Suaini, N. H. A., Loo, E. X., Peters, R. L., Yap, G. C., Allen, K. J., Van Bever, H., … Tham, E. H. (2021). Children of Asian ethnicity in Australia have higher risk of food allergy and early‐onset eczema than those in Singapore. Allergy. doi:10.1111/all.14823
Abstract:
Background: In Western countries, Asian children have higher food allergy risk than Caucasian children. The early-life environmental exposures for this discrepancy are unclear. We aimed to compare prevalence of food allergy and associated risk factors between Asian children in Singapore and Australia.
Methods: We studied children in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort (n = 878) and children of Asian ancestry in the HealthNuts cohort (n = 314). Food allergy was defined as a positive SPT ≥3 mm to egg or peanut AND either a convincing history of IgE-mediated reaction at 18 months (GUSTO) or a positive oral food challenge at 14-18 months (HealthNuts). Eczema was defined as parent-reported doctor diagnosis.
Results: Food allergy prevalence was 1.1% in Singapore and 15.0% in Australia (P<0.001). Egg introduction was more often delayed (>10 months) in Singapore (63.5%) than Australia (16.3%; P<0.001). Prevalence of early-onset eczema (<6 months) was lower in Singapore (8.4%) than Australia (30.5%) (P<0.001). Children with early-onset eczema were more likely to have food allergy than those without eczema in Australia [aOR 5.11 (2.34-11.14); P<0.001] and Singapore [aOR4.00 (0.62-25.8); P = 0.145].
Conclusions: Among Asian children, prevalence of early-onset eczema and food allergy was higher in Australia than Singapore. Further research with larger sample sizes and harmonized definitions of food allergy between cohorts is required to confirm and extend these findings. Research on environmental factors influencing eczema onset in Australia and Singapore may aid understanding of food allergy pathogenesis in different parts of the world.
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Funding Info:
This research / project is supported by the National Medical Research Council (NMRC) - Translational and Clinical Research (TCR) Flagship Programme
Grant Reference no. : NMRC/TCR/004-NUS/2008
This research / project is supported by the National Medical Research Council (NMRC) - Translational and Clinical Research (TCR) Flagship Programme
Grant Reference no. : NMRC/TCR/012-NUHS/2014
This research / project is supported by the National Medical Research Council - Clinician Scientist Award
Grant Reference no. : NMRC/CSA/022/2010
This research / project is supported by the National Research Foundation - NUS-HUJ-CREATE Programme for Inflammation Research
Grant Reference no. : NRF370062-HUJ-NUS (Project 10)
This research is supported by core funding from: Singapore Institute for Clinical Sciences
Grant Reference no. : -
The HealthNuts study was funded by the National Health Medical Research Council (NHMRC) of Australia, Ilhan Food Allergy Foundation and AnaphylaxiStop.
Support for research at the Murdoch Children’s Research Institute was provided by the Victorian Government’s Operational Infrastructure Support Program.
Description:
This is the peer reviewed version of the following article: Suaini NHA, Loo EX, Peters RL, Yap GC, Allen KJ, Van Bever H, Martino DJ, Goh AEN, Dharmage SC, Colega MT, Chong MFF, Ponsonby AL, Tan KH, Tang MLK, Godfrey KM, Lee BW, Shek LP, Koplin JJ, Tham EH. Children of Asian ethnicity in Australia have higher risk of food allergy and early-onset eczema than those in Singapore. Allergy. 2021 Mar 22. doi: 10.1111/all.14823. Epub ahead of print. PMID: 33751595., which has been published in final form at 10.1111/all.14823. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.