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Age and Seasonal Variation in Allergen Sensitivity Among Children: A Comprehensive Analysis of Food and Environmental
Bilal Hashmi1, Asma Sherazi2, Lena Jafri1
1Pathology and Laboratory Medicine, Aga Khan University, Karachi, PAK.
Insights
Pediatric allergy testing reveals dust mites are common environmental allergens, while egg and shrimp are frequent food allergens. Sensitization patterns vary by age, with younger children more prone to environmental allergens and adolescents to food allergens.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Laboratory Science
- Epidemiology
Background:
- Allergic conditions significantly contribute to global pediatric morbidity.
- Limited data exist on age-related and seasonal allergen sensitization patterns in low- and middle-income countries.
- Understanding these patterns is crucial for effective pediatric allergy management.
Purpose of the Study:
- To evaluate the frequency and seasonal variation of food and environmental allergen sensitization in children.
- To analyze age- and sex-related differences in allergen-specific IgE positivity.
- To provide region-specific insights into pediatric allergen sensitization.
Main Methods:
- Retrospective, cross-sectional, laboratory-based study of 2,796 pediatric patients (<18 years).
- Analysis of specific IgE levels for six food and eight environmental allergens using the IMMULITE® 2000 system.
- Statistical assessment of associations between allergen positivity, age, sex, and season.
Main Results:
- Dust mites (Dermatophagoides species) were the most prevalent environmental allergens (over 50%).
- Egg white and shrimp were the most common food allergens (around 30%).
- Environmental allergen sensitization was higher in younger children; food allergen sensitization peaked in adolescents (11-18 years).
- Higher overall allergen positivity was observed in males.
- Increased sensitization occurred during autumn and winter months.
Conclusions:
- The study characterizes age- and season-dependent patterns of allergen sensitization in a Pakistani pediatric cohort.
- Findings reflect immunologic sensitization, not confirmed clinical allergy or population prevalence.
- These data offer valuable region-specific insights for clinical evaluation and patient counseling.
Abstract:
Background Allergic conditions, particularly food and environmental allergies, are increasingly recognized as important contributors to pediatric morbidity worldwide. However, data describing age-related and seasonal patterns of allergen sensitization in children from low- and middle-income countries remain limited. This retrospective, cross-sectional, laboratory-based study aimed to evaluate the frequency and seasonal variation of food and environmental allergen sensitization among children undergoing allergen-specific IgE testing. Methods A total of 2,796 pediatric patients (1,676 males and 1,120 females) under 18 years of age who underwent allergen-specific IgE testing between January 2013 and July 2023 were included. Participants were categorized into four age groups: <1, 2-5, 6-10, and 11-18 years. Six food allergens and eight environmental allergens were analyzed using the IMMULITE® 2000 system (Siemens Healthcare Diagnostics Inc., Deerfield, IL, USA) with 3gAllergy® kits. Specific IgE ≥0.35 kU/L was considered positive. Associations between allergen positivity, age, sex, and season were assessed using chi-square and Kruskal-Wallis tests. Results Dermatophagoides farinae (52.5%) and Dermatophagoides pteronyssinus (52.1%) were the most frequently detected environmental allergens, while egg white (30%) and shrimp (28.7%) were the most common food allergens. Environmental allergen positivity was higher in younger children, whereas food allergen positivity peaked in adolescents (11-18 years). Male participants demonstrated higher overall allergen positivity rates. Significant seasonal variation was observed, with increased sensitization during autumn and winter months. Conclusions This study characterizes patterns of allergen sensitization within a clinically tested pediatric cohort in Pakistan, demonstrating age- and season-related variation in allergen-specific IgE positivity. As a laboratory-based analysis, the findings reflect immunologic sensitization rather than confirmed clinical allergy and should not be interpreted as population-level prevalence. These data provide region-specific insights that may support clinical evaluation and patient counseling in similar settings.
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