National University Health System, Singapore, Singapore.
Int Arch Allergy Immunol. 2012;159(4):384-90. doi: 10.1159/000338940. Epub 2012 Jul 27.
Fish allergy is the third most common food allergy after milk and egg in parts of Europe, but there is little data about prevalence in South East Asia where it is an important part of regular diets.
We aimed to obtain an estimate of the population prevalence of fish allergy among older children in the Philippines, Singapore and Thailand.
The population prevalence of fish allergy in 14- to 16-year-old children in the 3 countries was evaluated using a structured written questionnaire which was distributed to students of randomly selected secondary schools. An extended questionnaire to determine convincing fish allergy on the basis of typical clinical manifestations within 2 h of ingestion was administered to those with positive responses.
From a cohort of 25,842 students, responses were 81.1% in the Philippines (n = 11,434), 67.9% in Singapore (n = 6,498) and 80.2% (n = 2,034) in Thailand. Using criteria for convincing food allergy, fish allergy was much higher in the Philippines [2.29%, 95% confidence interval (CI) 2.02-2.56] than in Singapore (0.26%, 95% CI 0.14-0.79) and Thailand (0.29%, 95% CI 0.06-0.52). Weighted multiple logistic regression analyses showed that compared to the Philippines, prevalence rates were lower in Singapore [odds ratio (OR) 0.40, 95% CI 0.27-0.60, p < 0.0001] and Thailand (OR 0.13, 95% CI 0.05-0.33, p < 0.0001). Females were more likely to have fish allergy compared to males for all children combined (OR 1.32, 95% CI 1.11-1.58, p = 0.002). Most allergies appeared mild, as only 28% of cases sought medical consultation at the time of the reaction and 31.2% of cases reported continued exposure despite allergic symptoms.
Fish allergy in late childhood is more common in the Philippines compared to Singapore and Thailand. Differences in food processing, dietary habits and other cultural practices might be important risk factors for the development of fish allergy in these populations.
在欧洲部分地区，鱼类过敏是继牛奶和鸡蛋之后第三大常见的食物过敏，但在东南亚，鱼类过敏的流行程度较低，因为鱼类是当地人们日常饮食的重要组成部分。
我们旨在获得菲律宾、新加坡和泰国 14 至 16 岁儿童中鱼类过敏的人群患病率估计值。
通过向随机选择的中学的学生分发结构化书面问卷，评估这 3 个国家中 14 至 16 岁儿童的鱼类过敏人群患病率。对那些有阳性反应的人进行了扩展问卷，以确定基于摄入后 2 小时内典型临床表现的明确鱼类过敏。
在 25842 名学生中，菲律宾的应答率为 81.1%（n=11434），新加坡为 67.9%（n=6498），泰国为 80.2%（n=2034）。使用明确食物过敏的标准，菲律宾的鱼类过敏率明显高于新加坡[2.29%，95%置信区间（CI）2.02-2.56]和泰国[0.29%，95%CI 0.06-0.52]。加权多因素逻辑回归分析表明，与菲律宾相比，新加坡的流行率较低[比值比（OR）0.40，95%CI 0.27-0.60，p<0.0001]，泰国的流行率较低[OR 0.13，95%CI 0.05-0.33，p<0.0001]。与男性相比，所有儿童中女性更有可能患有鱼类过敏[比值比（OR）1.32，95%CI 1.11-1.58，p=0.002]。大多数过敏反应表现为轻度，因为只有 28%的病例在反应时寻求医疗咨询，而 31.2%的病例尽管有过敏症状仍继续暴露。
与新加坡和泰国相比，菲律宾儿童晚期的鱼类过敏更为常见。食物加工、饮食习惯和其他文化习俗的差异可能是这些人群中鱼类过敏发展的重要危险因素。
