Gijs Walraven|Ousman Nyan|Marianne A. B. van der Sande|Winston Banya|S. M. Ceesay|Paul Milligan|Keith P. W. J. McAdam
Asthma, smoking and chronic cough in rural and urban adult communities in The Gambia
MRC Unit the Gambia|MRC Unit the Gambia|MRC Unit the Gambia|MRC Unit the Gambia|MRC Unit the Gambia|MRC Unit the Gambia|MRC Unit the Gambia
background asthma reported rare traditional rural communities thought increasing lifestyles become urbanized western objectives communitybased survey noncommunicable diseases conducted october 1996 june 1997 included comparison prevalence asthma smoking chronic cough rural urban gambia methods cluster sample survey conducted random sample rural urban adults 15 years age subjects asked respiratory symptoms using locally adapted version based iultd questionnaire spirometry basal methacholine provocation reversibility bronchodilator skin prick tests performed randomly selected subsample subjects interviewed said wheezed diagnosed asthmatic doctor results 2166 participants urban population 41 reported wheezing whistling chest previous 12 months 36 reported doctordiagnosed asthma 06 chronic cough rural population 3223 participants figures 33 07 12 respectively wheeze common women cough 3 months year common agegroups 45 reported currently smoked accounted 34 urban 42 rural men figures much lower women 15 60 seven 574 randomly selected subjects 14 exhibited bronchial hyperresponsiveness methacholine challenge four 133 30 people selfreported wheeze 369 43 participants doctordiagnosed asthma reacted positively bronchial provocation methacholine remarkably high prevalence positive skin prick tests aeroallergens 38 participants history wheeze 27 without conclusion prevalence wheeze particularly association bronchial hyperresponsiveness low rural urban gambia contrast relatively high prevalence positive skin prick tests aeroallergens wheezers nonwheezers questioning mechanisms interaction allergy asthma presence protective factors asthma west african population high smoking rates justify international concern tobacco marketing developing societies