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Open Access Research article

Prevalence of asthma and allergies in children from the Greek-Cypriot and Turkish-Cypriot communities in Cyprus: a bi-communal cross-sectional study

Demetris Lamnisos12, Maria Moustaki3, Ourania Kolokotroni1, Huseyin Koksoy4, Muharrem Faiz5, Kenan Arifoglu4, Donald K Milton67, Nicos Middleton2 and Panayiotis K Yiallouros1*

Author Affiliations

1 Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus

2 Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus

3 3rd Department of Pediatrics, Attikon University Hospital, Athens, Greece

4 Cyprus Turkish Medical Association, Nicosia, Cyprus

5 Cyprus Social and Economic Research Centre – KADEM, Nicosia, Cyprus

6 Harvard School of Public Health, Boston, Massachusetts, USA

7 University of Maryland School of Public Health, College Park, Maryland, USA

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BMC Public Health 2013, 13:585  doi:10.1186/1471-2458-13-585

Published: 16 June 2013

Abstract

Background

The Greek-Cypriot (G/C) and Turkish-Cypriot (T/C) communities have lived apart since 1974, with the former presumably adopting a more westernized way of life. We estimated the prevalence of asthma and allergies among children in the two communities and investigated differences in socio-demographic and lifestyle risk factors.

Methods

The ISAAC questionnaire was completed by 10156 children aged 7–8 and 13–14 years. Relative differences in asthma and allergic symptoms between the two communities were expressed as odds ratios (OR), estimated in multivariable logistic regression models before and after adjusting for participants’ risk characteristics.

Results

In contrast to our original speculation, consistently lower prevalence rates were observed for respiratory outcomes (but not eczema) among G/C compared to T/C children in both age-groups. For instance, the prevalence of current wheeze among 7–8 year-olds was 8.7% vs 11.4% (OR = 0.74, 95%, CI: 0.61, 0.90) and of current rhinoconjuctivitis 2.6% vs 4.9% (OR = 0.52, 95% CI: 0.37, 0.71). Surprisingly, the proportion reporting family history of allergy was almost double in the G/C community. With the exception of early life nursery attendance, several protective factors were more prevalent amongst T/C, such as bedroom sharing, less urbanized environment and exposure to farm animals. In contrast, exposure to tobacco smoke was more frequent in the T/C community. Controlling for risk factors did not account for the observed lower prevalence of current wheeze (in the younger age-group) and rhinoconjuctivitis (in both age-groups) among G/C children while differences in the prevalence of eczema between the two communities were no longer statistically significant.

Conclusions

A mixed picture of potential risk factors was observed in the two communities of Cyprus, not consistently favoring one over the other community since, for example, bedroom sharing and rural living but also exposure to tobacco smoke were more common among T/C children. Investigated risk factors do not fully account for the lower prevalence of asthma and allergies among G/C children, especially against a background of higher family history of allergy in this community.

Keywords:
Asthma; Allergic rhinoconjuctivits; Eczema; Children; Cyprus; Greek Cypriot; Turkish Cypriot