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Pediatric allergy and immunology at Siriraj Hospital
1Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Insights
Childhood asthma and allergic rhinitis are increasing in Thailand. Mite-impermeable mattress covers significantly reduce house dust mite allergens, a key asthma risk factor in Thai children.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Epidemiology
Background:
- Childhood allergic diseases, including asthma and allergic rhinitis, show a rising prevalence in Thailand.
- Allergic sensitization, primarily to house dust mites, cockroaches, and cat dander, is a significant risk factor for asthma development in Thai children.
- House dust mites are identified as the predominant allergen source causing sensitization in allergic Thai children, with widespread presence in homes.
Purpose of the Study:
- To investigate the prevalence and risk factors of childhood allergic diseases in Thailand.
- To assess the effectiveness of mite-impermeable mattress covers in reducing house dust mite allergen levels.
- To highlight ongoing research and developments in pediatric allergy and immunology in Thailand.
Main Methods:
- Epidemiologic studies to identify risk factors for allergic sensitization and asthma.
- Nationwide surveys to determine the ubiquity and levels of house dust mites in Thai homes.
- Intervention study evaluating the impact of mite-impermeable mattress covers on allergen reduction.
Main Results:
- House dust mite allergen levels in Thailand generally exceed international thresholds, though Bangkok homes show moderate levels.
- Top-covering mattresses with locally produced mite-impermeable membranes substantially reduced mite allergens.
- Research is also active in outdoor aeroallergens and pharmacologic management of allergic diseases.
Conclusions:
- House dust mite control, particularly through mattress encasement, is a viable strategy to mitigate asthma risk in allergic Thai children.
- Continued research and the establishment of specialized care (e.g., Thailand Registry of Primary Immune Deficiency, board certification) are crucial for advancing pediatric allergy and immunology in Thailand.
Abstract:
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.