15 research outputs found
Frequency of food allergy in Europe:an updated systematic review and meta-analysis
Food allergy (FA) is increasingly reported in Europe, however, the latest prevalence estimates were based on studies published a decade ago. The present work provides the most updated estimates of the prevalence and trends of FA in Europe. Databases were searched for studies published between 2012 and 2021, added to studies published up to 2012. In total, 110 studies were included in this update. Most studies were graded as moderate risk of bias. Pooled lifetime and point prevalence of self-reported FA were 19.9% (95% CI 16.6â23.3) and 13.1% (95% CI 11.3â14.8), respectively. The point prevalence of sensitization based on specific IgE (slgE) was 16.6% (95% CI 12.3â20.8), skin prick test (SPT) 5.7% (95% CI 3.9â7.4), and positive food challenge 0.8% (95% CI 0.5â0.9). While lifetime prevalence of self-reported FA and food challenge positivity only slightly changed, the point prevalence of self-reported FA, sIgE and SPT positivity increased from previous estimates. This may reflect a real increase, increased awareness, increased number of foods assessed, or increased number of studies from countries with less data in the first review. Future studies require rigorous designs and implementation of standardized methodology in diagnosing FA, including use of double-blinded placebo-controlled food challenge to minimize potential biases
Prevalence estimates of eight big food allergies in Europe: Updated systematic review and meta-analysis
In 2014, the European Academy of Allergy and Clinical Immunology published prevalence estimates for food allergy (FA) and food sensitization (FS) to the so-called eight big food allergens (i.e. cow's milk, egg, wheat, soy, peanut, tree nuts, fish and shellfish) in Europe for studies published between 2000 and 2012. The current work provides 10-year updated prevalence estimates for these food allergens. A protocol was registered on PROSPERO before starting the research (reference number CRD42021266657). Six databases were searched for studies published 2012â2021, added to studies published up to 2012, resulting in a total of 93 studies. Most studies were graded as at moderate risk of bias. The overall pooled estimates for all age groups of self-reported lifetime prevalence were as follows: cow's milk (5.7%, 95% confidence interval 4.4â6.9), egg (2.4%, 1.8â3.0), wheat (1.6%, 0.9â2.3), soy (0.5%, 0.3â0.7), peanut (1.5%, 1.0â2.1), tree nuts (0.9%, 0.6â1.2), fish (1.4%, 0.8â2.0) and shellfish (0.4%, 0.3â0.6). The point prevalence of food challenge-verified allergy were as follows: cow's milk (0.3%, 0.1â0.5), egg (0.8%, 0.5â1.2), wheat (0.1%, 0.01â0.2), soy (0.3%, 0.1â0.4), peanut (0.1%, 0.0â0.2), tree nuts (0.04%, 0.02â0.1), fish (0.02%, 0.0â0.1) and shellfish (0.1%, 0.0â0.2). With some exceptions, the prevalence of allergy to common foods did not substantially change during the last decade; variations by European regions were observed
âHelping Mentally Ill, a Reward Both in this Life and Afterâ: A Qualitative Study Among Community Health Professionals in Somaliland
This study aimed to describe the experiences of community mental health workers, predominantly female, nurses and doctors providing community-based mental health services in Borama, Somaliland. A qualitative explorative study using focus group discussions was conducted. Data were collected from three focus group discussions with 22 female community health workers, two medical doctors, and two registered nurses and analyzed using content analysis with an inductive approach. Three main categories were identified from the analysis: (1) bridging the mental health gap in the community; (2) working in a constrained situation; and (3) being altruistic. Overall, the community mental health workers felt that their role was to bridge the mental health gap in the community. They described their work as a rewarding and motivated them to continue despite challenges and improving community healthcare workers' work conditions and providing resources in mental health services will contribute to strengthening mental health services in Somaliland.
