Prevalence and factors associated with exercise-induced bronchospasm among rural school children in Ilesa, Nigeria.

BACKGROUND: Exercise-induced bronchospasm (EIB) assessed using changes in peak expiratory flow rates (PEFRs) to free range exercise is a relatively cheap way of screening for asthma in resource-poor centres where children with asthma are often undiagnosed and poorly managed. This study sets out to determine the prevalence and factors associated with EIB among rural schoolchildren in Ilesa, Nigeria. SUBJECTS AND METHODS: Children aged 8-16 years from two middle schools in rural Ilesa were selected by multistage sampling. Their sociodemographic characteristics and personal/family history of asthma and allergies were obtained. The children had their PEFR measured before, 5, 10 and 15 min after 6-8 min of free running exercise to achieve 80% of their maximal pulse rate. EIB was defined as change in PEFR expressed as a percentage of the pre-exercise value ≥15%. The prevalence and factors associated with EIB were determined. RESULTS: The mean (standard deviation) age of the 250 study participants was 12.5 (1.5) years (M: F 0.9:1) None of the children had previously been diagnosed with asthma. The prevalence of EIB was 9.2%, 6.4% and 4.0% at 5, 10 and 15 min post-exercise, respectively. Household poultry birds, personal history of allergies, wheeze in the past 12 months and family history of asthma were associated with EIB (P < 0.05); only wheezing in the past 12 months independently predicted EIB (odds ratio = 6.343; 95% confidence interval = 2.040-8.798; P= 0.020). CONCLUSION: The prevalence of EIB among rural schoolchildren in Ilesa was 9.2%. EIB was associated with the history of allergies and wheeze and presence of household poultry birds. We recommend routine screening of these children for early diagnosis and good asthma symptom control.

Influence of lime juice on the severity of sickle cell anemia.

BACKGROUND AND OBJECTIVES: The pain in sickle cell anemia (SCA) is often triggered by dehydration, acidosis, and fever that are usually due to malaria. Intake of lime juice was recently demonstrated to facilitate clearance of the malaria parasite. It was therefore sought to determine whether regular intake of lime juice will ameliorate crisis, especially recurrent bone pain. DESIGN: In this preliminary, open-labeled, randomized study, the effects of lime juice on the clinical and some laboratory characteristics of children with SCA were tested. RESULTS: Among the 113 children with SCA studied in two hospitals, the 58 receiving lime treatment had lower rates of significant painful episodes than the 55 without lime (37 versus 83 crises in 6 months, and 0.64±0.11 versus 1.51±0.34 average rates per child, p<0.001). Also, fewer subjects than the controls had significant painful episodes (50.0% versus 92.7%); febrile illness (46.6% versus 87.3%) and admission rate (3.4% versus 34.5%) (p<0.001). The mean hematocrit of the subjects (26.23±2.03%) at the end of the study was also higher, p<0.001. However, transfusion rate, presence of hepatomegaly, splenomegaly, and jaundice was similar. Treatment with lime did not cause any significant side-effect. CONCLUSIONS: Regular intake of lime juice may be of great therapeutic and nutritional relevance in children with SCA.