SynthesisThorax2019
Urbanisation and asthma in low-income and middle-income countries: a systematic review of the urban-rural differences in asthma prevalence.
Synthesis in Thorax, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Identifying risk factors for COPD and adult-onset asthma: an umbrella review.European respiratory review : an official journal of the European Respiratory Society · 2023Pooled it
- Geographical Differences of Risk of Asthma and Allergic Rhinitis according to Urban/Rural Area: a Systematic Review and Meta-analysis of Cohort Studies.Journal of urban health : bulletin of the New York Academy of Medicine · 2023Pooled it
- Pooled it
- Implementation of Coach McLungsBMC medical informatics and decision making · 2022Trial
- Differential Allergenicity and Heavy Metal Content in Dactylis glomerata and Lolium perenne Pollen Across Contrasting Environments.Environmental toxicology · 2026Article
- Factors influencing preterm infant microbiota and their role in wheezing development.Pediatric research · 2026Article
- Asthma prevalence, associated factors and role of adverse childhood experiences among school-going adolescents: the national School Health Survey in Togo (SHeST-study).BMJ open respiratory research · 2026Article
- Asthma in African children and adolescents: Burden, barriers, and management strategies.African journal of thoracic and critical care medicine · 2026Review
- Guideline-driven and dependable management of asthma: an evidence-based systematic review.Annals of medicine and surgery (2012) · 2025Article
- Month of birth and outdoor temperature after birth predict childhood atopic diseases in Finland.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2025Article
- ARIA-Italy managing allergic rhinitis and asthma in a changing world: The role of the Pharmacist.The World Allergy Organization journal · 2025Review
- Association Between Asthma and Gout: A Longitudinal Follow-Up Study Using a National Health Screening Cohort.Biomedicines · 2025Article
- Assessing the Impact of Air Quality and Socioeconomic Conditions on Respiratory Disease Incidence.Tropical medicine and infectious disease · 2025Article
- Editorial: Preventing childhood asthma-the neglected impact of existing public health interventions.Frontiers in allergy · 2025Article
- Wild-Mouse-Derived Gut Microbiome Transplantation in Laboratory Mice Partly Alleviates House-Dust-Mite-Induced Allergic Airway Inflammation.Microorganisms · 2024Article
- Ecuadorian healthcare professionals' perspectives on attributes of asthma care coordination: a qualitative study.BMJ open · 2024Article
- Social inequalities in childhood asthma.The World Allergy Organization journal · 2024Review
- APPaRENT 3: Asthma Patients' and Physicians' Perspectives on the Burden and Management of Asthma in Seven Countries.Advances in therapy · 2024Article
- A cross-sectional study on the self-management of asthma and asthma control among adult asthmatic patients in the Aseer region, KSA.Scientific reports · 2024Article
- Prevalence of Wheezing and Its Association with Environmental Tobacco Smoke Exposure among Rural and Urban Preschool Children in Mpumalanga Province, South Africa.International journal of environmental research and public health · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundUrbanisation has been associated with temporal and geographical differences in asthma prevalence in low-income and middle-income countries (LMICs). However, little is known of the mechanisms by which urbanisation and asthma are associated, perhaps explained by the methodological approaches used to assess the urbanisation-asthma relationship.
objectiveThis review evaluated how epidemiological studies have assessed the relationship between asthma and urbanisation in LMICs, and explored urban/rural differences in asthma prevalence.
methodsAsthma studies comparing urban/rural areas, comparing cities and examining intraurban variation were assessed for eligibility. Included publications were evaluated for methodological quality and pooled OR were calculated to indicate the risk of asthma in urban over rural areas.
resultsSeventy articles were included in our analysis. Sixty-three compared asthma prevalence between urban and rural areas, five compared asthma prevalence between cities and two examined intraurban variation in asthma prevalence. Urban residence was associated with a higher prevalence of asthma, regardless of asthma definition: current-wheeze OR:1.46 (95% CI:1.22 to 1.74), doctor diagnosis OR:1.89 (95% CI:1.47 to 2.41), wheeze-ever OR:1.44 (95% CI:1.15 to 1.81), self-reported asthma OR:1.77 (95% CI:1.33 to 2.35), asthma questionnaire OR:1.52 (95% CI:1.06 to 2.16) and exercise challenge OR:1.96 (95% CI:1.32 to 2.91).
conclusionsMost evidence for the relationship between urbanisation and asthma in LMICs comes from studies comparing urban and rural areas. These studies tend to show a greater prevalence of asthma in urban compared to rural populations. However, these studies have been unable to identify which specific characteristics of the urbanisation process may be responsible. An approach to understand how different dimensions of urbanisation, using contextual household and individual indicators, is needed for a better understanding of how urbanisation affects asthma. PROSPERO REGISTRATION NUMBER: CRD42017064470.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.