Lifestyle domains as determinants of wheeze prevalence in urban and rural schoolchildren in Ecuador: cross sectional analysis.

BACKGROUND: The acquisition of a modern lifestyle may explain variations in asthma prevalence between urban and rural areas in developing countries. However, the effects of lifestyle on asthma have been investigated as individual factors with little consideration given to the effects of lifestyle as a set of attributes. The aim of the present study was to identify modern lifestyle domains and assess how these domains might explain wheeze prevalence in urban and rural areas. METHODS: We analysed data from cross-sectional studies of urban and rural schoolchildren in Esmeraldas Province, Ecuador. Variables were grouped as indicators of socioeconomic factors, sedentarism, agricultural activities and household characteristics to represent the main lifestyle features of the study population. We used multiple correspondence analyses to identify common lifestyle domains and cluster analysis to allocate children to each domain. We evaluated associations between domains and recent wheeze by logistic regression. RESULTS: We identified 2-3 lifestyle domains for each variable group. Although wheeze prevalence was similar in urban (9.4%) and rural (10.3%) schoolchildren, lifestyle domains presented clear associations with wheeze prevalence. Domains relating to home infrastructure (termed transitional, rudimentary, and basic urban) had the strongest overall effect on wheeze prevalence in both urban (rudimentary vs. basic urban, OR = 2.38, 95% CI 1.12-5.05, p = 0.024) and rural areas (transitional vs. basic urban, OR = 2.02, 95% CI 1.1-3.73, p = 0.024; rudimentary vs. basic urban, OR = 1.88, 95% CI 1.02-3.47, p = 0.043). A high level of sedentarism was associated with wheeze in the rural areas only (OR = 1.64, 95% CI 1.23-2.18, p = 0.001). CONCLUSIONS: We identified lifestyle domains associated with wheeze prevalence, particularly living in substandard housing and a high level of sedentarism. Such factors could be modified through programmes of improved housing and education. The use of lifestyle domains provides an alternative methodology for the evaluation of variations in wheeze prevalence in populations with different levels of development

Coastal Subsistence Strategies and Mangrove Swamp Evolution at Bubog I Rockshelter (Ilin Island, Mindoro, Philippines) from the Late Pleistocene to the mid-Holocene

Subsistence adaptations to coastal environments and the capacity to take advantage of mangrove swamps has likely played an important role in the success of the maritime colonization of Southeast Asian and Wallacean islands by modern humans. Yet, ichthyoarchaeological studies remain rare in this part of the world. Bubog I rockshelter (Ilin Island, southwestern Mindoro, the Philippines) has yielded a stratigraphic filling extending from 30 ka to 4 ka, including a human-produced shell midden. Several remains from marine and terrestrial animals have been recovered from the site. We report here on an Australo-Melanesian subsistence behavior based on ichthyofaunal, crustacean, and large mammal remains. Their adaptation to successfully exploit different marine environments from open reef to mangrove swamps is demonstrated by the continuous presence of fishes from these marine zones throughout the stratigraphy and by the development of a range of fishing and foraging techniques. The increased hunting of Sus oliveri furthermore shows increased foraging in tropical rainforests after 6 ka. Interestingly, based on crustaceans analysis, mangrove foraging in Bubog I declined when the development of these swamps was at their maximum in other islands in the Philippines. Variability in subsistence strategies therefore appears to be a response to changing landscapes during the Pleistocene–Holocene transition with a strong marine specialization that only increased as mangrove habitats declined