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A population-based study of fish allergy in the Philippines, Singapore and Thailand

A population-based study of fish allergy in the Philippines, Singapore and Thailand
A population-based study of fish allergy in the Philippines, Singapore and Thailand

Background: Fish allergy is the third most common food allergy after milk and egg in parts of Europe, but there is little data about prevalence in South East Asia where it is an important part of regular diets. Objective: We aimed to obtain an estimate of the population prevalence of fish allergy among older children in the Philippines, Singapore and Thailand. Methods: The population prevalence of fish allergy in 14- to 16-year-old children in the 3 countries was evaluated using a structured written questionnaire which was distributed to students of randomly selected secondary schools. An extended questionnaire to determine convincing fish allergy on the basis of typical clinical manifestations within 2 h of ingestion was administered to those with positive responses. Results: From acohort of 25,842 students, responses were 81.1% in the Philippines (n = 11,434), 67.9% in Singapore (n = 6,498) and 80.2% (n = 2,034) in Thailand. Using criteria for convincing food allergy, fish allergy was much higher in the Philippines [2.29%, 95% confidence interval (CI) 2.02-2.56] than in Singapore (0.26%, 95% CI 0.14-0.79) and Thailand (0.29%, 95% CI 0.06-0.52). Weighted multiple logistic regression analyses showed that compared to the Philippines, prevalence rates were lower in Singapore [odds ratio (OR) 0.40, 95% CI 0.27-0.60, p < 0.0001] and Thailand (OR 0.13, 95% CI 0.05-0.33, p < 0.0001). Females were more likely to have fish allergy compared to males for all children combined (OR 1.32, 95% CI 1.11-1.58, p = 0.002). Most allergies appeared mild, as only 28% of cases sought medical consultation at the time of the reaction and 31.2% of cases reported continued exposure despite allergic symptoms. Conclusion: Fish allergy in late childhood is more common in the Philippines compared to Singapore and Thailand. Differences in food processing, dietary habits and other cultural practices might be important risk factors for the development of fish allergy in these populations.

Fish allergy, Food allergy, South East Asia
1018-2438
384-390
Connett, Gary James
55d5676c-90d8-46bf-a508-62eded276516
Gerez, Irvin
d3044582-b609-4a0b-b4b1-249bc7c972f3
Cabrera-Morales, Elizabeth Ann
aaad9785-6afa-424d-9875-892fe1184f98
Yuenyongviwat, Araya
7aa812fb-2b8a-4981-9796-d2030ad25ac5
Ngamphaiboon, Jarungchit
f9c7f9b3-97be-4248-a632-ed43c8f6c553
Chatchatee, Pantipa
29827c25-7c20-4766-b25d-dd4901c4cf12
Sangsupawanich, Pasuree
eeafdac1-e176-42ce-9899-385d83402944
Soh, Shu E.
acd6791d-fbf2-4ec7-a1f5-7bb539f44049
Yap, Gaik Chin
280a12f8-89d9-4f25-92a7-3b56cc8a5b99
Shek, Lynette Pei Chi
ff5b44bf-5ab5-4249-8cf1-21751a4f6ae8
Lee, Bee Wah
81ec0089-b824-4835-b908-1fc8e9f62249
Connett, Gary James
55d5676c-90d8-46bf-a508-62eded276516
Gerez, Irvin
d3044582-b609-4a0b-b4b1-249bc7c972f3
Cabrera-Morales, Elizabeth Ann
aaad9785-6afa-424d-9875-892fe1184f98
Yuenyongviwat, Araya
7aa812fb-2b8a-4981-9796-d2030ad25ac5
Ngamphaiboon, Jarungchit
f9c7f9b3-97be-4248-a632-ed43c8f6c553
Chatchatee, Pantipa
29827c25-7c20-4766-b25d-dd4901c4cf12
Sangsupawanich, Pasuree
eeafdac1-e176-42ce-9899-385d83402944
Soh, Shu E.
acd6791d-fbf2-4ec7-a1f5-7bb539f44049
Yap, Gaik Chin
280a12f8-89d9-4f25-92a7-3b56cc8a5b99
Shek, Lynette Pei Chi
ff5b44bf-5ab5-4249-8cf1-21751a4f6ae8
Lee, Bee Wah
81ec0089-b824-4835-b908-1fc8e9f62249

