M Panjari1, J J Koplin1,2, S C Dharmage1,2, R L Peters1,3, L C Gurrin1,2, S M Sawyer1,3,4, V McWilliam1,3,5, J K Eckert1, D Vicendese6, B Erbas6, M C Matheson1,2, M L K Tang1,3,5, J Douglass7, A-L Ponsonby1, T Dwyer1,8, S Goldfeld1,3,5, K J Allen1,3,5,9. 1. The Murdoch Childrens Research Institute, Parkville, Vic., Australia. 2. The Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Vic., Australia. 3. The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia. 4. Centre for Adolescent Health, Royal Children's Hospital, Parkville, Vic., Australia. 5. The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Vic., Australia. 6. La Trobe University, Bundoora, Vic., Australia. 7. The Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, University of Melbourne, Parkville, Vic., Australia. 8. George Institute for Global Health, United Kingdom School of Psychology and Public Health, University of Oxford, Oxford, UK. 9. Institute of Inflammation and Repair, University of Manchester, Manchester, UK.
Abstract
BACKGROUND: Asian infants born in Australia are three times more likely to develop nut allergy than non-Asian infants, and rates of challenge-proven food allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate the risk factors for nut allergy, we assessed the whole-of-state prevalence distribution of parent-reported nut allergy in 5-year-old children entering school. METHODS: Using the 2010 School Entrant Health Questionnaire administered to all 5-year-old children in Victoria, Australia, we assessed the prevalence of parent-reported nut allergy (tree nut and peanut) and whether this was altered by region of residence, socio-economic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders. RESULTS: Parent-reported nut allergy prevalence was 3.1% (95% CI 2.9-3.2) amongst a cohort of nearly 60 000 children. It was more common amongst children of mothers with higher education and socio-economic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian-born mothers (aOR 2.67, 95% CI 2.28-3.27) were more likely to have nut allergy than non-Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of nut allergy (aOR 0.1, 95% CI 0.03-0.31). CONCLUSION: Migration from Asia after the early infant period appears protective for the development of nut allergy. Additionally, rural regions have lower rates of nut allergy than urban areas.
BACKGROUND: Asian infants born in Australia are three times more likely to develop nutallergy than non-Asian infants, and rates of challenge-proven food allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate the risk factors for nutallergy, we assessed the whole-of-state prevalence distribution of parent-reported nutallergy in 5-year-old children entering school. METHODS: Using the 2010 School Entrant Health Questionnaire administered to all 5-year-old children in Victoria, Australia, we assessed the prevalence of parent-reported nutallergy (tree nut and peanut) and whether this was altered by region of residence, socio-economic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders. RESULTS: Parent-reported nutallergy prevalence was 3.1% (95% CI 2.9-3.2) amongst a cohort of nearly 60 000 children. It was more common amongst children of mothers with higher education and socio-economic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian-born mothers (aOR 2.67, 95% CI 2.28-3.27) were more likely to have nutallergy than non-Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of nutallergy (aOR 0.1, 95% CI 0.03-0.31). CONCLUSION: Migration from Asia after the early infant period appears protective for the development of nutallergy. Additionally, rural regions have lower rates of nutallergy than urban areas.
Authors: Warren W Acker; Joseph M Plasek; Kimberly G Blumenthal; Kenneth H Lai; Maxim Topaz; Diane L Seger; Foster R Goss; Sarah P Slight; David W Bates; Li Zhou Journal: J Allergy Clin Immunol Date: 2017-05-31 Impact factor: 10.793