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Food allergy in South African children with atopic dermatitis
Author(s) -
Gray Claudia L.,
Levin Michael E.,
Zar Heather J.,
Potter Paul C.,
Khumalo hlanhla P.,
Volkwyn Lucia,
Fenemore Bartha,
du Toit George
Publication year - 2014
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12270
Subject(s) - medicine , food allergy , peanut allergy , allergy , atopic dermatitis , sensitization , oral food challenge , population , egg allergy , observational study , pediatrics , asthma , dermatology , immunology , environmental health
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.