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      Pet-Keeping in Relation to Asthma, Rhinitis, and Eczema Symptoms Among Adolescents in Kuwait: A Cross-Sectional Study

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      1 , 2 , *
      Frontiers in Pediatrics
      Frontiers Media S.A.
      pets, allergy, asthma, eczema, rhinitis, cat, dog, rabbit

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          Abstract

          Background: Findings on the associations between household pet-keeping and allergic diseases, including asthma, rhinitis, and eczema, have been contradictory, with investigations reporting positive, negative, and null associations. This study sought to estimate the prevalence of pet-keeping among families in Kuwait and to assess the associations between pet-keeping and symptoms of allergic diseases among adolescents.

          Methods: Schoolchildren aged 11–14 years ( n = 3,864) were enrolled in this cross-sectional study. The children's parents completed questionnaires regarding their child's environmental exposures, including pet-keeping in the past 12 months, and clinical history and symptoms of allergic diseases. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and their 95% confidence intervals (CIs) were estimated.

          Results: Pet-keeping in the past 12 months was reported by 42.8% of the participating families. Birds, cats, rabbits, fish, and dogs were kept by 28.3, 13.2, 7.8, 3.9, and 3.1% of all households, respectively. Current cat ownership was significantly associated with current wheezing (aPR 1.29, 95% CI 1.05–1.58), current rhinitis symptoms (aPR 1.18, 95% CI 1.02–1.36), and ever doctor-diagnosed eczema (aPR 1.25, 95% CI 1.03–1.50). Current rabbit-keeping was positively associated with multiple symptoms of asthma (e.g., study-defined current asthma: aPR 1.38, 95% CI 1.04–1.82) and eczema (e.g., severe eczema: aPR 1.94, 95% CI 1.02–3.71). Similarly, current bird-keeping was associated with study-defined current rhinitis (aPR 1.19, 95% CI 1.05–1.41) and current itchy rash (aPR 1.27, 95% CI 1.10–1.46).

          Conclusions: Household pet-keeping is very common and diverse in Kuwait and was found to be positively associated with symptoms of allergic diseases among adolescents. The findings of associations between rabbit-keeping and symptoms of asthma and eczema add to the existing literature and further highlight the importance of considering the pet type when assessing such associations.

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          Most cited references40

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          Global map of the prevalence of symptoms of rhinoconjunctivitis in children: The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three.

          Phase One of the International Study of Asthma and Allergies in Childhood (ISAAC) measured the global patterns of prevalence and severity of symptoms of rhinoconjunctivitis in children in 1993-1997. International Study of Asthma and Allergies in Childhood Phase Three was a cross-sectional survey performed 5-10 years after Phase One using the same methodology. Phase Three covered all of the major regions of the world and involved 1 059 053 children of 2 age groups from 236 centres in 98 countries. The average overall prevalence of current rhinoconjunctivitis symptoms was 14.6% for the 13- to 14-year old children (range 1.0-45%). Variation in the prevalence of severe rhinoconjunctivitis symptoms was observed between centres (range 0.0-5.1%) and regions (range 0.4% in western Europe to 2.3% in Africa), with the highest prevalence being observed mainly in the centres from middle and low income countries, particularly in Africa and Latin America. Co-morbidity with asthma and eczema varied from 1.6% in the Indian sub-continent to 4.7% in North America. For 6- to 7-year old children, the average prevalence of rhinoconjunctivitis symptoms was 8.5%, and large variations in symptom prevalence were also observed between regions, countries and centres. Wide global variations exist in the prevalence of current rhinoconjunctivitis symptoms, being higher in high vs low income countries, but the prevalence of severe symptoms was greater in less affluent countries. Co-morbidity with asthma is high particularly in Africa, North America and Oceania. This global map of symptom prevalence is of clinical importance for health professionals.
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            Does Pet Ownership in Infancy Lead to Asthma or Allergy at School Age? Pooled Analysis of Individual Participant Data from 11 European Birth Cohorts

            Objective To examine the associations between pet keeping in early childhood and asthma and allergies in children aged 6–10 years. Design Pooled analysis of individual participant data of 11 prospective European birth cohorts that recruited a total of over 22,000 children in the 1990s. Exposure definition Ownership of only cats, dogs, birds, rodents, or cats/dogs combined during the first 2 years of life. Outcome definition Current asthma (primary outcome), allergic asthma, allergic rhinitis and allergic sensitization during 6–10 years of age. Data synthesis Three-step approach: (i) Common definition of outcome and exposure variables across cohorts; (ii) calculation of adjusted effect estimates for each cohort; (iii) pooling of effect estimates by using random effects meta-analysis models. Results We found no association between furry and feathered pet keeping early in life and asthma in school age. For example, the odds ratio for asthma comparing cat ownership with “no pets” (10 studies, 11489 participants) was 1.00 (95% confidence interval 0.78 to 1.28) (I2 = 9%; p = 0.36). The odds ratio for asthma comparing dog ownership with “no pets” (9 studies, 11433 participants) was 0.77 (0.58 to 1.03) (I2 = 0%, p = 0.89). Owning both cat(s) and dog(s) compared to “no pets” resulted in an odds ratio of 1.04 (0.59 to 1.84) (I2 = 33%, p = 0.18). Similarly, for allergic asthma and for allergic rhinitis we did not find associations regarding any type of pet ownership early in life. However, we found some evidence for an association between ownership of furry pets during the first 2 years of life and reduced likelihood of becoming sensitized to aero-allergens. Conclusions Pet ownership in early life did not appear to either increase or reduce the risk of asthma or allergic rhinitis symptoms in children aged 6–10. Advice from health care practitioners to avoid or to specifically acquire pets for primary prevention of asthma or allergic rhinitis in children should not be given.
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              Exposure to outdoor air pollution during trimesters of pregnancy and childhood asthma, allergic rhinitis, and eczema.

              Mounting evidence suggests that exposure to ambient air pollution is associated with the development of childhood allergic diseases, but the effect of prenatal exposure to air pollution on the risk of childhood asthma and allergy is unclear.
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                Author and article information

                Contributors
                Journal
                Front Pediatr
                Front Pediatr
                Front. Pediatr.
                Frontiers in Pediatrics
                Frontiers Media S.A.
                2296-2360
                23 June 2020
                2020
                : 8
                : 331
                Affiliations
                [1] 1Faculty of Medicine, Kuwait University , Safat, Kuwait
                [2] 2Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University , Safat, Kuwait
                Author notes

                Edited by: Philip Keith Pattemore, University of Otago, New Zealand

                Reviewed by: Thomas Townend, Canterbury District Health Board, New Zealand; Qihong Deng, Central South University, China; Luis Garcia-Marcos, University of Murcia, Spain

                *Correspondence: Ali H. Ziyab aziyab@ 123456hsc.edu.kw

                This article was submitted to Children and Health, a section of the journal Frontiers in Pediatrics

                Article
                10.3389/fped.2020.00331
                7324793
                32656169
                3b89707e-18d1-484c-b7be-aaedfb95d89e
                Copyright © 2020 AlShatti and Ziyab.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 19 September 2019
                : 20 May 2020
                Page count
                Figures: 1, Tables: 4, Equations: 0, References: 52, Pages: 10, Words: 7419
                Categories
                Pediatrics
                Original Research

                pets,allergy,asthma,eczema,rhinitis,cat,dog,rabbit
                pets, allergy, asthma, eczema, rhinitis, cat, dog, rabbit

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