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Childhood atopic diseases and early life circumstances : an ecological sstudy in Cuba

(2012) PLOS ONE. 7(6).
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Abstract
Background: Children are especially vulnerable during periods of resource shortage such as economic embargoes. They are likely to suffer most from poor nutrition, infectious diseases, and other ensuing short-term threats. Moreover, early life circumstances can have important consequences for long-term health. We examined the relationship between early childhood exposure to the Cuban economic situation in the nineties and the occurrence of atopic diseases later in childhood. Methodology/Principal Findings: A cross-sectional study of 1321 primary schoolchildren aged 4-14 was conducted in two Cuban municipalities. Asthma, allergic rhinoconjunctivitis and atopic dermatitis were diagnosed using the International Study of Asthma and Allergies in Childhood questionnaire. Children were divided into three groups of exposure to the economic situation in the nineties according to birth date: (1) unexposed; (2) exposed during infancy; (3) exposed during infancy and early childhood. Associations were assessed using multiple logistic regression models. Exposure during infancy had a significant inverse association with the occurrence of asthma (OR 0.56, 95% CI 0.33-0.94) and allergic rhinoconjunctivitis (OR 0.46, 95% CI 0.25-0.85). The associations were stronger after longer exposure, i.e. during infancy and early childhood, for asthma (OR 0.40, 95% CI 0.17-0.95) and allergic rhinoconjunctivitis (OR 0.29, 95% CI 0.11-0.77). No significant associations were found for atopic dermatitis. Conclusions/Significance: Exposure to the economic situation in the nineties during infancy and early childhood was inversely associated with asthma and allergic rhinoconjunctivitis occurrence later in childhood. We hypothesize that factors related to this period, such as infectious diseases and undernutrition, may have an attenuating effect on atopic disease development. The exact cause and underlying mechanisms need to be further elucidated.
Keywords
CARDIOVASCULAR-DISEASE, ALLERGIC RHINOCONJUNCTIVITIS, ECONOMIC-CRISIS, WORLDWIDE VARIATIONS, PRENATAL EXPOSURE, DUTCH FAMINE, HEALTH-CARE, ASTHMA, PREVALENCE, IMPACT

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Chicago
van der Werff, Suzanne D, Katja Polman, Maiza Campos Ponce, Jos WR Twisk, Raquel Junco Díaz, Mariano Bonet Gorbea, and Patrick Van Der Stuyft. 2012. “Childhood Atopic Diseases and Early Life Circumstances : an Ecological Sstudy in Cuba.” Plos One 7 (6).
APA
van der Werff, S. D., Polman, K., Ponce, M. C., Twisk, J. W., Junco Díaz, R., Bonet Gorbea, M., & Van Der Stuyft, P. (2012). Childhood atopic diseases and early life circumstances : an ecological sstudy in Cuba. PLOS ONE, 7(6).
Vancouver
1.
van der Werff SD, Polman K, Ponce MC, Twisk JW, Junco Díaz R, Bonet Gorbea M, et al. Childhood atopic diseases and early life circumstances : an ecological sstudy in Cuba. PLOS ONE. 2012;7(6).
MLA
van der Werff, Suzanne D et al. “Childhood Atopic Diseases and Early Life Circumstances : an Ecological Sstudy in Cuba.” PLOS ONE 7.6 (2012): n. pag. Print.
@article{3061236,
  abstract     = {Background: Children are especially vulnerable during periods of resource shortage such as economic embargoes. They are likely to suffer most from poor nutrition, infectious diseases, and other ensuing short-term threats. Moreover, early life circumstances can have important consequences for long-term health. We examined the relationship between early childhood exposure to the Cuban economic situation in the nineties and the occurrence of atopic diseases later in childhood. 
Methodology/Principal Findings: A cross-sectional study of 1321 primary schoolchildren aged 4-14 was conducted in two Cuban municipalities. Asthma, allergic rhinoconjunctivitis and atopic dermatitis were diagnosed using the International Study of Asthma and Allergies in Childhood questionnaire. Children were divided into three groups of exposure to the economic situation in the nineties according to birth date: (1) unexposed; (2) exposed during infancy; (3) exposed during infancy and early childhood. Associations were assessed using multiple logistic regression models. Exposure during infancy had a significant inverse association with the occurrence of asthma (OR 0.56, 95% CI 0.33-0.94) and allergic rhinoconjunctivitis (OR 0.46, 95% CI 0.25-0.85). The associations were stronger after longer exposure, i.e. during infancy and early childhood, for asthma (OR 0.40, 95% CI 0.17-0.95) and allergic rhinoconjunctivitis (OR 0.29, 95% CI 0.11-0.77). No significant associations were found for atopic dermatitis. 
Conclusions/Significance: Exposure to the economic situation in the nineties during infancy and early childhood was inversely associated with asthma and allergic rhinoconjunctivitis occurrence later in childhood. We hypothesize that factors related to this period, such as infectious diseases and undernutrition, may have an attenuating effect on atopic disease development. The exact cause and underlying mechanisms need to be further elucidated.},
  articleno    = {e39892},
  author       = {van der Werff, Suzanne D and Polman, Katja and Ponce, Maiza Campos and Twisk, Jos WR and Junco Díaz, Raquel and Bonet Gorbea, Mariano and Van Der Stuyft, Patrick},
  issn         = {1932-6203},
  journal      = {PLOS ONE},
  keywords     = {CARDIOVASCULAR-DISEASE,ALLERGIC RHINOCONJUNCTIVITIS,ECONOMIC-CRISIS,WORLDWIDE VARIATIONS,PRENATAL EXPOSURE,DUTCH FAMINE,HEALTH-CARE,ASTHMA,PREVALENCE,IMPACT},
  language     = {eng},
  number       = {6},
  pages        = {6},
  title        = {Childhood atopic diseases and early life circumstances : an ecological sstudy in Cuba},
  url          = {http://dx.doi.org/10.1371/journal.pone.0039892},
  volume       = {7},
  year         = {2012},
}

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