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Paediatric food allergy trends in a community-based specialist allergy practice, 1995-2006
1John James Medical Centre, Canberra, ACT, Australia. rmullins@allergycapital.com.au
Insights
Demand for pediatric food allergy services surged over a decade, with food allergy cases increasing twelvefold in children under six. This highlights an urgent need for epidemiological studies and public health planning in Australia.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology
- Public Health
Background:
- Specialist food allergy services are crucial for diagnosing and managing allergic conditions in young children.
- Understanding trends in demand for these services can serve as an indicator of changing food allergy prevalence.
- The Australian Capital Territory provides a specific geographical focus for this study.
Purpose of the Study:
- To investigate the changes in demand for specialist food allergy services for children aged 0-5 years between 1995 and 2006.
- To use this demand as an index for assessing shifts in the prevalence of food allergy in this age group.
- To compare these trends with national hospital morbidity data.
Main Methods:
- Retrospective analysis of 1489 children aged 0-5 years referred to a community-based specialist allergy practice.
- Examination of trends in demand for food allergy assessments, dietary triggers, and severity over 12 years.
- Comparison with Australian hospital admission data for anaphylaxis.
Main Results:
- Food allergy was diagnosed in 47% of children seen, with peanut, egg, cow's milk, and cashew being common allergens.
- Annual demand for evaluations in children aged 0-5 years increased over fourfold from 1995 to 2006.
- The proportion of children diagnosed with food allergy rose from 20.0% to 57.5%, with a twelvefold increase in cases; food anaphylaxis also significantly increased.
- Hospital admission rates for anaphylaxis in children aged 0-4 years showed a similar substantial rise.
Conclusions:
- There is a critical need for systematic epidemiological research on food allergy in Australia to identify risk factors and inform public health strategies.
- The apparent increase in food allergy prevalence has significant implications for public health, workforce planning, and the availability of allergy services.
- Coordinated studies are essential to guide policy and resource allocation for managing childhood food allergies.
Objective:
To examine changing demand for specialist food allergy services for children aged 0-5 years over the 12 years from 1995 to 2006 as an index of changing prevalence.
Design, Setting And Participants:
Retrospective analysis of the records of 1489 children aged 0-5 years referred to a community-based specialist allergy practice in the Australian Capital Territory (population, about 0.33 million).
Main Outcome Measures:
Trends in demand for assessment for food allergy, dietary triggers and severity over 12 years, compared with Australian hospital morbidity data.
Results:
47% (697/1489) of 0-5 year-old children seen in private practice had food allergy (175 with food-associated anaphylaxis), most commonly to peanut, egg, cows milk and cashew. Over 12 years, the number of children in this age group evaluated each year increased more than fourfold, from 55 cases in 1995 to 240 in 2006. There was no change in the proportion diagnosed with allergic rhinitis in 1995 and 2006 (14.5% and 13.3%, respectively), urticaria (14.5% and 12.9%) or atopic eczema (54.5% and 57.0%). By contrast, the proportion with asthma dropped from 33.7% in 1995 to 12.5% in 2006 and the number with food allergy increased 12-fold, from 11 to 138 patients (and from 20.0% to 57.5% of children seen) The number with food anaphylaxis increased from five to 37 children (9.0% to 15.4%) over the same period. There were similar trends in age-adjusted Australian hospital admission rates for anaphylaxis in children aged 0-4 years, which increased from 39.3 to 193.8 per million population between the financial years 1993-94 and 2004-05, a substantially greater increase than for older age groups, or for the population as a whole (36.2 to 80.3 per million population).
Conclusions:
There is an urgent need for coordinated systematic studies of the epidemiology of food allergy in Australia, to ascertain risk factors and guide public health policy. An increased prevalence of food allergy has implications for public health and medical workforce planning and availability of allergy services in Australia.
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