Atopik Astımlı Türkiye Cumhuriyeti Vatandaşları ile Mültecilerin Deri Prick Test Sonuçlarının Karşılaştırılması

Amaç: Astım ve atopi çevresel maruziyetler ile değişkenlik gösterir. Göç ve Mültecilikte Alerjik astım hastaları için dezavantajlı grupta yer alır. Materyal ve Metod: Kesitsel tasarımlı 431 hastada, Ocak 2015-2017 tarihleri arasında, Atopik astımlı Türkiye Cumhuriyeti vatandaşı ile Çadır kampta yaşayan Suriyeli Mültecilerin Deri Prick Test (DPT) sonuçlarının değerlendirilmesi amaçlandı. Bulgular: Atopik Astım tanılı %45,7 Suriyeli Mülteciler olmak üzere toplam 431 hastaya SPT yapıldı. Kadın cinsiyet %75,4 ‘tür. Yaş ortalaması 30,5 ’tir. Hem TC vatandaşı hem de Mültecilerde en çok görülen alerjen Ev tozu akarıdır. Uyruğa göre: Mantar karışımı (13,343/0,000), Hamam Böceği (8,541/0,003) ve Tahıl karışımına (6,556/0,011) gruplar arasında anlamlı fark izlendi. Cinsiyete göre: Mantar Karışımı (6,173/0,013) ve Hamam Böceğine (4,495/0,034) gruplar arasında anlamlı fark izlendi. Yaş gruplarına göre: 17-34 yaş grubunda Mantar Karışımına (21,567/0,000), 45 ve üzeri yaş grubunda ise Ağaç polenine (6,062/0,048) karşı gruplarda anlamlı fark bulunmuştur. Sonuç: Göç ve Mültecilik durumlarında Alerjik Astım önemli bir sağlık sorunudur. TC vatandaşı ve Mültecilerde en sık alerjen pozitifliği ev tozu akarında görülmektedir. Suriyeli Mültecilerde sırayla Ev tozu akarı, Ot karışımı ve Mantar karışımı şeklindedir. Bu çalışma Mültecilerde Aeroalerjenleri gösteren ilk çalışma olmasıyla literatüre katkı sunacaktır.

Anahtar Kelimeler:

Aeroallergen, Astma, Deri Prick Test, Göçmen, Mülteci

The Comparison of Skin Prick Test Results of the Refugees with the Citizens of the Republic of Turkey with Atopic Asthma

Background: The aim of this study to evaluate the results of the skin prick test (SPT) of citizens of the Republic of Turkey (T.R.) and Syrian refugees who are with atopic asthma. Materials and Methods: This cross-sectional study was conducted with 431 patients between January 2015 and 2017. At the study were evaluated the results of the SPT of the citizens of the T.R with atopic asthma and Syrian refugees who are living in tent camps. For this study, approval was obtained from the non-interventional ethics committee of Harran University with the decision dated June 04, 2017 and numbered 17/04/23.Results: SPT was performed in 431 patients with atopic asthma, 45.7% of whom were Syrian Refugees. Of the patients, 75.4% were female. The mean age was 30.5. House dust mite is the most common allergen encountered in both Turkish citizens and refugees. By the nationality, a significant difference was observed between the groups in terms of mould mixture (p <0.001), cockroach (p<0.05) and grain mixture (p<0.05). According to gender, there was a significant difference between the groups in terms of mould mixture (p <0.05) and cockroach (p<0.05). It was observed that the sensitivity of wild grass (41%) and cat hair (39.1%) in T.C women, mushroom mixture (61.9%) in Syrian refugee women and wild grass (60.7%) in Syrian refugee men were higher.Conclusion: Allergic asthma is an important health problem in migration and refugee situations. In Turkish citizens and refugees, allergen positivity is most common in house dust mites. In Syrian refugees, it is as house dust mite, herb mix and mushroom mix, respectively. This study will contribute to the literature as it is the first study to show allergens in refugees.

