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

Autor: Botha M; Division of Paediatric Allergy, Department of Paediatrics, University of Cape Town, Cape Town, South Africa., Basera W; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa., Facey-Thomas HE; Division of Paediatric Allergy, Department of Paediatrics, University of Cape Town, Cape Town, South Africa., Gaunt B; Zithulele Hospital, Eastern Cape Department of Health, Zithulele, South Africa; Division of Primary Health Care, Health Sciences Faculty, University of Cape Town, Cape Town, South Africa., Gray CL; Division of Paediatric Allergy, Department of Paediatrics, University of Cape Town, Cape Town, South Africa., Ramjith J; Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa; Department for Health Evidence, Biostatistics Research Group, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands., Watkins A; Division of Paediatric Allergy, Department of Paediatrics, University of Cape Town, Cape Town, South Africa., Levin ME; Division of Paediatric Allergy, Department of Paediatrics, University of Cape Town, Cape Town, South Africa; inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN). Electronic address: michael.levin@uct.ac.za.
Jazyk: angličtina
Zdroj: The Journal of allergy and clinical immunology [J Allergy Clin Immunol] 2019 Feb; Vol. 143 (2), pp. 662-668.e2. Date of Electronic Publication: 2018 Aug 07.
DOI: 10.1016/j.jaci.2018.07.023
Abstrakt: 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 FA was 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.
(Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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