Includes bibliographical references. / Background: Food allergy (FA) is a significant and often life-threatening health problem affecting about 4-6% of children and their families globally. In some developed countries FA prevalence has reached 10% and it is believed that developing economies may follow a similar trend since there is a reported rise in the global burden of other allergic diseases like asthma, allergic rhinitis and eczema. However, there is a dearth of population studies at global level documenting challenge-proven Ig-E mediated food allergy (FA) prevalence. As such, we studied an unselected population of children attending crèches in Cape Town, South Africa. Methodology All children aged 12-36 months attending the selected crèches between February 2013 and October 2013 were eligible for the study. Participants were assessed with an allergy questionnaire, had skin prick tests (SPTs) done and if they qualified, were invited for an oral food challenge (OFC) at the Red Cross Hospital Paediatric Allergy Clinic (RCHPAC). The SPT wheal size results were categorised into ≥1mm, ≥3mm and ≥7mm. We gave a general description of the study sample with respect to the demographic characteristics and compared participants and non-participants. We reported sensitisation pattern towards foods in the panel i.e. egg white extract, peanut, cow’s milk, wheat(flour), soy, hazelnut and fish (cod) according to the SPT categories. The effects of age, ethnicity, sex and concomitant allergy on sensitisation patterns were assessed. Associations between the potential predictor variables and sensitisation were assessed by Z-test for proportions and Chi-square/Fisher’s exact. PART I presents the study protocol with a brief motivation for the relevance of the study and the methodology used. PART II presents a structured literature review on FA and FS in large populations of selected and unselected cohorts. It provides an overview of empirical evidence on prevalence estimates from both the developed and developing world, and the potential risk factors causing Fav. PART III summarises the methodology, results and interpretation of the analysis conducted in a journal-ready manuscript according to Current Allergy and Clinical Immunology Journal requirements. Results The sample consisted of; 39% black African, 20% Caucasian and 41% mixed race participants, with a median age 26 months (IQR: 22-31). Amongst 121 participants (66% response rate, 92% participation rate and 94% completion rate), the prevalence of SPT≥1mm to any food was 16%, SPT≥3mm 12% and SPT≥7mm 4%. The prevalence of challenge-proven Ig-E mediated raw egg allergy was 1.7% and peanut allergy 0.8%. Black African participants had higher sensitisation rates (23%) of SPT≥1mm to any food, when compared to Caucasian (13%) and mixed race (10%) participants despite the difference not reaching statistical significance (p=0.17). Conclusions: This study was acceptable and feasible in this population that has a low prevalence of Ig-E mediated FA that is comparable to other studies from developed countries using objective measures in unselected cohorts. The prevalence of FS is appreciably high in this sample and there are ethnic differences that require further investigation. The findings seem to suggest an existing burden of Ig-E mediated FAs in the South African context that is un-diagnosed and therefore not managed
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uct/oai:localhost:11427/13250 |
| Date | January 2014 |
| Creators | Basera , Wisdom |
| Contributors | Levin, Michael E |
| Publisher | University of Cape Town, Faculty of Health Sciences, Department of Public Health and Family Medicine |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Master Thesis, Masters, MPH |
| Format | application/pdf |
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