The association of low birth weight with serum C reactive protein in 3-year-old children living in Cuba: A population-based prospective study.

OBJECTIVE: Low birthweight is associated with a decreased risk of childhood leukemia and an increased risk of both cardiovascular disease and all-cause mortality in adult life. Possible biological mediators include systemic innate immunity and inflammation. We tested the hypothesis that birthweight was inversely associated with serum high sensitivity C reactive protein assay (hsCRP), a measure of both innate immunity and systemic inflammation. METHODS: Data on birthweight and current anthropometric measures along with a range of exposures were collected at 1 and 3 years of age in a population-based cohort study of young children living in Havana, Cuba. A total of 986 children aged 3-years-old provided blood samples that were analyzed for serum hsCRP levels. RESULTS: Nearly 49% of children had detectable hsCRP levels in their serum. Lower birthweight was linearly associated with the natural log of hsCRP levels (beta coefficient -0.70 mg L-1 per kg increase in birthweight, 95% CI: -1.34 to -0.06). This was attenuated but still present after adjustment for the child's sex and municipality (-0.65 mg L-1 per kg birthweight; 95% CI: -1.38 to +0.08). There were no associations between growth from birth or anthropometric measures at 3 years and systemic inflammation. CONCLUSIONS: Birthweight was inversely associated with serum hsCRP levels in children aged 3 years living in Cuba. These observations provide a potential mechanism that is present at the age of 3 years to explain the association between low birthweight and both decreased childhood leukemia and increased cardiovascular disease in adults.

Factores asociados a la sibilancia recurrente en lactantes de La Habana, Cuba / Factors associated to the recurrent wheezing in nurslings of Havana, Cuba

Introducción: en Cuba la prevalencia de sibilancia recurrente a nivel poblacional a edades tempranas es desconocida. Objetivo: identificar la magnitud y factores asociados en el lactante con sibilancia recurrente. Método: diseño epidemiológico transversal. Una muestra de 1956 niños entre las edades de 12 a 15 meses que viven en 4 municipios de La Habana fue seleccionada para su inclusión en el estudio. A los que se les aplicó por los investigadores un cuestionario validad internacionalmente y aplicado en el territorio nacional (ISAAC), con vista a obtener datos del primer año de vida. La sibilancia recurrente fue definida por la presencia de 3 ó más episodios. Resultados: la prevalencia de sibilancia recurrente fue de 20 por ciento. Los factores de riesgo de mayor importancia fueron: historia familiar de asma OR 1,89 (IC 95%:1,09-3,27), sospecha de alergia a picadura de insectos OR 1,75 (IC 95 por ciento: 1,09-2,80), antecedente de distress respiratorio al nacimiento OR 1,74 (IC 95 por ciento: 1,36-2,22) y el uso del paracetamol incluido el kogrip OR 1,40 (IC 95 por ciento: 1,14-1,73). Presencia de diferencias significativas del riesgo de sibilancia recurrente entre los 4 municipios luego del ajuste de factores de confusión. Conclusiones: la sibilancia recurrente fue identificada como un problema de salud en La Habana. Factores de riesgo modificables para la sibilancia recurrente fueron detectados en el grupo estudio, al igual que diferencias del riesgo entre los municipios. Hechos que debe tenerse en cuenta para la elaboración de futuras intervenciones(AU)

Introduction: prevalence of recurrent wheezing among Cuban infants is not known. Objective: Identify the magnitude and factors associated to recurrent wheezing in infants. Method: across-sectional epidemiological study was conducted of a sample of 1 956 children aged 12-15 months from four Havana municipalities randomly selected for inclusion in the research. A questionnaire validated internationally and used in the national territory (ISAAC) was applied to collect data about the first year of life. Recurrent wheezing was defined by the presence of three or more episodes. Results: prevalence of recurrent wheezing was 20 percent. The most important risk factors were a family history of asthma OR 1.89 (CI 95 percent:1.09-3.27), suspected allergy to insect bites OR 1.75 (CI 95 percent: 1.09-2.80), a history of respiratory distress at birth OR 1.74 (CI 95 percent: 1.36-2.22) and the use of paracetamol including Kogrip OR 1.40 (CI 95 percent: 1.14-1.73). Risk for recurrent wheezing showed significant differences between the four municipalities after adjustment for confounding factors. Conclusions: recurrent wheezing was identified as a health problem in Havana. Modifiable risk factors for recurrent wheezing were detected in the study sample. Risk differences were found between the municipalities. These facts should be considered when planning future interventions(AU)

Factores asociados a la sibilancia recurrente en lactantes de La Habana, Cuba / Factors associated to the recurrent wheezing in nurslings of Havana, Cuba

