BACKGROUND: The prevalence of food allergy in South Africa is unknown, but previously thought to be rare in black South Africans. This study aimed to determine the prevalence of, and risk factors for, IgE-mediated food allergy in South African children with atopic dermatitis (AD). METHODOLOGY: This was a prospective, observational study in a paediatric university hospital in Cape Town. Children with AD, aged 6 months to 10 yrs, were randomly recruited from the dermatology clinic. They were assessed for sensitization and allergy by questionnaire, skin prick tests, Immuno Solid Phase Allergen Chip (ISAC) test and incremental food challenges. RESULTS: 100 participants (59 black Africans and 41 of mixed race) were enrolled, median age 42 months. There were high overall rates of food sensitization (66%) and food allergy (40%). Egg (25%) and peanut (24%) were the most common allergies. Black participants had comparable sensitization (69% vs. 61%) but lower allergy rates (34% vs. 46%) than mixed race participants. This was especially evident for peanut allergy (15% Blacks vs. 37% mixed race allergic to peanut, p = 0.01). Early-onset AD (<6 months), severe eczema, and young age <2 yrs were significant risk factors for food allergy. CONCLUSION: The prevalence of food allergy is unexpectedly high in South African children with AD, and comparable with food allergy rates in patients with AD in developed countries. There are ethnic differences, with significantly lower peanut allergy rates in Blacks compared to mixed race patients. These results are not generalizable to an unselected South African population, which requires further study.
BACKGROUND: The prevalence of food allergy in South Africa is unknown, but previously thought to be rare in black South Africans. This study aimed to determine the prevalence of, and risk factors for, IgE-mediated food allergy in South African children with atopic dermatitis (AD). METHODOLOGY: This was a prospective, observational study in a paediatric university hospital in Cape Town. Children with AD, aged 6 months to 10 yrs, were randomly recruited from the dermatology clinic. They were assessed for sensitization and allergy by questionnaire, skin prick tests, Immuno Solid Phase Allergen Chip (ISAC) test and incremental food challenges. RESULTS: 100 participants (59 black Africans and 41 of mixed race) were enrolled, median age 42 months. There were high overall rates of food sensitization (66%) and food allergy (40%). Egg (25%) and peanut (24%) were the most common allergies. Black participants had comparable sensitization (69% vs. 61%) but lower allergy rates (34% vs. 46%) than mixed race participants. This was especially evident for peanutallergy (15% Blacks vs. 37% mixed race allergic to peanut, p = 0.01). Early-onset AD (<6 months), severe eczema, and young age <2 yrs were significant risk factors for food allergy. CONCLUSION: The prevalence of food allergy is unexpectedly high in South African children with AD, and comparable with food allergy rates in patients with AD in developed countries. There are ethnic differences, with significantly lower peanutallergy rates in Blacks compared to mixed race patients. These results are not generalizable to an unselected South African population, which requires further study.
Authors: Pamela A Frischmeyer-Guerrerio; Marjohn Rasooly; Wenjuan Gu; Samara Levin; Rekha D Jhamnani; Joshua D Milner; Kelly Stone; Anthony L Guerrerio; Joseph Jones; Magnus P Borres; Erica Brittain Journal: Ann Allergy Asthma Immunol Date: 2019-01-10 Impact factor: 6.347
Authors: Luis Caraballo; Josefina Zakzuk; Bee Wah Lee; Nathalie Acevedo; Jian Yi Soh; Mario Sánchez-Borges; Elham Hossny; Elizabeth García; Nelson Rosario; Ignacio Ansotegui; Leonardo Puerta; Jorge Sánchez; Victoria Cardona Journal: World Allergy Organ J Date: 2016-06-27 Impact factor: 4.084
Authors: George Du Toit; Graham Roberts; Peter H Sayre; Henry T Bahnson; Suzana Radulovic; Alexandra F Santos; Helen A Brough; Deborah Phippard; Monica Basting; Mary Feeney; Victor Turcanu; Michelle L Sever; Margarita Gomez Lorenzo; Marshall Plaut; Gideon Lack Journal: N Engl J Med Date: 2015-02-23 Impact factor: 91.245
Authors: N Mothes-Luksch; G Jordakieva; L Hinterhölzl; A N Jensen; P K Hallmann; M Kundi; E Jensen-Jarolim Journal: World Allergy Organ J Date: 2018-09-11 Impact factor: 4.084