PDF

___

1. Boulet LP, Reddel HK, Bacharier LB, Bateman ED, Becker A, Bruselle, et al. The revised 2019 Golabal Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2019. Available from: www.ginasthma.org
2. Asthma Diagnosis and Treatment Guide. Turkish Thoracic Society. TTJ Supll. 2014(1);12-18 www.toraks.org.tr 2016.
3. Arruda LK, Barbosa MC, Santos AB, Moreno AS, Chapman MD, Pomes A. Recombinant allergens for diagnosis of cockroach allergy. Curr Allergy Asthma Rep 2014;14:1-11
4. Kalyoncu F, Çöplü L, Selçuk ZT, Emri AŞ, Kolaçan B, Kocabaş A, et al. Survey of the allergic status of patients with bronchial asthma in Turkey: a multicenter study. Allergy 1995;50:451-5.
5. Frati F, Incorvaia C, Cavaliere C, Di Cara G, Marcucci F, Esposito S, Masieri S. The skin prick test. J Biol Regul Homeost Agents 2018 Jan-Feb; 32 ( 1 Suppl. 1):19-24.
6. http://www.ceylanpinar.gov.tr/ Access Date: December 25, 2018)
7. Mowafi H. Conflict, displacement and health in the Middle East. Glob Public Health 2011;6:5 472-87
8. Peltokorpi V. İntercultural communication in foregien, subsidiaries, the ınfluence Expatriates language and cultural competencies. SJM 2010;26:2 176-88
9. Çıtıl R, Eğri M. Migration and Infectious Diseases (Göçler ve Enfeksiyon Hastalıkları). Türkiye Klinikleri J Public Health-Special Topics 2017;3:1 14-21
10. Ahmed H, Ospina MB, Sideri K, Vliagoftis H. Retrospective analysis of aeroallergen's sensitization patterns in Edmonton, Canada. Allergy Asthma Clin Immunol. 2019 Feb 13;15:6. doi: 10.1186/s13223-019-0320-y.
11. Farrokhi S, Gheybi MK, Movahed A, Tahmasebi R, Iranpour D, Fatemi A, et al. Common aeroallergens in patients with asthma and allergic rhinitis living in southwestern part of iran: based on skin prick test reactivity. Iran J Allergy Asthma Immunol 2014;14:133-138.
12. Bayram N, Uyar M, Elbek O, Dikensoy Ö, Ayeten F. Allergy skin test results of an outpatient pulmonary clinic in Gaziantep. Gaziantep Med J 2013;19:152-154
13. Koç İ, Doğan Y, Doğan S, Karataş Z.A., Skin prick test results of atopic asthmatic subjects in a chest disease clinic in Sanliurfa, Dicle Medical Journal, 2015; 42 (2): 166-169 doi:10.5798/diclemedj.0921.2015.02.0552
14. Oudin A, Richter JC, Taj T, Al-nahar L, Jakobson K. Poor housing conditions in association with child health in a disadvantaged immigrant population: a cross-sectional study in Rosengård, Malmö, SwedenBMJ Open 2016;6:e007979. doi: 10.1136/bmjopen-2015-007979
15. Radhakrishnan D, Guttmann A, To T, Reisman JJ, Knight BD, Moiaverian N, Manuel DG, et al. Generational Patterns of Asthma Incidence among Immigrants to Canada over Two Decades. A Population-based Cohort Study. Ann Am Thorac Soc. 2019 Feb;16(2):248-257. doi: 10.1513/AnnalsATS.201803-187OC.
16. N. El-Sharif, Z. Abdeen, R. Qasrawiz, G. Moens, B. Nemery. Asthma prevalence in children living in villages, cities and refugee camps in Palestine. Eur Respir J 2002; 19: 1026–1034 DOI: 10.1183/09031936.02.01832001
17. Kurtuluş Ş, Sak ZHA, Can R. Chest Diseases in Refugees Living in a Tent Camp and in Turkish Citizens Living in the District: Ceylanpınar Experience. Turk Thorac J. 2018 Jul; 19(3): 117–121. Published online 2018 Jun 12. doi: 10.5152/TurkThoracJ.2018.17070
18. Gupta A, Singh M, Chakrabarti A, Mathew JL, Rawat A. Correlation between fungal sensitisation in childhood persistent asthma and disease severity. Mycoses. 2018 Mar;61(3):195-200. doi: 10.1111/myc.12726. Epub 2017 Nov 22.
19. Jeong KY, Son M, Lee JH, Hong CS, Park JW. Allergenic characterization of a novel allergen, homologous to chymotrypsin, from german cockroach. Allergy Asthma Immunol Res 2015 May;7(3):283-9. doi: 10.4168/aair.2015.7.3.283.
20. Mahesh P, Kummeling I, Amrutha D, Vedanthan P. Efect of area of residence on patterns of aeroallergen sensitization in atopic patients. Am J Rhinol Allergy. 2010. https://doi.org/10.2500/ajra.2010.24.3529.
21. Kalyoncu AF, Stalenheim G., Serum IgE levels and allergic spectra in immigrants to Sweden. Allergy. 1992;47:277-80. DOI: 10.1111/j.1398-9995.1992.tb02053.x
22. Çölgeçen E, Özyurt K, İntepe YS, Gencer, ZK, Özkırış M, Ede G, Karaçavuş S. Skin prick test results in patients with atopic symptoms in Yozgat district. JCEI 2014;5: 64-68.
23. Custovic A, Taggart SC, Woodcock A. House dust mite and cat allergen in different indoor environments. Clin Exp Allergy 1994;24:1164-1168.
24. Wang J, Wu Y, Li J, Huang X, Zhu R. Eight Aeroallergen Skin Extracts May Be the Optimal Panel for Allergic Rhinitis Patients in Central China. Int Arch Allergy Immunol 2017;173:193-198 https://doi.org/10.1159/000479429