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Prevalence of asthma, atopy and bronchial hyperresponsiveness and their interrelation in a semi-rural area of Chile

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OBJECTIVE: To assess the prevalence of asthma symptoms and their association with sensitisation to eight allergens and bronchial hyperresponsiveness (BHR) to methacholine.

SETTING: A random sample of 1232 adults, aged 22 to 28 years, studied in a Chilean semi-rural area.

DESIGN: A cross-sectional design for the purpose of this analysis.

RESULTS: The prevalence of wheeze was 27.4% (95%CI 24.9–29.9) and waking with breathlessness 13.7% (95%CI 11.8–15.6), higher than the results of a multi-centre European study. Only 7.8% (95%CI 6.3–9.3) had a positive BHR (≤8 mg/ml) and 26.3% (95%CI 23.8–28.8) were atopic. The Youden index of asthma symptoms in non-atopic subjects varied from 0.184 to 0.259 when using BHR as gold standard for asthma, and increased from 0.379 to 0.504 among those with positive atopy. Only 4.5% reported asthma, and the Youden index was slightly higher in comparison to the asthma symptom groups.

CONCLUSION: The prevalence of asthma symptoms in young adults was high, but only a small proportion of these were sensitised or had a positive BHR. We believe that aetiological studies of asthma should analyse subjects with asthma symptoms separately from those with positive atopic status or positive BHR.

Keywords: adults; asthma symptoms; atopy; bronchial hyperresponsiveness; epidemiology

Document Type: Regular Paper

Affiliations: 1: Department of Paediatrics, Faculty of Medicine University of Chile, Chile 2: Pathophysiology Programme, Biomedical Science Institute, Faculty of Medicine University of Chile, Chile 3: Department of Nutrition, Faculty of Medicine University of Chile, Chile 4: Department of Public Health Sciences, Guy's, King's and St Thomas School of Medicine, King College of London, United Kingdom

Publication date: 01 November 2005

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