North Gaza Centre

Personnel

• Mr Shaban Mortaja

Why was this centre selected for ISAAC?

In a personal communication, year 2000, with Professor Ameen Thalji, a researcher in Pediatric’s health in the West Bank and Jerusalem, he reported a gradient increase of childhood infections as seen at the emergency rooms and hospitals’ clinics in the past 10 years. Thalji and Abdeen agreed that a potential justification could be the increased effect of indoor allergen especially house dusts mites and smoking, and outdoor air pollution by traffic and allergens which were also believed to be the main risk factors for increasing asthma in the Palestinian children (Professor Ameen Thalji and Professor Hani Abdeen, personal communication, 2000). Similarly, a case control study in Gaza Strip at the refugees’ camps (1) indicated that house dust mites were probably important allergens in the region and has a major role in asthma trends and its severity among children especially at the coastal areas. Also, kerosene use for heating and cooking was a strong potential risk factor for developing asthma symptoms in those children, in addition to the effect of smoking and house dust mites. Therefore, poverty and humidity in Palestine and especially in Gaza Strip were considered important risk factors for asthma too.

Until year 2000, there was no real work that described the real situation or explored the possible risk factors and determinants of asthma in Palestine. The urban-rural and inland-coastal area differences were not studied in depth. Therefore, we decided at Al Quds University-Palestine in cooperation with KULeven Belgium to initiate several studies in two selected area (West Bank and Gaza Strip) that provide a framework for further etiological research into lifestyle, environmental, genetic and medical care factors affecting asthma prevalence and incidence. Ramallah governorate, the inland area, and Gaza governorate, the coastal area, were chosen for implementing the series of studies that was planned according to ISAAC protocols (phase three and phase 2)

ISAAC Phase Three studies:

This phase was done in two governorates: Gaza and Ramallah governorates. After a two-stage stratified systematic sampling, approximately 14,500 schoolchildren, from the first and second grades of elementary school (ages 5 to 8 years) and eighth and ninth school grades (ages 12 to 15 years), were invited to participate in a survey using ISAAC phase III questionnaires and protocols.

The main study results showed that younger children had a higher 12-month wheezing prevalence rate of 9.6% compared to older children (7.2%) and more physician-diagnosed asthma (8.4% and 5.9%, respectively). However, nocturnal cough and exercise-related wheezing were higher in the older age group compared with younger children. Younger children living in North Gaza district showed slightly higher prevalence rates for asthma and asthma symptoms, but older children had higher rates in Ramallah district. After adjustment using logistic regression analysis, male sex, living in inland areas, and younger age were shown to predict 12-month wheezing and physician-diagnosed asthma (2).

References

1.     Mumcuoglu KY, Abed Y, Armenios B, et al. Asthma in Gaza refugee camp children and its relationship with house dust mites.  Ann.Allergy 1994; 72: 163-166.
2. El-Sharif NA, Nemery B, Barghuthy F, Mortaja S, Qasrawi R, Abdeen Z. Geographical variations of asthma and asthma symptoms among schoolchildren aged 5 to 8 years and 12 to 15 years in Palestine: the International Study of Asthma and Allergies in Childhood (ISAAC). Ann Allergy Asthma Immunol. 2003 Jan;90(1):63-71.