Abstract
BackgroundAllergic diseases are considered to be some of the fastest growing chronic conditions in Africa. Of concern is the paucity of knowledge about the local environment and its role in allergic disease development. In response to this, we explored whether Imbrasia belina, a popular indigenous edible insect commonly known as mopane worm, is a potential allergen of clinical and public health significance in Zimbabwe. This study was intended to assess the plausibility and feasibility of this hypothesis with a view to evaluate the insect’s health impact in a larger study.MethodsThe study participants included male and female villagers aged 10 years and above in Gwanda district, Zimbabwe. Eligible participants who completed the household questionnaire were referred to the local clinic for skin prick tests and to measure lung function and allergic airway inflammation. Allergen sensitisation patterns were evaluated using 10 different inhalant allergen extracts including an in-house preparation of mopane worm. Lung function was measured with a Koko Legend spirometer, and fractional exhaled nitric oxide levels (FeNO) (NIOX VERO) were measured in participants with at least one abnormal spirometric parameter. Data was analysed using Stata version 13 software.ResultsOf the 46 eligible participants that completed the household questionnaire, 17 went to the clinic giving a response rate of 37%. The majority who completed the questionnaire were adults (91%) and the children (9%) were all female. The prevalence of sensitisation to Imbrasia belina was 50%, and the prevalence ranged from 22 to 72% for the other allergens including cockroach, mosquito and house dust mites. The data collection tools were safe and well tolerated by participants with no adverse events reported. Self-reported respiratory symptoms, abnormal lung function and elevated FeNO were recorded amongst participants sensitised to mopane worm.ConclusionPre-defined feasibility criteria were met with the exception of a lower than expected response rate for clinic data collection in this pilot study. For the main study, modifying the sampling strategy and applying more consistent community engagement will improve the response rates.
Highlights
Allergic diseases are considered to be some of the fastest growing chronic conditions in Africa
It is in response to this logic that we considered exploring whether mopane worm could potentially be an allergen of clinical and public health significance in Zimbabwe, in communities where exposure is very high
On the 13th of November 2019, 46 eligible participants living within a 1-km radius of the clinic selected for this study completed the household questionnaire giving a recruitment rate of 100% against the set target
Summary
Allergic diseases are considered to be some of the fastest growing chronic conditions in Africa. Of concern is the paucity of knowledge about the local environment and its role in allergic disease development. There is a paucity of published epidemiological information about allergic diseases in Africa despite the rapidly increasing burden [1]. This is largely due to limited funding and expertise in allergy research [2] as well as the prioritisation of infectious diseases such as HIV/ AIDS, tuberculosis, malaria and recently COVID-19. There are many local exposures whose role as important allergens is yet to be investigated and documented [11]. To make progress towards understanding the allergy epidemic in Africa requires careful consideration of the contextually relevant risk factors
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