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The epidemiology of food allergy in Europe: a systematic review and meta-analysis

The epidemiology of food allergy in Europe: a systematic review and meta-analysis
The epidemiology of food allergy in Europe: a systematic review and meta-analysis
Food allergy (FA) is an important atopic disease although its precise burden is unclear. This systematic review aimed to provide recent, up-to-date data on the incidence, prevalence, time trends, and risk and prognostic factors for FA in Europe. We searched four electronic databases, covering studies published from 1 January 2000 to 30 September 2012. Two independent reviewers appraised the studies and qualified the risk of bias using the Critical Appraisal Skills Programme tool. Seventy-five eligible articles (comprising 56 primary studies) were included in a narrative synthesis, and 30 studies in a random-effects meta-analysis. Most of the studies were graded as at moderate risk of bias. The pooled lifetime and point prevalence of self-reported FA were 17.3% (95% CI: 17.0-17.6) and 5.9% (95% CI: 5.7-6.1), respectively. The point prevalence of sensitization to ?1 food as assessed by specific IgE was 10.1% (95% CI: 9.4-10.8) and skin prick test 2.7% (95% CI: 2.4-3.0), food challenge positivity 0.9% (95% CI: 0.8-1.1). While the incidence of FA appeared stable over time, there was some evidence that the prevalence may be increasing. There were no consistent risk or prognostic factors for the development or resolution of FA identified, but sex, age, country of residence, familial atopic history, and the presence of other allergic diseases seem to be important. Food allergy is a significant clinical problem in Europe. The evidence base in this area would benefit from additional studies using standardized, rigorous methodology; data are particularly required from Eastern and Southern Europe.
0105-4538
Nwaru, B.I.
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Hickstein, L.
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Panesar, S.S.
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Muraro, A.
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Werfel, T.
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Cardona, V.
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Dubois, A.E.J.
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Halken, S.
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Hoffmann-Sommergruber, K.
7b282387-19b5-4d07-bac8-1679f25197b7
Poulsen, L.K.
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Roberts, Graham
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Van Ree, R.
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Vlieg-Boerstra, B.J.
dc35ae65-880f-4788-b193-d4001acd1446
Sheikh, A.
f34621ac-f425-42fd-81e3-2057b1c9ce2f
Nwaru, B.I.
33533f93-b388-49cf-b725-54d8977a4028
Hickstein, L.
10a4f21d-c481-49f3-8e30-b3d4c6cdf738
Panesar, S.S.
2a52528f-b993-4fd0-9c4b-8d48716d262c
Muraro, A.
31a2d167-86e1-4e11-87ad-6ffb7e32cd47
Werfel, T.
257ddb96-94d9-4ed3-8fbf-7b490e3f9efa
Cardona, V.
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Dubois, A.E.J.
bf063b50-7bd4-4bdf-9d31-16a6e743762e
Halken, S.
6204ce6f-7b6e-4041-9da2-a5f250467fbb
Hoffmann-Sommergruber, K.
7b282387-19b5-4d07-bac8-1679f25197b7
Poulsen, L.K.
aa64f94a-6059-4bb3-aab0-6103612ebfeb
Roberts, Graham
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3
Van Ree, R.
4100f8ce-ece6-4ab0-9a4f-e0e862ef078d
Vlieg-Boerstra, B.J.
dc35ae65-880f-4788-b193-d4001acd1446
Sheikh, A.
f34621ac-f425-42fd-81e3-2057b1c9ce2f

Nwaru, B.I., Hickstein, L., Panesar, S.S., Muraro, A., Werfel, T., Cardona, V., Dubois, A.E.J., Halken, S., Hoffmann-Sommergruber, K., Poulsen, L.K., Roberts, Graham, Van Ree, R., Vlieg-Boerstra, B.J. and Sheikh, A. (2013) The epidemiology of food allergy in Europe: a systematic review and meta-analysis. Allergy. (doi:10.1111/all.12305). (PMID:24205824)

Record type: Article

Abstract

Food allergy (FA) is an important atopic disease although its precise burden is unclear. This systematic review aimed to provide recent, up-to-date data on the incidence, prevalence, time trends, and risk and prognostic factors for FA in Europe. We searched four electronic databases, covering studies published from 1 January 2000 to 30 September 2012. Two independent reviewers appraised the studies and qualified the risk of bias using the Critical Appraisal Skills Programme tool. Seventy-five eligible articles (comprising 56 primary studies) were included in a narrative synthesis, and 30 studies in a random-effects meta-analysis. Most of the studies were graded as at moderate risk of bias. The pooled lifetime and point prevalence of self-reported FA were 17.3% (95% CI: 17.0-17.6) and 5.9% (95% CI: 5.7-6.1), respectively. The point prevalence of sensitization to ?1 food as assessed by specific IgE was 10.1% (95% CI: 9.4-10.8) and skin prick test 2.7% (95% CI: 2.4-3.0), food challenge positivity 0.9% (95% CI: 0.8-1.1). While the incidence of FA appeared stable over time, there was some evidence that the prevalence may be increasing. There were no consistent risk or prognostic factors for the development or resolution of FA identified, but sex, age, country of residence, familial atopic history, and the presence of other allergic diseases seem to be important. Food allergy is a significant clinical problem in Europe. The evidence base in this area would benefit from additional studies using standardized, rigorous methodology; data are particularly required from Eastern and Southern Europe.

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Published date: 11 November 2013
Organisations: Faculty of Medicine

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Local EPrints ID: 360136
URI: http://eprints.soton.ac.uk/id/eprint/360136
ISSN: 0105-4538
PURE UUID: 54bd2c7d-3ca1-4e31-9981-1e7816f6c5bd
ORCID for Graham Roberts: ORCID iD orcid.org/0000-0003-2252-1248

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Date deposited: 27 Nov 2013 13:22
Last modified: 18 Feb 2021 17:04

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Contributors

Author: B.I. Nwaru
Author: L. Hickstein
Author: S.S. Panesar
Author: A. Muraro
Author: T. Werfel
Author: V. Cardona
Author: A.E.J. Dubois
Author: S. Halken
Author: K. Hoffmann-Sommergruber
Author: L.K. Poulsen
Author: Graham Roberts ORCID iD
Author: R. Van Ree
Author: B.J. Vlieg-Boerstra
Author: A. Sheikh

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