission rate for pneumonia and the Fiji Indians whose asthma admission rate was three times higher than in the Fijians.…”

Urban-rural differences in questionnaire-derived markers of asthma in Kenyan school children

“…Another change in lifestyle that may have led to an introduction of house dust mites into sleeping quarters is the replacement of the traditional floor mats by blankets and mattresses. This has been offered as an explanation for the relatively sudden increase in asthma in all ages in Papua New Guinea from 0.9% in 1972 [12] to 7.3% in 1984 [13]. Urban studies in Kenyan adults [14] and Tanzanian children [15] show that asthma patients exhibit a high A respiratory health and home environment questionnaire was administered at school to parents or guardians.…”

Chronic lung disease in the Papua New Guinea Highlands.

“…About one-fifth of Highland asthmatics investigated, however, had additional symp-toms of chronic cough and might, for this reason, have been also classified as CLD. These cases were 12 years older at the onset of asthma (mean onset age 40) but otherwise resembled other asthmatics rather than the CLD group in terms of sensitivity to allergens (100% positive), sputum histology, and variability of FEV1 (Anderson, 1974b). Lung volumes were consistent with obstruction and the Ti was normal.…”

“…Subjects whose main complaint was episodic wheezing were classified as asthma, and these are described elsewhere (Anderson, 1974b (Meade et al, 1965) the total lung capacity (TLC), functional residual capacity (FRC), and residual volume (RV) were measured by the steady state helium method, and the transfer factor (TI) was measured by the single breath method. The mixed venous carbon dioxide tension (PMco2) was estimated by the rebreathing method of Campbell and Howell (1962).…”

“…Sera from 33 CLD subjects and 11 subjects over (Anderson, 1974b). Haemoglobin (Hb) levels were compared with those reported for a nearby population (Crane et al, 1972).…”