Prevalence and risk factors of wheeze and eczema in 1-year-old children: the Butajira birth cohort, Ethiopia

Background The rising global prevalence of asthma and other allergic conditions has been linked to potential aetiological factors influencing the developing immune system. Objective To investigate the prevalence and associated risk factors for wheeze and eczema in 1-year-old children in a birth cohort from Butajira, Ethiopia. Methods In 2005/6, a population-based cohort of 1065 pregnant women was established. At 1 year of age, data on wheeze and eczema in the children were collected from the mother via an interview-administered questionnaire, along with numerous demographic and lifestyle factors. A stool sample was also obtained from the child for geohelminth analysis. Results The prevalence of wheeze was 11.5% (103/899) and eczema 8.6% (77/899). Independent predictors of wheeze were maternal allergic history [adjusted OR (AOR)=3.00, 95% CI 1.23-7.36], paternal allergic history (AOR=2.59, 95% CI 1.08-6.25), increasing household size (P for trend=0.023; AOR=3.54, 95% CI 1.31-9.56 for 7+ vs. 1-3 individuals) and paracetamol use by the child (overall P < 0.001; AOR 11.04, 95% CI 4.30-28.31 for 4+ tablets in past month vs. never). Factors independently associated with eczema were maternal allergic history (AOR=3.68, 95% CI 1.54-8.77), household size (overall P=0.035; AOR=0.45, 95% CI 0.23-0.87 for 4-6 individuals relative to 1-3) and place of sleeping (overall P < 0.001; AOR=0.29, 95% CI 0.10-0.82 for floor vs. bed/platform). Conclusion These findings support the hypothesis that eczema in early life in these children is a manifestation of allergy, while wheezing is probably due to infection as well as allergy