Disparities in pediatric anaphylaxis triggers and management across Asia
Issued Date
2024-01-01
Resource Type
ISSN
01054538
eISSN
13989995
Scopus ID
2-s2.0-85187434561
Pubmed ID
38462795
Journal Title
Allergy: European Journal of Allergy and Clinical Immunology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Allergy: European Journal of Allergy and Clinical Immunology (2024)
Suggested Citation
Leung A.S.Y., Tham E.H., Pacharn P., Xing Y., Trinh H.K.T., Lee S., Ahn K., Chatchatee P., Sato S., Ebisawa M., Lee B.W., Wong G.W.K. Disparities in pediatric anaphylaxis triggers and management across Asia. Allergy: European Journal of Allergy and Clinical Immunology (2024). doi:10.1111/all.16098 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/97671
Title
Disparities in pediatric anaphylaxis triggers and management across Asia
Author's Affiliation
Siriraj Hospital
Chinese University of Hong Kong, Faculty of Medicine
National Hospital Organization Sagamihara National Hospital
University of Medicine and Pharmacy at HCMC
Ajou University School of Medicine
NUS Yong Loo Lin School of Medicine
Prince of Wales Hospital Hong Kong
King Chulalongkorn Memorial Hospital
Samsung Medical Center, Sungkyunkwan university
Chinese University of Hong Kong, Faculty of Medicine
National Hospital Organization Sagamihara National Hospital
University of Medicine and Pharmacy at HCMC
Ajou University School of Medicine
NUS Yong Loo Lin School of Medicine
Prince of Wales Hospital Hong Kong
King Chulalongkorn Memorial Hospital
Samsung Medical Center, Sungkyunkwan university
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: The epidemiology and management of anaphylaxis are not well-reported in Asia. Methods: A regional pediatric anaphylaxis registry was established by the Asia-Pacific Research Network for Anaphylaxis (APRA), using standardized protocols for prospective data collection, to evaluate the triggers and management of anaphylaxis in the Asia-Pacific region. Pediatric patients below 18 years presenting with anaphylaxis across four Asian countries/cities (Thailand, Singapore, Hong Kong (HK), and Qingdao) were included. Allergen triggers, symptoms, anaphylaxis severity, and management were compared. Results: Between 2019 and 2022, 721 anaphylaxis episodes in 689 patients from 16 centers were identified. The mean age at anaphylaxis presentation was 7.0 years (SD = 5.2) and 60% were male. Food was the most common trigger (62%), particularly eggs and cow's milk in children aged 3 years and below. In school-age children, nut anaphylaxis was most common in HK and Singapore, but was rare in the other countries, and wheat was the top allergen in Bangkok. Shellfish anaphylaxis was most common in children aged 7–17. Adrenaline was administered in 60% of cases, with 9% given adrenaline before hospital arrival. Adrenaline devices were prescribed in up to 82% of cases in Thailand but none in Qingdao. Conclusions: The APRA identified food as the main trigger of anaphylaxis in children, but causative allergens differed even across Asian countries. Fewer than two-thirds of cases received adrenaline treatment, pre-hospital adrenaline usage was low, and adrenaline device prescription remained suboptimal. The registry recognizes an unmet need to strengthen anaphylaxis care and research in Asia-Pacific.