Introducción: en Cuba la prevalencia de sibilancia recurrente a nivel poblacional a edades tempranas es desconocida.Objetivo: identificar la magnitud y factores asociados en el lactante con sibilancia recurrente.Método: diseño epidemiológico transversal. Una muestra de 1956 niños entre las edades de 12 a 15 meses que viven en 4 municipios de La Habana fue seleccionada para su inclusión en el estudio. A los que se les aplicó por los investigadores un cuestionario validad internacionalmente y aplicado en el territorio nacional (ISAAC), con vista a obtener datos del primer año de vida. La sibilancia recurrente fue definida por la presencia de 3 ó más episodios.Resultados: la prevalencia de sibilancia recurrente fue de 20 por ciento. Los factores de riesgo de mayor importancia fueron: historia familiar de asma OR 1,89 (IC 95 por ciento:1,09-3,27), sospecha de alergia a picadura de insectos OR 1,75 (IC 95 por ciento: 1,09-2,80), antecedente de distress respiratorio al nacimiento OR 1,74 (IC 95 por ciento: 1,36-2,22) y el uso del paracetamol incluido el kogrip OR 1,40 (IC 95 por ciento: 1,14-1,73). Presencia de diferencias significativas del riesgo de sibilancia recurrente entre los 4 municipios luego del ajuste de factores de confusión.Conclusiones: la sibilancia recurrente fue identificada como un problema de salud en La Habana. Factores de riesgo modificables para la sibilancia recurrente fueron detectados en el grupo estudio, al igual que diferencias del riesgo entre los municipios. Hechos que debe tenerse en cuenta para la elaboración de futuras intervenciones(AU)

Introduction: prevalence of recurrent wheezing among Cuban infants is not known.Objective: Identify the magnitude and factors associated to recurrent wheezing in infants.Method: across-sectional epidemiological study was conducted of a sample of 1 956 children aged 12-15 months from four Havana municipalities randomly selected for inclusion in the research. A questionnaire validated internationally and used in the national territory (ISAAC) was applied to collect data about the first year of life. Recurrent wheezing was defined by the presence of three or more episodes.Results: prevalence of recurrent wheezing was 20 percent. The most important risk factors were a family history of asthma OR 1.89 (CI 95 percent:1.09-3.27), suspected allergy to insect bites OR 1.75 (CI 95 percent: 1.09-2.80), a history of respiratory distress at birth OR 1.74 (CI 95 percent: 1.36-2.22) and the use of paracetamol including Kogrip OR 1.40 (CI 95 percent: 1.14-1.73). Risk for recurrent wheezing showed significant differences between the four municipalities after adjustment for confounding factors.Conclusions: recurrent wheezing was identified as a health problem in Havana. Modifiable risk factors for recurrent wheezing were detected in the study sample. Risk differences were found between the municipalities. These facts should be considered when planning future interventions(AU)

What are the main environmental exposures associated with elevated IgE in Cuban infants? A population-based study.

OBJECTIVE: Immunoglobulin E (IgE) plays a key role in allergy disease pathogenesis, but little is known about the environmental factors associated with higher IgE levels in infants. The aim of this study was to determine the risk factors for elevated serum total IgE infants living in Havana. METHODS: Eight hundred and seventy-seven infants provided blood samples. Data on allergic disease symptoms and a wide range of exposures were collected. RESULTS: The median IgE was 35 IU/ml (interquartile range 13-96). The risk of having an IgE level above the median was higher for children who had been breastfed for 4 months or more (adjusted odds ratio (OR) 1.28; 95% confidence interval (CI): 1.02-1.61) and for children who reported cockroaches in their home (OR 1.30; 95% CI: 1.03-1.63). The risk was lower for children whose mother was in paid employment (OR 0.73; 95% CI: 0.54-0.97 compared with those who did not), for children living in homes where gas and electricity were used for cooking (OR 0.45; 95% CI: 0.32-0.62 compared with electricity only) and for children with domestic pets at birth (OR 0.83; 95% CI: 0.70-1.00). There was no association between paracetamol use and serum IgE levels. CONCLUSIONS: Associations between gas fuel use and maternal employment indicate that IgE levels in early life are lower in children who may be living in relative affluence. The discrepancy in the effect of early exposure to pets or cockroaches may reflect differences in these allergens, or be confounded by relative affluence. Further investigation of this cohort will determine how these effects translate into the expression of allergic disease in later life.

Risk factors for eczema in infants born in Cuba: a population-based cross-sectional study.

BACKGROUND: There is a concern that allergic disease in childhood is higher than expected in Cuba. The aim of this study was to determine the risk factors for eczema of infants aged 12-15 months living in Havana. METHODS: We used a cross-sectional epidemiological study design. Data on eczema symptoms and a wide range of lifestyle factors were collected by researcher administered questionnaires. RESULTS: Data were collected on 1956 children (96% response rate), of whom 672 (34%) were reported as having had eczema. Independent risk factors for eczema included young maternal age (adjusted odds ratio (OR) 0.98 per additional year of age; 95% confidence interval (CI) 0.97-0.99), child's weight (OR 1.13 per additional kg; 95% CI: 1.03-1.25), insect sting allergy (OR 2.11; 95% CI: 1.33-3.35), rodents in the home (OR 1.39; 95% CI: 1.10-1.76), attendance at childcare facilities (OR 1.34: 95% CI: 1.05-1.70) and self-reported mould in the home (OR 1.23; 95% CI: 1.07-1.41). Infant exposure to paracetamol was associated with an increased risk of eczema even after adjustment for wheeze (OR 1.22; 95% CI: 1.03-1.46). CONCLUSION: Despite a very different culture and environment, the consistency of these findings with those from more economically developed countries suggests potential causal associations. The association with paracetamol, even after adjustment for wheeze, suggests that intervention studies are required in young infants, to ascertain if this commonly used anti-pyretic medication increases allergic disease.