Comparison of food allergy prevalence among Chinese infants in Chongqing, 2009 versus 1999
Department of Pediatrics, Division of Primary Child Care, Children's Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China. Pediatrics International
(Impact Factor: 0.73).
10/2010; 52(5):820-4. DOI: 10.1111/j.1442-200X.2010.03166.x
Food allergy prevalence is increasing in developed countries, but these results have not yet been verified in developing countries, especially in China. Our aim was to determine whether the prevalence and characteristics of food allergy have changed over the last 10 years in Chongqing, China.
Two cross-sectional studies were performed, 10 years apart (1999 and 2009) using the same diagnostic methods in the same age group (0-24 months) of the same clinic in Chongqing, China. A total of 401 infants were randomly selected for the present study. Food allergy was confirmed by food challenge. spss 15.0 was used to analyze the difference in prevalence.
Food allergy prevalence increased significantly from 3.5% in 1999 to 7.7% in 2009 (P= 0.017). The prevalence of a positive skin-prick-test response was also increased (from 9.9% to 18%; P= 0.002). Egg and cow's milk were still the most common food allergens, which cause skin and gastrointestinal symptoms in most infants.
This is the first study in China to indicate time trends in food allergy prevalence and characteristics. Our data show that in the 10-year period from 1999 to 2009, the prevalence of food allergy seems to have increased in China.
Available from: Susan L Prescott
- "The vast majority of countries reported an increase in food allergy prevalence in the preceding 10 years, although in most cases this was based on increasing health care burden (Additional file 1: Table S1). There was published evidence to support an increasing prevalence from Australia [2,46], Japan , China , Korea , USA  and Norway [21,49]. In the Chinese study, the same methodology was used in the same population 10 years apart and showed a doubling of challenge-proven IgE-mediated food allergy from 3.5% in 1999 to 7.7% in 2009 . "
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ABSTRACT: While food allergies and eczema are among the most common chronic non-communicable diseases in children in many countries worldwide, quality data on the burden of these diseases is lacking, particularly in developing countries. This 2012 survey was performed to collect information on existing data on the global patterns and prevalence of food allergy by surveying all the national member societies of the World Allergy Organisation, and some of their neighbouring countries. Data were collected from 89 countries, including published data, and changes in the health care burden of food allergy. More than half of the countries surveyed (52/89) did not have any data on food allergy prevalence. Only 10% (9/89) of countries had accurate food allergy prevalence data, based on oral food challenges (OFC). The remaining countries (23/89) had data largely based on parent-reporting of a food allergy diagnosis or symptoms, which is recognised to overestimate the prevalence of food allergy. Based on more accurate measures, the prevalence of clinical (OFC proven) food allergy in preschool children in developed countries is now as high as 10%. In large and rapidly emerging societies of Asia, such as China, where there are documented increases in food allergy, the prevalence of OFC-proven food allergy is now around 7% in pre-schoolers, comparable to the reported prevalence in European regions. While food allergy appears to be increasing in both developed and developing countries in the last 10--15 years, there is a lack of quality comparative data. This survey also highlights inequities in paediatric allergy services, availability of adrenaline auto-injectors and standardised National Anaphylaxis Action plans. In conclusion, there remains a need to gather more accurate data on the prevalence of food allergy in many developed and developing countries to better anticipate and address the rising community and health service burden of food allergy.
Available from: PubMed Central
- "There are only two Asian studies that have evaluated prevalence trends in food allergy. As with the global trend, a study of 0 to 2 year olds from Chongqing, China by Hu et al.  who used the exact same methodology 10 years apart showed that the prevalence of challenge-proven IgE-mediated food allergy has doubled from 3.5% in 1999 to 7.7% in 2009. In contrast, in a study of Korean school-children, based on food allergy symptoms alone, showed little change in prevalence over a 5 year period. "
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ABSTRACT: Asia is a populous and diverse region and potentially an important source of information on food allergy. This review aims to summarize the current literature on food allergy from this region, comparing it with western populations. A PubMed search using strategies "Food allergy AND Asia", "Food anaphylaxis AND Asia", and "Food allergy AND each Asian country" was made. Overall, 53 articles, published between 2005 and 2012, mainly written in English were reviewed. The overall prevalence of food allergy in Asia is somewhat comparable to the West. However, the types of food allergy differ in order of relevance. Shellfish is the most common food allergen from Asia, in part due to the abundance of seafood in this region. It is unique as symptoms vary widely from oral symptoms to anaphylaxis for the same individual. Data suggest that house dust mite tropomysin may be a primary sensitizer. In contrast, peanut prevalence in Asia is extremely low compared to the West for reasons not yet understood. Among young children and infants, egg and cow's milk allergy are the two most common food allergies, with prevalence data comparable to western populations. Differences also exist within Asia. Wheat allergy, though uncommon in most Asian countries, is the most common cause of anaphylaxis in Japan and Korea, and is increasing in Thailand. Current food allergy data from Asia highlights important differences between East and West, and within the Asian region. Further work is needed to provide insight on the environmental risk factors accounting for these differences.
Available from: Motohiro Ebisawa
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ABSTRACT: The 2nd Milan Meeting on Adverse Reactions to Bovine Proteins was the venue for the presentation of the first consensus-based approach to the management of cow's milk allergy. It was also the first time that the Grading of Recommendations, Assessments, Development, and Evaluation approach for formulating guidelines and recommendations was applied to the field of food allergy. In this report we present the contributions in allergen science, epidemiology, natural history, evidence-based diagnosis, and therapy synthesized in the World Allergy Organization Diagnosis and Rationale for Action against Cow's Milk Allergy guidelines and presented during the meeting. A consensus emerged between discussants that cow's milk allergy management should reflect not only basic research but also a newer and better appraisal of the literature in the light of the values and preferences shared by patients and their caregivers in partnership. In the field of diagnosis, atopy patch testing and microarray technology have not yet evolved for use outside the research setting. With foreseeable breakthroughs (eg, immunotherapy and molecular diagnosis) in the offing, the step ahead in leadership can only stem from a worldwide organization implementing consensus-based clinical practice guidelines to diffuse and share clinical knowledge.
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