Sibship size, birth order and risk of asthma and allergy: protocol for a systematic review and meta-analysis
Introduction The hygiene hypothesis suggests that reduced exposure to microbes might have contributed to the increase in prevalence and incidence of asthma and allergy observed during the second half of the last century. Following this proposal, several studies have investigated the role of sibship size and birth order in the development of asthma and allergic diseases, but the underlying evidence is conflicting. The objective of the present systematic review will be to identify, critically appraise and synthesise previous primary studies investigating the association of sibship size and birth order with the risk of asthma and allergic diseases. Methods and analysis The following databases will be searched: AMED, CABI, CINAHL, Embase, Google Scholar, OAIster, Open Access Theses and Dissertations, Open Grey, ProQuest Dissertations & Theses Global, PsycINFO, PubMed, SciELO, Scopus, Web of Science and WHO Global Index Medicus. Studies published up until 31 December 2020 will be eligible. There will be no restrictions by language and geographical location. Risk of bias in the included studies will be assessed using the Effective Public Health Practice Project quality assessment tool. The produced evidence will be synthesised narratively, and studies that present comparable numerical data will be included in meta-analyses using random effects model. Ethics and dissemination Only data from the published literature will be included in this systematic review. Therefore, no ethical approval is required. The final review paper will be published in a peer-reviewed journal. PROSPERO registration number CRD42020207905
Siblings and risk of allergic rhinitis : A systematic review and meta-analysis
Following the âhygiene hypothesisâ and the increase in the prevalence of atopic diseases such as allergic rhinitis, a plethora of studies have investigated the role of sibship composition as a protective factor, but findings are conflicting. The aim of this study was to synthesize the global literature linking birth order and sibship size (number of siblings) to the risk of allergic rhinitis. Fifteen databases were systematically searched, with no restrictions on publication date or language. Observational studies with defined sibship composition (birth order or sibship size) as exposure and allergic rhinitis or allergic rhinoconjunctivitis (self-reported or clinically diagnosed) as outcome were eligible. Study selection, data extraction, and quality assessment were performed independently in pairs. Relevant data were summarized in tables. Comparable numerical data were analyzed using meta-analysis with robust variance estimation (RVE). Seventy-six reports with >2 million subjects were identified. Being second- or later-born child was associated with protection against both current (pooled risk ratio [RR] 0.79, 95% CI 0.73â0.86) and ever (RR 0.77, 95% CI 0.68â0.88) allergic rhinitis. Having siblings, regardless of birth order, was associated with a decreased risk of current allergic rhinitis (RR 0.89, 95% CI 0.83â0.95) and allergic rhinoconjunctivitis (RR 0.92, 95% CI 0.86â0.98). These effects were unchanged across age, time period, and geographical regions. Our findings thus indicate that primarily, a higher birth order, and to a lesser extent the number of siblings, is associated with a lower risk of developing allergic rhinitis.publishedVersionPeer reviewe
Is sibship composition a risk factor for childhood asthma? Systematic review and meta-analysis
Background: Following the âhygiene hypothesisâ, the role of sibship composition in asthma and wheezing has been extensively studied, but the findings are inconsistent. For the first time, this systematic review and meta-analysis synthesized evidences from studies investigating the association of sibship size and birth order with risk of asthma and wheezing. Methods: Fifteen databases were searched to identify eligible studies. Study selection and data extraction were performed independently by pairs of reviewers. Meta-analysis with robust variance estimation (RVE) was used to produce pooled risk ratio (RR) effect estimates from comparable numerical data. Results: From 17,466 identified records, 158 reports of 134 studies (> 3 million subjects) were included. Any wheezing in the last †1.5 years occurred more frequently in infants with â„ 1 sibling [pooled RR 1.10, 95% confidence interval (CI) 1.02â1.19] and â„ 1 older sibling (pooled RR 1.16, 95% CI 1.04â1.29). The pooled effect sizes for asthma were overall statistically nonsignificant, although having â„ 1 older sibling was marginally protective for subjects aged â„ 6 years (pooled RR 0.93, 95% CI 0.88â0.99). The effect estimates weakened in studies published after 2000 compared with earlier studies. Conclusions: Being second-born or later and having at least one sibling is associated with a slightly increased risk of temporary wheezing in infancy. In contrast, being second-born or later is associated with marginal protection against asthma. These associations appear to have weakened since the turn of the millennium, possibly due to lifestyle changes and socioeconomic development. [MediaObject not available: see fulltext.
