Prevalence of a family history of atopic disease among 3 generations of atopic respiratory patients in Tirana, Albania.

BACKGROUND AND OBJECTIVE: Having relatives with allergic disease is associated with an increased risk of such disease, but children without a significant genetic predisposition account for much of the increase in asthma prevalence. The aim of this study was to investigate whether the prevalence of a reported family history of allergy has increased among atopic respiratory patients diagnosed in Outpatient Service No. 3 in Tirana in recent decades. METHODS: We evaluated the records of 693 atopic respiratory patients sensitized to mites (n = 480) or pollen (n = 218) or both (n = 5) to detect reports of allergic disease among their close relatives. Patients were classified in 3 groups: those born in 1959 or earlier, those born between 1960 and 1979, and those born between 1980 and 2003. The chi2 test was used for statistical comparisons. RESULTS: The prevalence of a family history of allergy among those born before 1960 (42.7%) was nearly 2-fold greater than the prevalence among those born between 1960 and 1979 (25.3%) or between 1980 and 2003 (23.1%) (P < .001). CONCLUSIONS: Younger generations of atopic respiratory patients report a family history of allergic disease about half as frequently as older ones. It is possible that massive introduction of antibiotics such as penicillin and streptomycin in the late 1960s and early 1970s for use against respiratory or gastrointestinal infections has increased survival for a considerable number of young children, switching the gene thesaurus of successive adult populations to an allergy-predisposing genotype.

Hymenoptera sting anaphylactic reactions in the Mediterranean population of Albania.

BACKGROUND: Relatively few studies have examined the relation of different hymenoptera sting reactions. OBJECTIVE: To investigate the relation of anaphylactic reactions against stings of different hymenoptera subspecies in the Mediterranean population of Albania. MATERIALS AND METHODS: A retrospective study was conducted using the clinic files of 111 patients who were diagnosed for hymenoptera sting reactions from 1987 to 1996. Antigens used consisted of purified hymenoptera venom (bee, wasp, and paperwasp). The patients were diagnosed by intracutaneous tests in concentrations of 0.001 microgram/ml, 0.01 microgram/ml, 0.1 microgram/ml, and 1 microgram/ml. RESULTS: The median age of the patients was 27 years. 57% of stings occurred between 20 to 40 years of age. The majority of anaphylactic reactions were recorded during the months of June to October, 81% of the patients were admitted to the hospital due to Mueller grade II to III reactions. In 26% of all cases, crossreactions (bee-wasp 16%, bee-wasp-paperwasp 7%, wasp-paperwasp 2%, bee-paperwasp 1%) were found. Of all anaphylactic reactions, 64% were attributed to bees, 24% to wasps, 8% to both bees and wasps, and 2% to paperwasps. CONCLUSIONS: In contrast to industrialized countries such as the United States or Western Europe where urban populations predominate, reactions to bee venom were more prevalent in the present study population.

Asthma and allergy in Albania.

BACKGROUND: The risk of allergic disease may be influenced by the degree of "westernization". A survey was conducted to ascertain whether the prevalence of allergy was lower in Albania than elsewhere in Europe, as it has been the most isolated European country. METHODS: The subjects were residents of Tirana aged 20-44 years. A screening questionnaire was completed by 2653 subjects. A more detailed questionnaire was administered to a random sample of 564 respondents, together with skin prick tests and serum IgE assay. RESULTS: The prevalence of wheeze in the last year, and of wheeze without a cold, was lower in Albania than in any country that participated in the European Community Respiratory Health Survey. Nasal allergy and atopy (as indicated by serum specific IgE) were also uncommon in Albania, although serum total IgE concentrations were high. CONCLUSIONS: The findings confirmed the hypothesis of a low prevalence of allergy in Albania. Possible reasons include the recent economic isolation of Albania, the infrequency of smoking by women, the lack of domestic pets, and the high incidence of childhood infection and parasitic infestation. The prevalence of allergy and its potential determinants should be monitored in Albania as that country acquires the characteristics of other parts of Europe.

Factors associated with asthma in Albania.

BACKGROUND: This study was undertaken to see whether asthma in Albania (where it is particularly uncommon) is associated with certain 'western' characteristics, and with dietary and lifestyle factors that affect its occurrence elsewhere. METHODS: A screening survey was conducted among 2653 persons aged 20-44 years. A more detailed enquiry was conducted among a random subsample plus all others whose response indicated possible asthma. Three groups were compared: 495 probable nonasthmatics ('nonsymptomatics'); 106 with asthma-like symptoms and positive skin tests ('possible allergic asthmatics'); and 116 with similar symptoms and negative skin tests ('other symptomatics'). RESULTS: The possible allergic asthmatics were less likely than the nonsymptomatics to have attended school or nursery under the age of 5 years or to have shared a bedroom with an older child before that age. Continued education after the age of 18 years also appeared to be protective. Allowing for other factors, a strong negative relation was found with fruit and vegetable consumption, and weak positive relations with prepackaged food and fizzy drinks. Symptoms in skin prick test-negative subjects were associated with personal and parental smoking habit. CONCLUSIONS: This survey provides limited evidence linking asthma with aspects of western lifestyle. It supports the hypothesis that opportunities for infection during early childhood and the consumption of fruit and vegetables protect against asthma.