Identification of aero-allergen sensitization in children seeking treatment for bronchial asthma at a tertiary care hospital for children in Sri Lanka.

Mp Senanayake,Gn Malavige,D Ratnayake,Jassk Jayasinghe,V Jayasuriya,R De Silva,Mdcjp Jayamanna

doi:10.4038/cmj.v59i3.7469

Abstract

Despite a significant rise in asthma globally as well as in Sri Lanka, data regarding allergen sensitization patterns and other risk factors for asthma are not available. Therefore, we set out to determine the allergen sensitization patterns in children with asthma in Sri Lanka. Skin prick testing for common indoor aeroallergens (cockroach, cat, dog, house dust mite, moulds) were carried out in 156 children with bronchial asthma at Lady Ridgeway Hospital for Children. 49.1% of the patients were sensitized to at least one allergen and 6.4% were sensitized to three or more allergens. Of the children 37.8% tested positive to house dust mite, 23.7% to cockroach, 5.8% to indoor moulds, 12.2% to cats and 8.9% to dogs. Allergen sensitization was significantly less in children aged four years or younger than in older children (p<0.0001). A family history of asthma or allergic rhinitis (AR) was a significant risk factor (p<0.0001) for allergen sensitization (OR 10.9, 95% CI 3.9 to 30.1). Frequency of symptoms was significantly higher in those who used firewood alone compared to those who used other fuels (OR 2.5, 95% CI 1.1 to 5.8). Sensitization to aero-allergens was seen in a majority of children with asthma. Sensitization was significantly more in children above 4 years of age. Patients with more frequent symptoms and with AR were more likely to be sensitized to allergens.

Highlights

Asthma, atopic dermatitis (AD), allergic rhinitis (AR), allergic conjunctivitis and food allergies are a significant cause of morbidity and mortality
In this study we have determined the indoor aeroallergen sensitization patterns in children with asthma and allergic rhinitis living in Colombo, Sri Lanka
We found that 49.3% of children were sensitized to at least one allergen and that the patterns of aeroallergen sensitization was similar to temperate climates, with 37.8% of patients demonstrating sensitization to house dust mite (HDM) and 23.7% showing sensitization to cockroach

Summary

Introduction

Atopic dermatitis (AD), allergic rhinitis (AR), allergic conjunctivitis and food allergies are a significant cause of morbidity and mortality Such diseases, which are regarded as IgE antibody mediated diseases, occur due to sensitization to common environmental allergens [1]. The European Asthma Paediatric Group has recommended allergen testing in those who are likely to have allergen induced asthma, because identifying the asthma phenotype is important in patient management [5]. All these guidelines state that aeroallergens should be identified and avoided wherever possible

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