Birth order, sibship size, and risk of atopic dermatitis, food allergy, and atopy: A systematic review and metaâanalysis
Abstract Background Atopic dermatitis and food allergy are two frequently concomitant manifestations of the presence of atopy. A substantial number of studies have been published on the association of birth order and sibship size (number of siblings) with atopic dermatitis, food allergy, and atopy. The present work is the first systematic synthesis of the existing literature on this topic. Methods Fifteen databases were searched. Screening, data extraction, and quality assessment were performed by independent pairs. Comparable numerical data were statistically synthesized using randomâeffects robust variance estimation. Results In total, 114 studies were included out of 8819 papers obtained from database searches. Birth order â„2 versus 1 was associated with lower risk of ever atopic dermatitis (pooled risk ratio [RR] 0.91, 95% CI 0.84â0.98), current food allergy (RR 0.77, 95% CI 0.66â0.90), and positive skin prick test (SPT) to common aeroallergens (RR 0.86, 95% CI 0.77â0.97). Sibship size â„2 versus 1 was associated with decreased risk of current atopic dermatitis (RR 0.90, 95% CI 0.83â0.98), ever atopic dermatitis (RR 0.92, 95% CI 0.86â0.97), and positive SPT to common aeroallergens (RR 0.88, 95% CI 0.83â0.92). No putative associations were seen regarding atopy assessed through allergenâspecific immunoglobulin E with common allergens. Conclusion The presence of siblings and being secondâborn or later may decrease the lifetime risk of atopic dermatitis and food allergy, albeit marginally. Similar association was seen with SPT sensitization. However, significant protection was not found for IgE sensitization
Prevalence of sensitization to molecular food allergens in Europe: A systematic review
Abstract Background Recent reports indicate that the prevalence of food allergy is increasing, but accurate estimates remain a challenge due to crossâreactivity and limited use of precise diagnostic methods. Molecular allergy diagnostics, in which sensitization to individual molecular allergens is measured, is emerging as a promising tool for evaluation of sensitization profiles. In this systematic review, we summarized estimates of prevalence of sensitization to molecular food allergens in the general population in Europe. Methods Following a protocol prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO; reference CRD42021266657), we searched seven databases with no restrictions on publication date or language. Two reviewers independently screened the literature, extracted data, and appraised the risk of bias in the included studies. The findings were synthesized narratively. Results From 4776 deâduplicated records, five studies, with low to moderate overall risk of bias, were included. Fortyâsix molecular allergens from 18 foods were investigated. Overall, the prevalence of sensitization was low, particularly for major allergens, and nonâexistent for 10 molecular allergens (0% [95% CI 0â0.8]). The highest prevalence was seen for PRâ10 proteins, such as Cor a 1.04 (13.6% [95% CI 10.9â16.9]). Conclusions Available data, primarily from Northâwestern Europe, indicate that sensitization to molecular food allergens is overall low. The highest estimates were found for crossâreactive PRâ10 proteins. There were not enough studies to discern regional differences or perform metaâanalysis, highlighting the need for more populationârepresentative studies in order to elucidate patterns of sensitization to molecular food allergens in Europe
Prevalence of sensitization to molecular food allergens in Europe: A systematic review
Background: Recent reports indicate that the prevalence of food allergy is increasing, but accurate estimates remain a challenge due to cross-reactivity and limited use of precise diagnostic methods. Molecular allergy diagnostics, in which sensitization to individual molecular allergens is measured, is emerging as a promising tool for evaluation of sensitization profiles. In this systematic review, we summarized estimates of prevalence of sensitization to molecular food allergens in the general population in Europe.Methods: Following a protocol prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO; reference CRD42021266657), we searched seven databases with no restrictions on publication date or language. Two reviewers independently screened the literature, extracted data, and appraised the risk of bias in the included studies. The findings were synthesized narratively.Results: From 4776 de-duplicated records, five studies, with low to moderate overall risk of bias, were included. Forty-six molecular allergens from 18 foods were investigated. Overall, the prevalence of sensitization was low, particularly for major allergens, and non-existent for 10 molecular allergens (0% [95% CI 0-0.8]). The highest prevalence was seen for PR-10 proteins, such as Cor a 1.04 (13.6% [95% CI 10.9-16.9]).Conclusions: Available data, primarily from North-western Europe, indicate that sensitization to molecular food allergens is overall low. The highest estimates were found for cross-reactive PR-10 proteins. There were not enough studies to discern regional differences or perform meta-analysis, highlighting the need for more population-representative studies in order to elucidate patterns of sensitization to molecular food allergens in Europe.</p