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Clinical differences between children with asthma and rhinitis in rural and urban areas
Sánchez, Jorge; Sánchez, Andres & Cardona, Ricardo
Abstract
Background: Epidemiological studies have shown that children who
grow up on traditional farms are protected from allergic diseases.
However, less is known about if the environment influences the
pharmacotherapy in these patients.
Objective: To compare the treatment of asthmatic and rhinitis
children from urban and rural areas in Medellín, Colombia.
Methods: During one year, we follow up a group of children (6 to 14
years) with diagnostic of asthma or rhinitis living for more than five
years in urban or rural area. A questionnaire with socio-demographic
characteristics, pharmacotherapy treatments, was obtained each three
months. Atopy evaluation, spirometry and clinical test for asthma and
rhinitis severity were done at the beginning and one year later.
Results: Eighty six point four percent patients completed the follow
up (rural n: 134, urban n: 248). Patients in rural location required less
salbutamol (p: 0.01), visit to emergency department (p <0.01) and
have a less number of patients with FEV1 <80% (p: 0.05). For clinical
control rural children require less pharmacotherapy than urban
children (p: 0.01) and more patients with rhinitis (18% vs 8% p: 0.03)
and asthma (23% vs 12% p: 0.01) in the rural group could suspended
pharmacotherapy. Atopy (p <0.07) and poli-sensitization (p: <0.08)
was a little higher in urban than rural area. We observe that poverty/unhygienic indicators were risk factors for higher levels of specific
IgE among patients from urban area.
Conclusion: Patients with respiratory allergies located in urban area
require more pharmacotherapy and have less clinical response than
rural children.
Keywords
Asthma; children; diagnosis; treatment; rhinitis; rural; urban
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