Yüce Aysel, Dalgıç Buket, Çullu-Çokuğraş Fügen, Çokuğraş Haluk, Kansu Aydan, Alptekin-Sarıoğlu Aysugül, Şekerel Bülent Enis
Department of Pediatric Gastroenterology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Department of Pediatric Gastroenterology, Gazi University Faculty of Medicine, Ankara, Turkey.
Turk J Pediatr. 2017;59(3):233-243. doi: 10.24953/turkjped.2017.03.002.
Yüce A, Dalgıç B, Çullu-Çokuğraş F, Çokuğraş H, Kansu A, Alptekin-Sarıoğlu A, Şekerel BE. Cows milk protein allergy awareness and practice among Turkish pediatricians: A questionnaire-survey. Turk J Pediatr 2017; 59: 233-243. Region-specific recommendations for the prevention, diagnosis, and treatment of cows milk protein allergy (CMPA) are not available in Turkey. This cross-sectional questionnaire-survey was designed to evaluate CMPA awareness and practice among Turkish pediatricians. A total of 410 pediatricians were included based on their voluntary participation. Questionnaires elicited demographic data and pediatricians` awareness and practice of CMPA in infants and children. Atopic dermatitis (91.5%), diarrhea (88.0%) and significant blood in stool (85.9%) were the most common symptoms considered suggestive of CMPA. Continuation of breast feeding via elimination of CMP containing products from maternal diet was the most commonly selected (79.0%) therapeutic option in exclusively breast-fed infants diagnosed with CMPA. Amino acid-based formula was the most commonly selected formula in a non-exclusively breast-fed infant with CMPA, for infants presenting with anaphylaxis (58.8%), enterocolitis (40.7%) or multiple food allergies (52.0%), and also for at-risk infants (40.2%). Earliest time to re-challenge was identified to be 6 months by 52.0% of pediatricians. In conclusion, our findings revealed high awareness of CMPA among Turkish pediatricians in terms of clinical presentation and first priority diagnostic tests. However, CMPA practice among Turkish pediatricians needs to be improved in terms of avoidance of other mammalian milks, selection of therapeutic formulas among non-exclusively breast-fed infants and at-risk infants consistent with guideline-based indications and cost-effectivity.
于塞·A、达尔吉奇·B、库卢-乔库格拉斯·F、乔库格拉斯·H、坎苏·A、阿尔普特金-萨里奥卢·A、塞克雷尔·BE。土耳其儿科医生对牛奶蛋白过敏的认知与实践：一项问卷调查。《土耳其儿科学杂志》2017年；59: 233 - 243。土耳其尚无针对牛奶蛋白过敏（CMPA）预防、诊断和治疗的地区特异性建议。本横断面问卷调查旨在评估土耳其儿科医生对CMPA的认知与实践。基于自愿参与共纳入410名儿科医生。问卷收集了人口统计学数据以及儿科医生对婴儿和儿童CMPA的认知与实践情况。特应性皮炎（91.5%）、腹泻（88.0%）和大便潜血（85.9%）是被认为最提示CMPA的常见症状。对于诊断为CMPA的纯母乳喂养婴儿，最常选择的（79.0%）治疗方案是通过从母亲饮食中去除含CMP的产品来继续母乳喂养。对于非纯母乳喂养且患有CMPA的婴儿、出现过敏反应（58.8%）、小肠结肠炎（40.7%）或多种食物过敏（52.0%）的婴儿以及高危婴儿（40.2%），基于氨基酸的配方奶粉是最常选择的配方奶粉。52.0%的儿科医生确定再次激发的最早时间为6个月。总之，我们的研究结果显示土耳其儿科医生在临床表现和首要诊断检查方面对CMPA有较高认知。然而，在避免使用其他哺乳动物奶、在非纯母乳喂养婴儿和高危婴儿中根据基于指南的指征和成本效益选择治疗性配方奶粉方面，土耳其儿科医生对CMPA的实践仍需改进。
