Pediatric allergy and immunology at Siriraj Hospital.

Like other parts of the world, prevalence of childhood allergic diseases in Thailand, particularly of asthma and allergic rhinitis, has risen sharply over the past decade. Epidemiologic studies in this country indicated that allergic sensitization (mainly to house dust mites, cockroaches and cat dander) is the major important risk factor for the development of asthma. House dust mites are the most important source of allergens causing sensitization among allergic Thai children. A nationwide survey indicated that house dust mites are ubiquitous in Thai homes. Despite the authors' earlier finding that mite allergen levels in Thailand (mean group-I allergen level of 11 mcg/g dust), exceeded the recommended international threshold level to induce asthmatic symptoms (10 mcg/g dust), mite allergen levels in homes within the Bangkok area are in the modest range (5 mcg/g dust). With mattresses in Thailand being commonly laid on hardwood surfaces, the authors demonstrated that only top-covering of these mattresses with locally produced mite-impermeable membrane, mite allergens could be substantially reduced. Other active research in pediatric allergy in Thailand include complete surveys of outdoor aeroallergens and research in pharmacologic managements of allergic diseases. The Thailand Registry of Primary Immune Deficiency has recently been established to collect data on patients with these disorders and to improve means for diagnosis and treatment for these unfortunate patients. Finally, with a recent approval for board certification in pediatric allergy and immunology, it is expected that the number of specialists in this field will increase to a sufficient level to provide adequate care for allergic/immunologic children in Thailand.