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Pediatric allergic diseases in the Indian subcontinent— Epidemiology, risk factors and current challenges
Author(s) -
Krishna Mamidipudi Thirumala,
Mahesh Padukudru Anand,
Vedanthan Pudupakkam K.,
Mehta Vinay,
Moitra Saibal,
Christopher Devasahayam Jesudas
Publication year - 2020
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.13306
Subject(s) - medicine , population , environmental health , pediatrics , immunology
India is low‐middle‐income country (LMIC) with a population of 1.3bn, comprising about 20% of the global population. While the high‐income Western countries faced an “allergy epidemic” during the last three decades, there has been a gradual rise in prevalence of allergic diseases in India. Methods Narrative review. Results and Discussion Allergic diseases occur as a consequence of a complex interplay between genetic and environmental factors. There are multiple contrasting determinants that are important to consider in India including high levels of air pollution, in particular PM 2.5 due to burning of fossil fuels and biomass fuels, diverse aero‐biology, tropical climate, cultural and social diversity, religious beliefs/myths, linguistic diversity, literacy level, breastfeeding and weaning, diet (large proportion vegetarian), and high incidence rates of TB, HIV, malaria, filariasis, parasitic infestations, and others, that not only shape the immune system early in life, but also impact on biomarkers relevant to allergic diseases. India has a relatively weak and heterogeneous healthcare framework, and allergology has not yet been recognized as an independent specialty. There are very few post‐graduate training programs, and allergic diseases are managed by primary care physicians, organ‐based specialists, and general pediatricians. Adrenaline auto‐injectors are not available, there is patient unaffordability for inhalers, nasal sprays, and biologics, and this is compounded by poor compliance leading to 40%‐50% of asthmatic children having uncontrolled disease and high rates of oral corticosteroid use. Standardized allergen extracts are not available for skin tests and desensitization. This article provides a critical analysis of pediatric allergic diseases in India.