Infection-exposure in infancy is associated with reduced allergy-related disease in later childhood in a Ugandan cohort

Background: Lack of early infection-exposure has been associated with increased allergy-related disease (ARD) susceptibility. In tropical Africa, little is known about which infections contribute to development of ARDs, and at which time. Methods: We used latent class analysis to characterise the ea...

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Autores principales:	Lawrence Lubyayi, Harriet Mpairwe, Gyaviira Nkurunungi, Swaib A Lule, Angela Nalwoga, Emily L Webb, Jonathan Levin, Alison M Elliott
Formato:	article
Lenguaje:	EN
Publicado:	eLife Sciences Publications Ltd 2021
Materias:	childhood infection-exposure allergy-related disease atopy Uganda Medicine R Science Q Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/56d42158193540a995331d15eba85d55
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spelling	oai:doaj.org-article:56d42158193540a995331d15eba85d552021-11-15T06:59:41ZInfection-exposure in infancy is associated with reduced allergy-related disease in later childhood in a Ugandan cohort10.7554/eLife.660222050-084Xe66022https://doaj.org/article/56d42158193540a995331d15eba85d552021-09-01T00:00:00Zhttps://elifesciences.org/articles/66022https://doaj.org/toc/2050-084XBackground: Lack of early infection-exposure has been associated with increased allergy-related disease (ARD) susceptibility. In tropical Africa, little is known about which infections contribute to development of ARDs, and at which time. Methods: We used latent class analysis to characterise the early infection-exposure of participants in a Ugandan birth cohort and assessed ARDs in later childhood. Results: Of 2345 live births, 2115 children (90%) had data on infections within the first year of life while 1179 (50%) had outcome data at 9 years. We identified two latent classes of children based on first-year infection-exposure. Class 1 (32% membership), characterised by higher probabilities for malaria (80%), diarrhoea (76%), and lower respiratory tract infections (LRTI) (22%), was associated with lower prevalence of wheeze, eczema, rhinitis, and Dermatophagoides skin prick test (SPT) positivity at 9 years. Based on 5-year cumulative infection experience, class 1 (31% membership), characterised by higher probabilities for helminths (92%), malaria (79%), and LRTI (45%), was associated with lower probabilities of SPT positivity at 9 years. Conclusions: In this Ugandan birth cohort, early childhood infection-exposure, notably to malaria, helminths, LRTI, and diarrhoea, is associated with lower prevalence of atopy and ARDs in later childhood. Funding: This work was supported by several funding sources. The Entebbe Mother and Baby Study (EMaBS) was supported by the Wellcome Trust, UK, senior fellowships for AME (grant numbers 064693, 079110, 95778) with additional support from the UK Medical Research Council. LL is supported by a PhD fellowship through the DELTAS Africa Initiative SSACAB (grant number 107754). ELW received funding from MRC Grant Reference MR/K012126/1. SAL was supported by the PANDORA-ID-NET Consortium (EDCTP Reg/Grant RIA2016E-1609). HM was supported by the Wellcome’s Institutional Strategic Support Fund (grant number 204928/Z/16/Z).Lawrence LubyayiHarriet MpairweGyaviira NkurunungiSwaib A LuleAngela NalwogaEmily L WebbJonathan LevinAlison M ElliotteLife Sciences Publications Ltdarticlechildhoodinfection-exposureallergy-related diseaseatopyUgandaMedicineRScienceQBiology (General)QH301-705.5ENeLife, Vol 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	childhood infection-exposure allergy-related disease atopy Uganda Medicine R Science Q Biology (General) QH301-705.5
spellingShingle	childhood infection-exposure allergy-related disease atopy Uganda Medicine R Science Q Biology (General) QH301-705.5 Lawrence Lubyayi Harriet Mpairwe Gyaviira Nkurunungi Swaib A Lule Angela Nalwoga Emily L Webb Jonathan Levin Alison M Elliott Infection-exposure in infancy is associated with reduced allergy-related disease in later childhood in a Ugandan cohort
description	Background: Lack of early infection-exposure has been associated with increased allergy-related disease (ARD) susceptibility. In tropical Africa, little is known about which infections contribute to development of ARDs, and at which time. Methods: We used latent class analysis to characterise the early infection-exposure of participants in a Ugandan birth cohort and assessed ARDs in later childhood. Results: Of 2345 live births, 2115 children (90%) had data on infections within the first year of life while 1179 (50%) had outcome data at 9 years. We identified two latent classes of children based on first-year infection-exposure. Class 1 (32% membership), characterised by higher probabilities for malaria (80%), diarrhoea (76%), and lower respiratory tract infections (LRTI) (22%), was associated with lower prevalence of wheeze, eczema, rhinitis, and Dermatophagoides skin prick test (SPT) positivity at 9 years. Based on 5-year cumulative infection experience, class 1 (31% membership), characterised by higher probabilities for helminths (92%), malaria (79%), and LRTI (45%), was associated with lower probabilities of SPT positivity at 9 years. Conclusions: In this Ugandan birth cohort, early childhood infection-exposure, notably to malaria, helminths, LRTI, and diarrhoea, is associated with lower prevalence of atopy and ARDs in later childhood. Funding: This work was supported by several funding sources. The Entebbe Mother and Baby Study (EMaBS) was supported by the Wellcome Trust, UK, senior fellowships for AME (grant numbers 064693, 079110, 95778) with additional support from the UK Medical Research Council. LL is supported by a PhD fellowship through the DELTAS Africa Initiative SSACAB (grant number 107754). ELW received funding from MRC Grant Reference MR/K012126/1. SAL was supported by the PANDORA-ID-NET Consortium (EDCTP Reg/Grant RIA2016E-1609). HM was supported by the Wellcome’s Institutional Strategic Support Fund (grant number 204928/Z/16/Z).
format	article
author	Lawrence Lubyayi Harriet Mpairwe Gyaviira Nkurunungi Swaib A Lule Angela Nalwoga Emily L Webb Jonathan Levin Alison M Elliott
author_facet	Lawrence Lubyayi Harriet Mpairwe Gyaviira Nkurunungi Swaib A Lule Angela Nalwoga Emily L Webb Jonathan Levin Alison M Elliott
author_sort	Lawrence Lubyayi
title	Infection-exposure in infancy is associated with reduced allergy-related disease in later childhood in a Ugandan cohort
title_short	Infection-exposure in infancy is associated with reduced allergy-related disease in later childhood in a Ugandan cohort
title_full	Infection-exposure in infancy is associated with reduced allergy-related disease in later childhood in a Ugandan cohort
title_fullStr	Infection-exposure in infancy is associated with reduced allergy-related disease in later childhood in a Ugandan cohort
title_full_unstemmed	Infection-exposure in infancy is associated with reduced allergy-related disease in later childhood in a Ugandan cohort
title_sort	infection-exposure in infancy is associated with reduced allergy-related disease in later childhood in a ugandan cohort
publisher	eLife Sciences Publications Ltd
publishDate	2021
url	https://doaj.org/article/56d42158193540a995331d15eba85d55
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Infection-exposure in infancy is associated with reduced allergy-related disease in later childhood in a Ugandan cohort

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