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亚太地区食物过敏和过敏反应管理的现状与差距

Perspectives and gaps in the management of food allergy and anaphylaxis in the Asia-Pacific Region.

作者信息

Leung Agnes Sze Yin, Pawankar Ruby, Pacharn Punchama, Wong Lydia Su Yin, Le Pham Duy, Chan Grace, Rengganis Iris, Zhao Jing, Wang Jiu Yao, Woo Kent Chee-Keen, Ito Komei, Jeong Kyunguk, Recto Marysia, Lucas Michaela, Nagao Mizuho, Lobo Rommel Crisenio M, Munkhbayarlakh Sonomjamts, Sumadiono Sumadiono, Huq Syed Rezaul, Ranasinghe Thushali, Tang Mimi

机构信息

Department of Paediatrics, Prince of Wales Hospital, Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China.

Division of Allergy, Department of Pediatrics, Nippon Medical School, Tokyo, Japan.

出版信息

J Allergy Clin Immunol Glob. 2023 Dec 23;3(2):100202. doi: 10.1016/j.jacig.2023.100202. eCollection 2024 May.

Abstract

BACKGROUND

Food allergy (FA), which is a condition that has no effective cure and can result in severe life-threatening allergic reactions, remains a global public health concern; however, little is known about how FAs are currently managed in the Asia-Pacific region.

OBJECTIVE

The main objective of this survey was to evaluate the epidemiology of FA, as well as the availability of resources and practices for management of FA and anaphylaxis by health care providers across Asia.

METHODS

From June 2022 to September 2022, a questionnaire-based survey comprising 66 questions was electronically sent to member societies of the Asia Pacific Association of Allergy Asthma and Clinical Immunology by using Survey Monkey.

RESULTS

A total of 20 responses were received from 15 member countries and territories. Compared with the pediatric data, there was a lack of prevalence data for FA in adults. Except for Australia and Japan, most regions had between 0.1 and 0.5 allergists per 100,000 population and some had fewer than 0.1 allergists per 100,000 population. The perceived rate of FA in regions with a short supply of allergists was high. Although specific IgE tests and oral food challenges were available in all regions, the median wait time for oral food challenges at government facilities was 37 days (interquartile range = 10.5-60 days). Seven regions still relied on prescriptions of ampules and syringes of injectable adrenaline, and adrenaline autoinjectors were not accessible in 4 regions. Oral immunotherapy as FA treatment was available in half of the surveyed countries and territories.

CONCLUSIONS

Our study offers a cross-sectional evaluation of the management practices for FA in each Asia Pacific Association of Allergy Asthma and Clinical Immunology member country or territory. Urgent actions are required to enhance allergy services, improve the accessibility and affordability of adrenaline autoinjectors, and conduct robust epidemiologic studies.

摘要

背景

食物过敏(FA)是一种尚无有效治愈方法且可导致严重的危及生命的过敏反应的疾病,仍然是一个全球公共卫生问题;然而,对于亚太地区目前如何管理食物过敏,人们知之甚少。

目的

本次调查的主要目的是评估食物过敏的流行病学情况,以及亚洲各地医疗保健提供者管理食物过敏和过敏反应的资源可用性及实践情况。

方法

2022年6月至2022年9月,通过Survey Monkey以电子方式向亚太过敏、哮喘与临床免疫学会的成员协会发送了一份包含66个问题的问卷调查。

结果

共收到来自15个成员国和地区的20份回复。与儿科数据相比,成人食物过敏的患病率数据不足。除澳大利亚和日本外,大多数地区每10万人口中过敏症专科医生不足0.5名,有些地区每10万人口中过敏症专科医生不足0.1名。过敏症专科医生供应短缺地区的食物过敏感知率较高。虽然所有地区都有特异性IgE检测和口服食物激发试验,但政府机构口服食物激发试验的中位等待时间为37天(四分位间距=10.5 - 60天)。7个地区仍依赖注射用肾上腺素安瓿和注射器的处方,4个地区无法获得肾上腺素自动注射器。一半的被调查国家和地区有口服免疫疗法作为食物过敏的治疗方法。

结论

我们的研究对亚太过敏、哮喘与临床免疫学会每个成员国或地区的食物过敏管理实践进行了横断面评估。需要采取紧急行动来加强过敏服务,提高肾上腺素自动注射器的可及性和可负担性,并开展有力的流行病学研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f64/10818080/dbe6b73baf0f/gr1.jpg

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