ArticleClinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology2019
Do helminth infections underpin urban-rural differences in risk factors for allergy-related outcomes?
Article in Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Effects of schistosomes on host anti-viral immune response and the acquisition, virulence, and prevention of viral infections: A systematic review.PLoS pathogens · 2021Pooled it
- Global Asthma Disparities: Deciphering the Multifaceted Environmental Exposome Between Eastern and Western Populations.Clinical reviews in allergy & immunology · 2026Review
- Rural-urban differences in oral typhoid vaccine responses in Uganda: contribution of Schistosoma mansoni.NPJ vaccines · 2026Article
- Social inequalities in childhood asthma.The World Allergy Organization journal · 2024Review
- The unique properties of IgG4 and its roles in health and disease.Nature reviews. Immunology · 2023Review
- Burden of and Trends in Urticaria Globally, Regionally, and Nationally from 1990 to 2019: Systematic Analysis.JMIR public health and surveillance · 2023Article
- Article
- Allergen skin test reactivity and asthma are inversely associated with ratios of IgG4/IgE and total IgE/allergen-specific IgE in Ugandan communities.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2021Article
- Article
- Risk factors associated with rhinitis, allergic conjunctivitis and eczema among schoolchildren in Uganda.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2021Article
- Article
- Urban-rural differences in immune responses to mycobacterial and tetanus vaccine antigens in a tropical setting: A role for helminths?Parasitology international · 2020Article
- Contrasting impact of rural, versus urban, living on glucose metabolism and blood pressure in Uganda.Wellcome open research · 2020Article
- Training the Fetal Immune System Through Maternal Inflammation-A Layered Hygiene Hypothesis.Frontiers in immunology · 2020Review
- Do helminth infections underpin urban-rural differences in risk factors for allergy-related outcomes?Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2019Article
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Authors and funding
18 authors at 5 institutions in 4 countries.
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Abstract
backgroundIt is proposed that helminth exposure protects against allergy-related disease, by mechanisms that include disconnecting risk factors (such as atopy) from effector responses.
objectiveWe aimed to assess how helminth exposure influences rural-urban differences in risk factors for allergy-related outcomes in tropical low- and middle-income countries.
methodsIn cross-sectional surveys in Ugandan rural Schistosoma mansoni (Sm)-endemic islands, and in nearby mainland urban communities with lower helminth exposure, we assessed risk factors for atopy (allergen-specific skin prick test [SPT] reactivity and IgE [asIgE] sensitization) and clinical allergy-related outcomes (wheeze, urticaria, rhinitis and visible flexural dermatitis), and effect modification by Sm exposure.
resultsDermatitis and SPT reactivity were more prevalent among urban participants, urticaria and asIgE sensitization among rural participants. Pairwise associations between clinical outcomes, and between atopy and clinical outcomes, were stronger in the urban survey. In the rural survey, SPT positivity was inversely associated with bathing in lakewater, Schistosoma-specific IgG4 and Sm infection. In the urban survey, SPT positivity was positively associated with age, non-Ugandan maternal tribe, being born in a city/town, BCG scar and light Sm infection. Setting (rural vs urban) was an effect modifier for risk factors including Sm- and Schistosoma-specific IgG4. In both surveys, the dominant risk factors for asIgE sensitization were Schistosoma-specific antibody levels and helminth infections. Handwashing and recent malaria treatment reduced odds of asIgE sensitization among rural but not urban participants. Risk factors for clinical outcomes also differed by setting. Despite suggestive trends, we did not find sufficient evidence to conclude that helminth (Sm) exposure explained rural-urban differences in risk factors. CONCLUSIONS AND CLINICAL RELEVANCE: Risk factors for allergy-related outcomes differ between rural and urban communities in Uganda but helminth exposure is unlikely to be the sole mechanism of the observed effect modification between the two settings. Other environmental exposures may contribute significantly.
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