Mona Al-Ahmad, Nermina Arifhodzic, Nasser Al Ahmed, Ali Al Anezi, Radakrishna Paniker, Nasser Fakim
Department of Allergy, Al-Rashed Allergy Center
Ministry of Health, Kuwait
Introduction: Indoor allergens (house dust mites) are the leading cause of allergic asthma in children worldwide. However, a desert climate does not provide optimal conditions for mite thriving.
The aim of study: To evaluate the relationship between sensitization to indoor vs. outdoor inhalant allergens in asthma development in Kuwaiti schoolchildren.
Methods: In a cohort of 246 randomly selected asthmatic children, both gender, aged 8-15 years old. Patients were recruited from September 2006 - October 2007 from Kuwait allergy center. All patients completed disease history questionnaire, underwent PFT and skin prick test (SPT) with the battery of inhalant allergens (Stellergenes, France), including those typical for desert climate. One hundred eleven healthy, age and gender matched children served as control
Results: majority of asthmatic children, 86.9 %,( mean age of 11.3 ± 2.9 years) had positive SPT to one or more inhalant allergens in comparison to 26.1% of healthy control. Sensitization to outdoor allergens prevailed in all asthmatic children, (44, 3% vs. 15.6% to house dust mites; p<.001). ). Sensitization to both indoor and outdoor allergens was found in 29% patients. No statistically significant difference (p > 0.05) in asthma severity between children sensitized to either indoor or outdoor allergens was found. (Indoor allergens: mild intermittent: 44.1%, mild - moderate persistent: 55.9%; Outdoor allergens: 42.6% and 57.3 % respectively). Co - morbid allergic rhinitis was found in more than 50% of our patients.
Conclusion: Unlike other countries, where asthma is most frequently related to exposure to indoor allergens, it is not the case in our region. Pollen allergens a major cause of asthma of Kuwaiti asthmatic school children. Extremely long pollination season in Kuwait region characterized by two typical, almost constant peaks, (spring and autumn) has important impact on pollen related asthma development. Harsh desert climate with drastic environmental changes, have a major impact on asthma phenotype.
Key words: indoor allergens, outdoor allergens, asthma development.