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

  1. Harriet Mpairwe  Is a corresponding author
  2. Milly Namutebi
  3. Gyaviira Nkurunungi
  4. Pius Tumwesige
  5. Irene Nambuya
  6. Mike Mukasa
  7. Caroline Onen
  8. Marble Nnaluwooza
  9. Barbara Apule
  10. Tonny Katongole
  11. Gloria Oduru
  12. Joseph Kahwa
  13. Emily L Webb
  14. Lawrence Lubyayi
  15. Neil Pearce
  16. Alison M Elliott
  1. Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Uganda
  2. London School of Hygiene and Tropical Medicine, United Kingdom

Abstract

Data on asthma aetiology in Africa are scarce. We investigated the risk factors for asthma among schoolchildren (5-17years) in urban Uganda. We conducted a case-control study, among 555 cases and 1,115 controls. Asthma was diagnosed by study clinicians. The main risk factors for asthma were tertiary education for fathers [adjusted OR (95% CI); 2.32 (1.71-3.16)] and mothers [1.85 (1.38-2.48)]; area of residence at birth, with children born in a small town or in the city having an increased asthma risk compared to schoolchildren born in rural areas [2.16 (1.60-2.92)] and [2.79 (1.79-4.35)], respectively; father's and mother's history of asthma; children's own allergic conditions; atopy; and cooking on gas/electricity. In conclusion, asthma was associated with a strong rural-town-city risk gradient, higher parental socio-economic status and urbanicity. This work provides the basis for future studies to identify specific environmental/lifestyle factors responsible for increasing asthma risk among children in urban areas in LMICs.

Data availability

Data is available at https://datacompass.lshtm.ac.uk/1369/

The following data sets were generated
    1. Webb E
    2. Mpairwe H
    (2019) SONA project - Asthma risk factors data
    London School of Hygiene & Tropical Medicine (LSHTM) Data Compass, https://doi.org/10.17037/DATA.00001369.

Article and author information

Author details

  1. Harriet Mpairwe

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    For correspondence
    Harriet.Mpairwe@mrcuganda.org
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-1199-4859
  2. Milly Namutebi

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    Competing interests
    The authors declare that no competing interests exist.
  3. Gyaviira Nkurunungi

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-4062-9105
  4. Pius Tumwesige

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    Competing interests
    The authors declare that no competing interests exist.
  5. Irene Nambuya

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    Competing interests
    The authors declare that no competing interests exist.
  6. Mike Mukasa

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    Competing interests
    The authors declare that no competing interests exist.
  7. Caroline Onen

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    Competing interests
    The authors declare that no competing interests exist.
  8. Marble Nnaluwooza

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    Competing interests
    The authors declare that no competing interests exist.
  9. Barbara Apule

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    Competing interests
    The authors declare that no competing interests exist.
  10. Tonny Katongole

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    Competing interests
    The authors declare that no competing interests exist.
  11. Gloria Oduru

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    Competing interests
    The authors declare that no competing interests exist.
  12. Joseph Kahwa

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    Competing interests
    The authors declare that no competing interests exist.
  13. Emily L Webb

    Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  14. Lawrence Lubyayi

    Immuno-modulation and Vaccines Programme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
    Competing interests
    The authors declare that no competing interests exist.
  15. Neil Pearce

    Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  16. Alison M Elliott

    Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.

Funding

Wellcome (Training fellowship 102512)

  • Harriet Mpairwe

Wellcome (Senior fellowship 095778)

  • Alison M Elliott

European research council (Project grant 668954)

  • Neil Pearce

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Ethics

Human subjects: Parents or guardians of the children provided written informed consent, and children eight years or older provided written informed assent. This consent was to participate in the study, and to publish anonymous results.The study was approved by the Uganda Virus Research Institute Research and Ethics Committee, and the Uganda National Council for Science and Technology [reference number HS 1707]. The two bodies follow Good Clinical Practice guidelines.

Reviewing Editor

  1. Belinda Nicolau, McGill University, Canada

Version history

  1. Received: June 19, 2019
  2. Accepted: November 13, 2019
  3. Accepted Manuscript published: November 15, 2019 (version 1)
  4. Version of Record published: December 16, 2019 (version 2)

Copyright

© 2019, Mpairwe et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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  1. Harriet Mpairwe
  2. Milly Namutebi
  3. Gyaviira Nkurunungi
  4. Pius Tumwesige
  5. Irene Nambuya
  6. Mike Mukasa
  7. Caroline Onen
  8. Marble Nnaluwooza
  9. Barbara Apule
  10. Tonny Katongole
  11. Gloria Oduru
  12. Joseph Kahwa
  13. Emily L Webb
  14. Lawrence Lubyayi
  15. Neil Pearce
  16. Alison M Elliott
(2019)
Risk factors for asthma among schoolchildren who participated in a case-control study in urban Uganda
eLife 8:e49496.
https://doi.org/10.7554/eLife.49496

Further reading

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    In most of the world, the mammography screening programmes were paused at the start of the pandemic, whilst mammography screening continued in Denmark. We examined the mammography screening participation during the COVID-19 pandemic in Denmark.

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    The study population comprised all women aged 50–69 years old invited to participate in mammography screening from 2016 to 2021 in Denmark based on data from the Danish Quality Database for Mammography Screening in combination with population-based registries. Using a generalised linear model, we estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) of mammography screening participation within 90, 180, and 365 d since invitation during the pandemic in comparison with the previous years adjusting for age, year and month of invitation.

    Results:

    The study comprised 1,828,791 invitations among 847,766 women. Before the pandemic, 80.2% of invitations resulted in participation in mammography screening within 90 d, 82.7% within 180 d, and 83.1% within 365 d. At the start of the pandemic, the participation in screening within 90 d was reduced to 69.9% for those invited in pre-lockdown and to 76.5% for those invited in first lockdown. Extending the length of follow-up time to 365 d only a minor overall reduction was observed (PR = 0.94; 95% CI: 0.93–0.95 in pre-lockdown and PR = 0.97; 95% CI: 0.96–0.97 in first lockdown). A lower participation was, however, seen among immigrants and among women with a low income.

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    The short-term participation in mammography screening was reduced at the start of the pandemic, whilst only a minor reduction in the overall participation was observed with longer follow-up time, indicating that women postponed screening. Some groups of women, nonetheless, had a lower participation, indicating that the social inequity in screening participation was exacerbated during the pandemic.

    Funding:

    The study was funded by the Danish Cancer Society Scientific Committee (grant number R321-A17417) and the Danish regions.

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