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Home > Risk of Childhood Asthma in a Tropical African Urban Setting: A Case - Control Study at the Aga Khan Hospital, Dar-Es-Salaam, Tanzania

Risk of Childhood Asthma in a Tropical African Urban Setting: A Case - Control Study at the Aga Khan Hospital, Dar-Es-Salaam, Tanzania

Thesis Info

Author

Koech, Lynda C.

Department

Family Medicine (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2013

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728067267

Similar


Objective: To determine the modifiable and non-modifiable risk factors for childhood asthma in children aged between two and 15years in a tropical urban East-African setting. Methods: Hospital based case-control study matched for age + two months and sex. Data were obtained from parents of cases and controls using a structured interviewer-administered questionnaire. The study sample consisted of 226 cases of two to 15years old, with physician-confirmed asthma, who met a set of defined clinical criteria and 226 controls with no previous diagnosis or symptoms of asthma matched by sex and age (+two months). The Risk Factors included in this study are broadly classified under family history of asthma, race, socio-economic factors, pre and perinatal factors, comorbid history of eczema or worm infestation and indoor environmental pollution. Setting: The outpatient paediatric clinic at Aga Khan Hospital, a secondary care hospital in Dar Es Salaam, Tanzania between July 2012 and January 2013. Results: Of the modifiable risk factors for asthma in this study, maternal smoking during pregnancy yielded an infinite Crude Odds Ratio P = 0.0207. Maternal diet rich in fish and other seafood during pregnancy showed a protective association with asthma (Adjusted Odds Ratio- 0.60; 95% confidence intervals 0.37 – 0.99, P =0.044). A diet rich in milk and dairy products during pregnancy was protective in children older than five years. (Adjusted Odds Ratio - 0.63, 95% confidence intervals 0.38- 1.06, P = 0.024). Family history of asthma is an important non-modifiable asthma risk factor; Paternal Asthma - Adjusted Odds Ratio of 3.14; Confidence Interval 1.49 -6.63, P=0.03), Maternal Asthma - Adjusted Odds Ratio 2.63; 95%Confidence Interval 1.34 – 5.15, P = 0.005and sibling asthma -Adjusted Odds Ratio 2.57; 95%Confidence Interval 1.60 – 4.14, P < 0.0001. Conclusion: Family history of asthma is strongly associated with asthma. Maternal diet during pregnancy is an important modifiable asthma risk factor in the tropical African setting with fish and sea-foods being protective. Further research in a more powered study is required to determine the role of maternal diet rich in milk and dairy products.
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سونا دل سنسار ،سہیلی

سونا دل سنسار سہیلی
بیٹھی ہوں بیزار سہیلی

رستہ تیرا دیکھ رہے ہیں
دل آنکھیں رخسار سہیلی

ساون رت آنکھوں میں ٹھہری
نیر بنے پتوار سہیلی

وقت ہمارا قیدی ہو گا
جیون ہے گھر بار سہیلی

تم سے رنگ فضاؔ کے سارے
تم بن سب بے کار سہیلی

موقف خيون آل عبيد من قيام الثورة عام 1920

لقد عمل الشيخ خيون آل عبيد على كسر هيبة بريطانيا في العراق من خلال إعداد خطة لقتل الحاكم البريطاني برترام توماس حاكم الشطرة يوم ذاك، لكن الأمور لم تأتِ لصالحه فقد كشفت خطته، عندما أفشى الشيخ صكبان آل علي الذي كان يشغل منصب ضابط شبانة اسرار تلك الخطة، والتي انعكست بدورها إلى تغيير مساره الذي انتهجه في مجابهة البريطانيين، وبذلك لم يلتحق الشيخ خيون آل عبيد بصفوف الثوار في هذه المرحلة، ووقف موقف المتفرج من الثورة. وتتناول هذه الدراسة موقف الشيخ خيون آل عبيد من اندلاع الثورة عام 1920. اقتضت طبيعة هذه الدراسة تقسيمها إلى مقدمة ومبحثين أساسيين وخاتمة، تناولنا في المبحث الأول دور الشيخ خيون في الحركة الوطنية قبيل اندلاع الثورة عام 1920. وخصصنا المبحث الثاني عن موقف الشيخ خيون آل عبيد من اندلاع الثورة عام 1920. واعتمدت الدراسة على مجموعة من المصادر المتنوعة وخاصة الوثائق البريطانية غير المنشورة. وكذلك الكتب العربية والمترجمة، فضلاً عن الاعتماد على الصحافة المحلية التي مثلت نبعاً غزيراً من المعلومات عن تلك الحقبة التأريخية

Cultivar Resistance and Chemical Control of Tomato Fruitworm, Heliothis Hb. Armigera on Tomato Lycopersicon Esculentum Mill.

