Prevalence and correlates of asthma, atopic dermatitis and allergic rhinitis among children in a primary healthcare clinic for low-income families in San Juan, Puerto Rico

The prevalence of allergic diseases has increased worldwide, affecting the quality of life of children and posing a serious burden on families and society. Respiratory diseases have been linked to poor living conditions. However, few data are available on the prevalence and correlates of these diseases in the underserved pediatric population in Puerto Rico. This study described the prevalence and correlates of childhood allergic diseases in children aged 6-14 years that received health services at a primary healthcare clinic in San Juan. 147 consecutive children recruited between February and August 2013. Parents were interviewed using an adapted version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire to determine the prevalence of asthma, allergic rhinitis, and eczema within the previous 12 months as well as residential, lifestyle and sociodemographic characteristics. Logistic regression models were used to assess the strength of the associations. Mean age of participants was 9.6±2.4 years; 51% were female. Prevalence of asthma, atopic dermatitis, and allergic rhinitis were 21.8%, 36.7%, and 11.7% respectively. Inability to access healthcare service due to lack of financial resources, passing of trucks near residence, assistance to childcare centers, antibiotic use, dampness in the walls, and dust inside the residence were associated to at least one allergic disease (p<0.05). Stratified analyses showed that males exposed to dust had 4.63 increased odds of atopic dermatitis (95%CI: 1.37-15.55) and children of ages 10 and under who attended childcare centers before age 3 had 6.02 increased odds of eczema (95%CI: 2.37-15.29). Further studies exploring these associations with a larger sample size are warranted.