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Published on: April 21, 2019
Real-life epidemiology of food allergy testing in Finnish children
Kaisa Pyrhönen1, Liisa Hiltunen, Simo Näyhä
1Institute of Health Sciences, University of Oulu, Oulu, Finland. kaisa.pyrhonen@oulu.fi
Insights
Many young children undergo food allergy (FA) testing, with 18% tested by age four. Boys and children with a family history of allergies were more likely to be tested for FA.
Area of Science:
- Pediatric Allergy and Immunology
- Public Health Research
- Diagnostic Practices
Background:
- Parental-reported food allergy (FA) symptoms affect over 30% of young children.
- The frequency and reasons for FA testing in the general pediatric population were previously unknown.
Purpose of the Study:
- To determine the incidence and patterns of food allergy testing in young children.
- To identify factors associated with FA testing in a general child population.
Main Methods:
- A population-based study in South Karelia, Finland, included 5920 children aged 0-4 years.
- Data were collected via questionnaires and retrospective review of FA test results (skin prick tests, IgE, food challenges).
- Questionnaire and patient record data were linked individually with parental consent.
Main Results:
- A total of 5849 FA tests were performed on 961 children; cumulative FA testing incidence reached 18% by age four.
- Testing for essential foods (milk, egg, cereals) occurred in 17% of children, and 90% of those with diagnosed FA for these items were tested.
- Boys had 30% higher testing incidence than girls, and children with parental allergies were twice as likely to be tested.
Conclusions:
- A significant proportion of children undergo food allergy testing in early childhood.
- Findings highlight the need to assess the economic impact of FA testing and optimize current diagnostic approaches.
Background:
The cumulative incidence of parental-reported symptoms of food allergy (FA) during the first years of life is estimated to exceed 30%. However, the occurrence and determinants of FA testing in a general child population have remained unknown.
Methods:
The study population comprised all 5920 children aged 0-4 yr in the province of South Karelia, Finland, identified from the nationwide population register. The study included a questionnaire survey and a retrospective collection of FA test results (skin prick tests, IgE antibodies, or open food challenges) from the patient records of the entire study population. The questionnaire and patient record data were linked together on an individual basis with the parents' permission.
Results:
A total of 5849 FA tests had been performed on 961 children. By the age of 4 yr, the cumulative incidence of FA testing was 18% for any food item; 17% for essential items (milk, egg, cereals) and 9% for other food items. Essential food items had been tested in 90% of children who reportedly had a physician-diagnosed FA for these. The incidence of testing was 30% higher in boys than in girls and twofold higher among the offspring whose either or both parents reportedly had some allergic manifestation.
Conclusions:
A large proportion of children are subjected to FA testing in their early years. This result shows the need to evaluate the financial burden of FA testing and to improve current testing practices.
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