The Public Health Impact of Parent-Reported Childhood Food Allergies in the United States
The Public Health Impact of Parent-Reported Childhood Food Allergies in the United States
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DOI：
10.1542/peds.2018-1235
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发表时间：
2018-12-01
期刊：
影响因子：
8
通讯作者：
Nadeau, Kari C.
中科院分区：
文献类型：
--
作者：
Gupta, Ruchi S.;Warren, Christopher M.;Nadeau, Kari C.
背景：儿童食物过敏（FA）是一种危及生命的慢性疾病，严重影响生活质量。这项以人群为基础的大型调查估计了所有主要过敏性食物的儿童FA患病率和严重程度。还收集了有关FA管理和卫生保健使用的详细过敏原特异性信息。方法：2015年至2016年对美国家庭进行调查，获得38408名儿童的家长代理回复。患病率估计是基于芝加哥大学全国代表性的基于概率的AmeriSpeak Panel（51%完成率）的NORC的回复，通过校准加权来增加非基于概率的回复，以提高准确性。通过加权比例估计患病率。采用多元逻辑回归模型评价FA预测因子。结果：总体而言，在排除4%父母报告的FA反应史与免疫球蛋白e介导的FA不一致的儿童后，估计当前FA患病率为7.6%（95%置信区间：7.1%-8.1%）。最常见的过敏原是花生（2.2%）、牛奶（1.9%）、贝类（1.3%）和树坚果（1.2%）。在食物过敏儿童中，42.3%报告>= 1严重FA， 39.9%报告多发性FA。此外，19.0%的患者报告前一年有>= 1次与fa相关的急诊科就诊，42.0%的患者报告>= 1次终身与fa相关的急诊科就诊，而40.7%的患者目前有肾上腺素自动注射器处方。非裔美国儿童和患有特应性合并症的儿童的患病率较高。结论：FA是一个主要的公共卫生问题，影响了大约8%的美国儿童。然而，大约11%的儿童被认为是食物过敏，这表明被认为的疾病负担可能比以前承认的要大。
BACKGROUND: Childhood food allergy (FA) is a life-threatening chronic condition that substantially impairs quality of life. This large, population-based survey estimates childhood FA prevalence and severity of all major allergenic foods. Detailed allergen-specific information was also collected regarding FA management and health care use.METHODS: A survey was administered to US households between 2015 and 2016, obtaining parent-proxy responses for 38 408 children. Prevalence estimates were based on responses from NORC at the University of Chicago's nationally representative, probability-based AmeriSpeak Panel (51% completion rate), which were augmented by nonprobability-based responses via calibration weighting to increase precision. Prevalence was estimated via weighted proportions. Multiple logistic regression models were used to evaluate FA predictors.RESULTS: Overall, estimated current FA prevalence was 7.6% (95% confidence interval: 7.1%-8.1%) after excluding 4% of children whose parent-reported FA reaction history was inconsistent with immunoglobulin E-mediated FA. The most prevalent allergens were peanut (2.2%), milk (1.9%), shellfish (1.3%), and tree nut (1.2%). Among food-allergic children, 42.3% reported >= 1 severe FA and 39.9% reported multiple FA. Furthermore, 19.0% reported >= 1 FA-related emergency department visit in the previous year and 42.0% reported >= 1 lifetime FA-related emergency department visit, whereas 40.7% had a current epinephrine autoinjector prescription. Prevalence rates were higher among African American children and children with atopic comorbidities.CONCLUSIONS: FA is a major public health concern, affecting similar to 8% of US children. However, > 11% of children were perceived as food-allergic, suggesting that the perceived disease burden may be greater than previously acknowledged.