During present investigation experiments were conducted on the pest phenology on tomato crop for three years (1989-91), at Pes t Peshawar. Institute, Tarnab, Research Agricultural pehnological studies comprised egg, larval population dynamics, spatial distribution analysis and development of larval time sequential sampling plan. On population dynamics, the regression equation for egg and/or larval population development showed feeble negative p values during 1989 and 1991, and positive p values All equations showed poor correlation during the year 1990. coefficient. The sequent ional sampling programme data showed two distinct population configurations i.e. outbreak and endemic. The differences in growth rates between types were small at first. , A total of ca . 6 samples reached to its peak and then declined. (each week) would be adequate to detect type of configuration in any one year. Spatial pattern of H. armigera Hb . egg distribution during the study revealed that index of dispersion (I.D.) values were more than 1 in 1990 and 1991. However, in 1989 the l.D. values oscillated around 1. Moreover, most of the green''s index (G.I.) values were positive which confirm the negative binomial The I.D. values of the distribution of Hÿ_ armigera Hb. eggs. spatial pattern of H. armigera Hb. larval distribution were mostly higher than 1. Therefore, larval distribution also fits negative binomial distribution. The results of discriminating doses of potassium fertilizer on egg and larval population, and the fruit infestation showed that there was no significant effect of fertilizer on the uptake of tomato plants, on egg and larval population, and on the infestation of tomato. To compare relative efficacy of nine insecticides, one application was done during the year (1989), and three during each remaining two years of study i.e. 1990 and 1991. All the insecticides were found successful in keeping the larval population below outbreak configuration level upto 15 days after spray. ( viii ) S ! Consolidation of study data over a period of three years revealed that Thiodon was statistically the most effective wiLh 77.88 percent larval mortality, followed by Folidol M (75.96%), Sevin (69.32%), Thuricide (67.12%), Dimilin (66.38%), Edcidin (65.32%) and Atabron (59.85%). Permasect and Azodrin were significantly the mortality larval and 54.66% 58.55% with effective least level). The resulLs also respectively (cdii = 17.03 at 0.05 indicated a tendency in the reduction of effectiveness of Folidol M, Azodrin, Dimilin and Thuricide over a period of three years which might probably be due to enhancement in the degree of tolerance developing in H. armiqera Hb . Cluster analysis on the interactions of eggs and larval per plant, percent fruit damage and yield in Kg per plant of 65 toniaLo cultivars gave five cluster groups. Frequency-wise cluster analysis showed two varieties in group A (3.08%), two in B (3.08%), one in C (1.53%), fifty nine in D (90.78%) and one in E (1.53%). In the regression analysis of correlation between characteristics of 65 varieties and H- armiqera Hb. infestation, step-wise model was fitted, the correlation between infestion gave negative dependence larval infestation (-0.3251) with poor correlation (-0.2558) . Similar coefficient results were obtained for correlation between yield and number of larvae per plant (b=0.4Q04, r=0 . 0893 ) The step-wise model correlation between larval chemical/physical population and parameters gave negative dependence on trichome length (-0.0100) and iron content (-15494E- 04) and positive dependence on zinc (0.0028) and vitamin C (0.0279). Cluster analysis on the interaction of larval duration, pupal duration, adult longevity, duration of life cycle, larval and pupal weight and survival to adult stage also gave five cluster groups . Frequency-wise cluster analysis showed two varieties in group A (3.08%), four in B (6.15%), fifty two in C (84.62%), three in D (4.62%) and one in E (1.53%). Tiny Tim being moderately resistant cultivar, was placed in group E. . The results indicated that integration of resistant cultivar, Tiny Tim and Bacillus thurinqiensis had maximum effect on larval mortality and minimum percent fruit infestation, it was followed by accession 87-11(1) also a resistant line, while the maximum infestation was recorded on the most susceptible cultivar, Big long. The host range and average number of larvae/plant of H. armiqera Hb were recorded on soybean (1.63), gram (4.80), tomato (0.31), tobacco (1.64), maize (0.81), sunflower (0.07), okra (0.67), potato (1.92) and burseem (0.90). Gram was observed to be the most favourable host plant of this pest