Rural and urban food allergy prevalence from the South African Food Allergy (SAFFA) study

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:143

Article

Botha, Maresa¹  Basera, Wisdom²  Facey-Thomas, Heidi E.¹  Gaunt, Ben^3,4  Gray, Claudia L.¹  Ramjith, Jordache^5,6  Watkins, Alexandra¹  Levin, Michael E.^1,7 

[1] Univ Cape Town, Dept Paediat, Div Paediat Allergy, Cape Town, South Africa

[2] Univ Cape Town, Fac Hlth Sci, Sch Publ Hlth & Family Med, Cape Town, South Africa

[3] Zithulele Hosp, Eastern Cape Dept Hlth, Zithulele, South Africa

[4] Univ Cape Town, Fac Hlth Sci, Div Primary Hlth Care, Cape Town, South Africa

[5] Univ Cape Town, Sch Publ Hlth & Family Med, Div Epidemiol & Biostat, Cape Town, South Africa

[6] Radboud Univ Nijmegen, Med Ctr, Biostat Res Grp, Dept Hlth Evidence,Radboud Inst Hlth Sci, Nijmegen, Netherlands

[7] Grp Worldwide Univ Network, inVIVO Planetary Hlth, Nijmegen, Netherlands

关键词: Africa;    allergy;    egg;    ethnicity;    food allergy;    food sensitization;    peanut;    prevalence;    skin prick test;    urban;    rural;   

DOI  :  10.1016/j.jaci.2018.07.023

来源: Elsevier

【 摘 要 】

Background: Food sensitization and challenge-proved food allergy (FA) have not been compared in urban and rural settings. Objective: We sought to determine and compare the prevalence of food sensitization and challenge-proved IgE-mediated FA in urban and rural South African toddlers aged 12 to 36 months. Methods: This cross-sectional study of unselected children included 1185 participants in urban Cape Town and 398 in the rural Eastern Cape. All participants completed a questionnaire and underwent skin prick tests (SPTs) to egg, peanut, cow's milk, fish, soya, wheat, and hazelnut. Participants with SPT responses of 1 mm or greater to 1 or more foods and not tolerant on history underwent an open oral food challenge. Result: The prevalence of FAwas 2.5% (95% CI, 1.6% to 3.3%) in urban children, most commonly to raw egg white (1.9%), followed by cooked egg (0.8%), peanut (0.8%), cow's milk (0.1%), and fish (0.1%). Urban sensitization (SPT response >= 1 mm) to any food was 11.4% (95% CI, 9.6% to 13.3%) and 9.0% (95% CI, 7.5% to 10.8%) at an SPT response of 3 mm or greater. Sensitization in rural cohorts was significantly lower than in the urban cohort (1-mm SPT response, 4.5% [95% CI, 2.5% to 6.6%]; 3-mm SPT response, 2.8% [95% CI, 1.4% to 4.9%]; P < .01). In the rural black African cohort 0.5% (95% CI, 0.1% to 1.8%) of children had food allergy, all to egg. This is significantly lower than the prevalence of the urban cohort overall (2.5%) and urban black African participants (2.9%; 95% CI, 1.5% to 4.3%; P = .006). Conclusion: FA prevalence in Cape Town is comparable with rates in industrialized middle-income countries and is significantly greater than in rural areas. Further analysis will describe and compare environmental exposures and other risk factors in this cohort.

【 授权许可】

Free