Factors associated with allergic rhinitis and combined allergic rhinitis and asthma syndrome (CARAS) in adults undergoing immunotherapy in a tropical country: Is ISAAC-III questionnaire useful in adult populations?

BACKGROUND: Allergic diseases affect about 10-30% of the population in low- or middle-income tropical countries. Few studies describe the factors associated with allergic diseases in adult patients undergoing immunotherapy in Latin American countries. OBJECTIVE: This study aimed to determine the factors associated with allergic rhinitis (AR) and AR in comorbidity with asthma (CARAS) in adults treated with immunotherapy in two allergy referral centers in Bogotá (Colombia). MATERIAL AND METHODS: Observational, cross-sectional study conducted between January 2018 and January 2019. ISAAC-III and sociodemographic questionnaires were applied to determine the factors associated with AR and CARAS in adults treated with immunotherapy who attended the allergy consult at the Fundación Santa Fe de Bogotá and Unimeq-Orl. RESULTS: Among 416 adults aged 18-68 years, 71.4% (n = 297) were women. Regarding the sensitization results obtained by skin prick test, the most frequent allergens were house dust mites (64.18%): 49.03% were positive for both Dermatophagoides pteronyssinus and Dermatophagoides farinae, while 28.61% were positive for Blomia tropicalis. Excluding house dust mites, the most frequent allergens were dog hair (31.01%), cat hair (15.1%), grasses (15.9%), and food (15.9%). The main factor associated with exclusive AR was regular acetaminophen use more than four times a year: Prevalence ratio (PR) = 1.77 (95% CI: 1.12-2.25). The main factor associated with CARAS was cesarean delivery PR: 1.44 (95% CI: 1.09-1.78). CONCLUSION: The main factor associated with AR was regular acetaminophen use, while that associated with CARAS was cesarean delivery. The ISAAC-III questionnaire can be a useful low-cost tool to assess the factors associated with allergic diseases in adults in tropical countries.

Factors associated with allergic rhinitis and combined allergic rhinitis and asthma syndrome (CARAS) in children aged 5-18 years undergoing immunotherapy in a tropical low- or middle-income country.

BACKGROUND: Tropics have some particularities that can impact the natural history and factors associated with allergic diseases. However, few studies described the characteristics of patients with allergic rhinitis (AR) and combined AR and asthma syndrome (CARAS) in Latin American tropical countries. OBJECTIVE: This study aimed to determine the medical, social, and environmental factors associated with AR and CARAS in children aged 5-18 years treated with immunotherapy in two allergy referral centers in Bogotá (Colombia). MATERIAL: and methods: An observational, cross-sectional study was conducted between January 2018 and January 2019. International Study Asthma Allergies Childhood-III and sociodemographic questionnaires were applied to adolescents and parents of children undergoing immunotherapy at the allergy consult in the Hospital Universitario Fundación Santa Fe de Bogotá and UNIMEQ-ORL. RESULTS: Among 830 children aged 5-18 years, 38.1% (n = 316) were women. Up to 63.25% of the population had a positive skin prick test for house dust mites: 63.25% for Dermatophagoides pteronyssinus, 61.81% for Dermatophagoides farinae, and 31.57% for Blomia tropicalis. The factors associated with AR were male sex (PR: 1.31, 95% CI: 1.08-1.57), antibiotic consumption during the first year of life (PR: 0.80; 95% CI: 0.63-0.99), and exposure to dogs (PR: 1.32; 95% CI: 1.06-2.66). The factors associated with CARAS were older age (PR=0.95; 95% CI: 0.95-0.99), acetaminophen consumption over four times a year (PR: 1.31; 95% CI: 1.03-1.55), and antibiotic consumption during the first year of life (PR: 1.21; 95% CI: 1.06-1.34). CONCLUSION: A high prevalence of B. tropicalis was found in this study. The factors associated with AR and CARAS are like those described in high-income tropical countries. Further studies are needed in low- or middle-income tropical countries to identify modifiable factors associated with allergic diseases.