High serum total IgE in children in geohelminthic endemic setting

Abstract

BACKGROUND: Elevated levels of total IgE (tlgE) in serum are characteristic of atopic diseases. However, the usefulness of tlgE in diagnosing atopic diseases in children living in areas endemic for helminth infections is not well established. OBJECTIVE: To assess the effect of geohelminth infections on serum tlgE levels in children with atopic diseases. DESIGN, SETTING AND METHODS: A total of 640 children in grade 5 were recruited from 17 schools in the Western Province. Data regarding atopic diseases were collected by a standard questionnaire. Screening for helminth infections was done by examining their stool samples by modified Kato-Katz technique. Serum tlgE was measured by fluoroenzymeimmunoassay. RESULTS: The mean age in the study population was 10 years (SD±0.3). The prevalence of geohelminth infection was 15.5%. Trichuris trichiura (14.3%) was the most common, followed by Ascaris lumbricoides (4.2%) and hookworm (0.2%). Mixed infection was detected in 20.3% of infected children. The cumulative prevalence of atopic diseases was 33.7%. Prevalence of asthma, rhinitis and eczema was 17%, 21.4% and 5% respectively. Geometric mean (GM) for tlgE for the geohelminth infected group (1039.9kU/L) was significantly higher than that of the non-infected group (575.4kU/L) (p=0.004). It was also higher in the allergic group (933.3kU/L) than in the non-allergic group (639.7kU/L) but the difference was not statistically significant (p=0.068). CONCLUSION: In the presence of geohelminth infections, raised IgE may be due to geohelminth infection or atopic diseases or both. Therefore, serum tlgE may not be a useful marker for allergic diseases in children living in areas endemic for geohelminth infections.