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High body mass index is not associated with atopy in schoolchildren living in rural and urban areas of Ghana

Irene A Larbi12, Kerstin Klipstein-Grobusch13*, Abena S Amoah2, Benedicta B Obeng4, Michael D Wilson2, Maria Yazdanbakhsh4 and Daniel A Boakye2

Author Affiliations

1 Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

2 Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon-Accra, Ghana

3 Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center, Utrecht, The Netherlands

4 Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands

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BMC Public Health 2011, 11:469  doi:10.1186/1471-2458-11-469

Published: 14 June 2011



Factors which determine the development of atopy and the observed rural-urban gradient in its prevalence are not fully understood. High body mass index (BMI) has been associated with asthma and potentially atopy in industrialized countries. In developing countries, the transition from rural to urban areas has been associated with lifestyle changes and an increased prevalence of high BMI; however, the effect of high BMI on atopy remains unknown in this population. We therefore investigated the association between high BMI and atopy among schoolchildren living in rural and urban areas of Ghana.


Data on skin prick testing, anthropometric, parasitological, demographic and lifestyle information for 1,482 schoolchildren aged 6-15 years was collected. Atopy was defined as sensitization to at least one tested allergen whilst the Centres for Disease Control and Prevention (CDC, Atlanta) growth reference charts were used in defining high BMI as BMI ≥ the 85th percentile. Logistic regression was performed to investigate the association between high BMI and atopy whilst adjusting for potential confounding factors.


The following prevalences were observed for high BMI [Rural: 16%, Urban: 10.8%, p < 0.001] and atopy [Rural: 25.1%, Urban: 17.8%, p < 0.001]. High BMI was not associated with atopy; but an inverse association was observed between underweight and atopy [OR: 0.57, 95% CI: 0.33-0.99]. Significant associations were also observed with male sex [Rural: OR: 1.49, 95% CI: 1.06-2.08; Urban: OR: 1.90, 95% CI: 1.30-2.79], and in the urban site with older age [OR: 1.76, 95% CI: 1.00-3.07], family history of asthma [OR: 1.58, 95% CI: 1.01-2.47] and occupational status of parent [OR: 0.33, 95% CI: 0.12-0.93]; whilst co-infection with intestinal parasites [OR: 2.47, 95% CI: 1.01-6.04] was associated with atopy in the rural site. After multivariate adjustment, male sex, older age and family history of asthma remained significant.


In Ghanaian schoolchildren, high BMI was not associated with atopy. Further studies are warranted to clarify the relationship between body weight and atopy in children subjected to rapid life-style changes associated with urbanization of their environments.