Effect of area of residence on patterns of aeroallergen sensitization in atopic patients

Background: An association with sensitization to inhaled allergens and allergic rhinitis and asthma has been established. A recent study concluded that the disparity in allergen sensitization might primarily be caused by environmental factors rather than genetic differences. The primary objective was to identify potential differences in sensitization among subjects with the same ethnicity in South India who reside in different environments. Methods: Five hundred forty-six patients presenting to a tertiary allergy center with allergic rhinitis and or asthma underwent evaluation using a structured questionnaire, skin-prick testing to common aeroallergens, and spirometry and were categorized according to area of residence. Results: The most common allergens causing sensitization were house-dust mite (range, 65-70%), trees (range, 52-56%), and cockroaches (range, 39-53%). There was lower risk of sensitization to cockroach allergens for subject

Pediatric Allergic Diseases in the Indian Subcontinent -Epidemiology, Risk Factors and Current Challenges.

INTRODUCTION India is low middle-income country (LMIC) with a population of 1.3bn, comprising about 20% of the global population. Whilst the high-income western countries faced an 'allergy epidemic' during the last three decades, there has been a gradual rise in prevalence of allergic diseases in India. METHODS Narrative review RESULTS AND DISCUSSION: Allergic diseases occur as a consequence of a complex interplay between genetic and environmental factors. There are multiple contrasting determinants that are important to consider in India including high levels of air pollution, in particular PM due to burning of fossil fuels and biomass fuels, diverse aero-biology, tropical climate, cultural and social diversity, religious beliefs/myths, linguistic diversity, literacy level, breastfeeding and weaning, diet (large proportion vegetarian), high incidence rates of TB, HIV, malaria, filariasis, parasitic infestations and others, that not only shape the immune system early in life, but also impact on biomarkers relevant to allergic diseases. India has a relatively weak and heterogeneous healthcare framework and allergology has not yet been recognized as an independent speciality. There are very few postgraduate training programmes and allergic diseases are managed by primary care physicians, organ-based specialists and general pediatricians. Adrenaline auto-injectors are not available, there is patient unaffordability for inhalers, nasal sprays and biologics and this is compounded by poor compliance leading to 40-50% of asthmatic children having uncontrolled disease and high rates of oral corticosteroid use. Standardised allergen extracts are not available for skin tests and desensitization

Is spurious penicillin allergy a major public health concern only in high-income countries?

Inaccurate penicillin allergy labels (PALs) are a major public health problem in high-income countries and has been linked to antimicrobial resistance (AMR) and huge healthcare costs. Data regarding epidemiology of PALs and its potential association with AMR is sparse in low-income countries (LICs), low-middle-income countries (LMICs) and upper-middle-income countries (UMICs). There are no established drug allergy labelling and delabelling pathways in the majority of the LICs, LMICs and UMICs and addressing these inequities is critical for safe clinical practice and in the global campaign against AMR. A standardised validated computerised decision support tool might help address these gaps, but understanding local factors including clinical governance, cultural, social, religious and human behaviour will be key to uptake and success of such an intervention