Inhalant allergies in Zimbabwe: a common problem

Allergic rhinitis, allergic conjunctivitis, allergic asthma and atopic dermatitis affect a quarter of the population of the industrialised countries and are the most common symptoms of type I hypersensitivity reactions. Their prevalence has been documented in many communities, yet data from Africa are limited. In the 5-year period from September 1997 to September 2002, approximately 14,000 patients of all ages were referred to the only specialist allergy clinic in Harare, Zimbabwe, for allergy investigation, diagnosis and therapeutic management. In approximately one tenth of these patients, food allergies were diagnosed; less frequent presentations included allergic pharyngitis, bee- or wasp-induced reactions and latex allergy. An allergologic basis for the clinical conditions was established following a careful clinical and physical examination, evaluation of family history and the detection of in vivo (skin prick test) or in vitro (radio-allergo-sorbent test; RAST) allergen-specific IgE antibodies to known sources of inhalant allergens, using commercial allergen extracts and a RAST assay kit. Asthma diagnosis was supported by the clinical and laboratory findings of salbutamol-reversible airways obstruction. Case files of the first 1,046 patients are reviewed in order to define the clinical presentation of allergic patients in this region. It is highlighted that allergy in general and inhalant allergy in particular are very common, if not widely acknowledged, clinical problems in this Central African region.