了解印度北部城乡学童的食物过敏负担。
Understanding the burden of food allergy among urban and rural school children from north India.
作者信息
Sehgal Shruti, Gupta Neeraj, Dadha Priyanka, Nagarajan Shyama, Gupta Ruma, Verma Manju Jain, Ibrahim Khalid, Bilaver Lucy A, Warren Christopher, Sachdev Anil, Nimmagadda Sai R, Gupta Ruchi S
机构信息
Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA.
Department of Pediatric Allergy and Pulmonology, Institute of Child Health, Sir Ganga Ram Hospital, Delhi, India.
出版信息
World Allergy Organ J. 2024 Jun 13;17(6):100916. doi: 10.1016/j.waojou.2024.100916. eCollection 2024 Jun.
BACKGROUND
There is paucity of reliable epidemiological data regarding the burden of food allergy in most developing countries, including India.
OBJECTIVE
To provide current estimates of the prevalence and distribution of food allergy among urban and rural school children aged 6-14 years in Delhi and the National Capital Region (NCR) of Khekra in India.
METHODS
A cross-sectional study was conducted from January 2022 to February 2023 to enroll school children, 6-14 years, from select urban and rural schools in Delhi and NCR. A questionnaire consisting of questions focused on household environment, early life factors, and pediatric food allergy characteristics was administered by a trained medical researcher to collect parent-proxy data. Univariate statistics were used to describe frequencies, percentages, and 95% confidence intervals for survey items.
RESULTS
The estimated prevalence of parent-reported food allergy was 0.8% (95% CI: 0.4-1.5; urban: 0.4%, 95% CI: 0.1-1.1; rural: 1.7%, 95% CI: 0.7-3.5). Fruits such as mango (0.3%, 95% CI: 0.1-0.9), strawberry (0.1%, 95% CI: 0.0-0.7), orange (0.1%, 95% CI: 0.0-0.7), and custard apple (0.1%, 95% CI: 0.0-0.7) were reported only by urban children, while rural children reported yogurt (0.6%, 95% CI: 0.1-1.8) and wheat (0.3%, 95% CI: 0.0-1.3). Both groups reported brinjal (also known as eggplant) and banana, 0.1% (95% CI: 0.0-0.7) of urban and 0.3% (95% CI: 0.0-1.3) of rural, respectively. Overall, commonly reported clinical symptoms were diarrhea and/or vomiting (100%, 95% CI: 76.2-100), abdominal pain (88.9%, 95% CI: 58.6-98.8), and rash/itchy skin (66.7%, 95% CI: 34.8-89.6). Among children with parent reported food allergy, 66.7% (95% CI: 34.8-89.6) of food allergies were physician diagnosed, of which 33.3% were diagnosed via history alone (95% CI:7.7-71.4) while 66.7% (95% CI: 28.6-92.3) were confirmed via skin prick test and/or blood test.
CONCLUSION
The overall prevalence of food allergy is very low in Delhi and Khekra, India. Future work should focus on elucidating the complex interplay of early-life, environmental, genetic, and lifestyle factors to understand the reasons for India's low food allergy burden and improve epidemiological clues to prevention for the nations with higher disease burden.
背景
在包括印度在内的大多数发展中国家，关于食物过敏负担的可靠流行病学数据匮乏。
目的
提供印度德里及印度凯克拉国家首都辖区（NCR）6至14岁城乡学童食物过敏患病率和分布情况的当前估计值。
方法
于2022年1月至2023年2月开展一项横断面研究，以招募德里和NCR选定城乡学校的6至14岁学童。一名经过培训的医学研究人员发放了一份问卷，其中问题聚焦家庭环境、早期生活因素和儿童食物过敏特征，以收集家长代理数据。单变量统计用于描述调查项目的频率、百分比和95%置信区间。
结果
家长报告的食物过敏估计患病率为0.8%（95%置信区间：0.4 - 1.5；城市：0.4%，95%置信区间：0.1 - 1.1；农村：1.7%，95%置信区间：0.7 - 3.5）。芒果（0.3%，95%置信区间：0.1 - 0.9）、草莓（0.1%，95%置信区间：0.0 - 0.7）、橙子（0.1%，95%置信区间：0.0 - 0.7）和番荔枝（0.1%，95%置信区间：0.0 - 0.7）等水果仅城市儿童报告有过敏，而农村儿童报告酸奶（0.6%，95%置信区间：0.1 - 1.8）和小麦（0.3%，95%置信区间：0.0 - 1.3）过敏。两组均报告茄子（也称为矮瓜）和香蕉过敏，城市为0.1%（95%置信区间：0.0 - 0.7），农村为0.3%（95%置信区间：0.0 - 1.3）。总体而言，常见的临床症状为腹泻和/或呕吐（100%，95%置信区间：76.2 - 100）、腹痛（88.9%，95%置信区间：58.6 - 98.8）以及皮疹/皮肤瘙痒（66.7%，95%置信区间：34.8 - 89.6）。在家长报告有食物过敏的儿童中，66.7%（95%置信区间：34.8 - 89.6）的食物过敏由医生诊断，其中33.3%仅通过病史诊断（95%置信区间：7.7 - 71.4），而66.7%（95%置信区间：28.6 - 92.3）通过皮肤点刺试验和/或血液检测确诊。
结论
印度德里和凯克拉的食物过敏总体患病率非常低。未来的工作应聚焦于阐明早期生活、环境、遗传和生活方式因素之间复杂的相互作用，以了解印度食物过敏负担较低的原因，并为疾病负担较高的国家改善预防的流行病学线索。
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