Food allergy in South African children with atopic dermatitis
Corresponding Author
Claudia L. Gray
Division of Allergology, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
Correspondence
Claudia Gray, MBChB, MSc, FRCPCH, DipAllergy, DipPaedNutrition, Department of Allergology, Red Cross War Memorial Children's Hospital, Klipfontein Road, Cape Town, 7700, South Africa.
Tel.: +27 (0) 21 5318013
Fax: +27 21 5319576
E-mail: [email protected]
Search for more papers by this authorMichael E. Levin
Division of Allergology, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
Search for more papers by this authorHeather J. Zar
Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
Search for more papers by this authorPaul C. Potter
Allergy Diagnostic and Clinical Research Unit, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
Search for more papers by this authorNonhlanhla P. Khumalo
Division of Dermatology, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
Search for more papers by this authorLucia Volkwyn
Division of Allergology, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
Search for more papers by this authorBartha Fenemore
Allergy Diagnostic and Clinical Research Unit, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
Search for more papers by this authorGeorge du Toit
MRM & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, King's Health Partners, London, UK
Department of Paediatric Allergy, Guy's and St Thomas’ NHS Foundation Trust, London, UK
Search for more papers by this authorCorresponding Author
Claudia L. Gray
Division of Allergology, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
Correspondence
Claudia Gray, MBChB, MSc, FRCPCH, DipAllergy, DipPaedNutrition, Department of Allergology, Red Cross War Memorial Children's Hospital, Klipfontein Road, Cape Town, 7700, South Africa.
Tel.: +27 (0) 21 5318013
Fax: +27 21 5319576
E-mail: [email protected]
Search for more papers by this authorMichael E. Levin
Division of Allergology, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
Search for more papers by this authorHeather J. Zar
Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
Search for more papers by this authorPaul C. Potter
Allergy Diagnostic and Clinical Research Unit, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
Search for more papers by this authorNonhlanhla P. Khumalo
Division of Dermatology, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
Search for more papers by this authorLucia Volkwyn
Division of Allergology, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
Search for more papers by this authorBartha Fenemore
Allergy Diagnostic and Clinical Research Unit, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
Search for more papers by this authorGeorge du Toit
MRM & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, King's Health Partners, London, UK
Department of Paediatric Allergy, Guy's and St Thomas’ NHS Foundation Trust, London, UK
Search for more papers by this authorAbstract
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.
Supporting Information
| Filename | Description |
|---|---|
| pai12270-Sup-0001-Supinfo.docxWord document, 32.3 KB | Data S1. Food-induced flares in AD. Data S2. Previous diagnosis of food allergy. Data S3. Peanut consumption patterns. Table S1. Studies on food challenge-proven food allergies in atopic dermatitis. Table S2. Definition of atopic dermatitis. Table S3. Criteria for determining the outcome of food challenges. Table S4. Summary of test results and clinical findings in patients who were classified as allergic but did not undergo a food challenge. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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