Factors associated with asthma in Albania

Background: This study was undertaken to see whether asthma in Albania (where it is particularly uncommon) is associated with certain 'western' characteristics, and with dietary and lifestyle factors that affect its occurrence elsewhere. Methods: A screening survey was conducted among 2653 persons aged 20-44 years. A more detailed enquiry was conducted among a random subsample plus all others whose response indicated possible asthma. Three groups were compared: 495 probable nonasthmatics ('nonsymptomatics'); 106 with asthma-like symptoms and positive skin tests ('possible allergic asthmatics'); and 116 with similar symptoms and negative skin tests ('other symptomatics'). Results: The possible allergic asthmatics were less likely than the nonsymptomatics to have attended school or nursery under the age of 5 years or to have shared a bedroom with an older child before that age. Continued education after the age of 18 years also appeared to be protective. Allowing for other factors, a strong negative relation was found with fruit and vegetable consumption and weak positive relations with prepackaged food and fizzy drinks. Symptoms in skin prick test-negative subjects were associated with personal and parental smoking habit. Conclusions: This survey provides limited evidence linking asthma with aspects of western lifestyle. It supports the hypothesis that opportunities for infection during early childhood and the consumption of fruit and vegetables protect against asthma.