Connett, Gary James, Gerez, Irvin, Cabrera-Morales, Elizabeth Ann, Yuenyongviwat, Araya, Ngamphaiboon, Jarungchit, Chatchatee, Pantipa, Sangsupawanich, Pasuree, Soh, Shu E., Yap, Gaik Chin, Shek, Lynette Pei Chi and Lee, Bee Wah (2012) A population-based study of fish allergy in the Philippines, Singapore and Thailand. International Archives of Allergy and Immunology, 159 (4), 384-390. (doi:10.1159/000338940).

Record type: Article

Abstract

Background: Fish allergy is the third most common food allergy after milk and egg in parts of Europe, but there is little data about prevalence in South East Asia where it is an important part of regular diets. Objective: We aimed to obtain an estimate of the population prevalence of fish allergy among older children in the Philippines, Singapore and Thailand. Methods: The population prevalence of fish allergy in 14- to 16-year-old children in the 3 countries was evaluated using a structured written questionnaire which was distributed to students of randomly selected secondary schools. An extended questionnaire to determine convincing fish allergy on the basis of typical clinical manifestations within 2 h of ingestion was administered to those with positive responses. Results: From acohort of 25,842 students, responses were 81.1% in the Philippines (n = 11,434), 67.9% in Singapore (n = 6,498) and 80.2% (n = 2,034) in Thailand. Using criteria for convincing food allergy, fish allergy was much higher in the Philippines [2.29%, 95% confidence interval (CI) 2.02-2.56] than in Singapore (0.26%, 95% CI 0.14-0.79) and Thailand (0.29%, 95% CI 0.06-0.52). Weighted multiple logistic regression analyses showed that compared to the Philippines, prevalence rates were lower in Singapore [odds ratio (OR) 0.40, 95% CI 0.27-0.60, p < 0.0001] and Thailand (OR 0.13, 95% CI 0.05-0.33, p < 0.0001). Females were more likely to have fish allergy compared to males for all children combined (OR 1.32, 95% CI 1.11-1.58, p = 0.002). Most allergies appeared mild, as only 28% of cases sought medical consultation at the time of the reaction and 31.2% of cases reported continued exposure despite allergic symptoms. Conclusion: Fish allergy in late childhood is more common in the Philippines compared to Singapore and Thailand. Differences in food processing, dietary habits and other cultural practices might be important risk factors for the development of fish allergy in these populations.

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More information

Accepted/In Press date: 18 April 2012
e-pub ahead of print date: 27 July 2012
Published date: November 2012
Keywords: Fish allergy, Food allergy, South East Asia

Identifiers

Local EPrints ID: 419579
URI: http://eprints.soton.ac.uk/id/eprint/419579
ISSN: 1018-2438
PURE UUID: ddb5704d-eaca-46a8-b0d8-1ee4eb0eb948
ORCID for Gary James Connett: ORCID iD orcid.org/0000-0003-1310-3239

Catalogue record

Date deposited: 13 Apr 2018 16:30
Last modified: 07 Oct 2020 02:20

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Contributors

Author: Gary James Connett ORCID iD
Author: Irvin Gerez
Author: Elizabeth Ann Cabrera-Morales
Author: Araya Yuenyongviwat
Author: Jarungchit Ngamphaiboon
Author: Pantipa Chatchatee
Author: Pasuree Sangsupawanich
Author: Shu E. Soh
Author: Gaik Chin Yap
Author: Lynette Pei Chi Shek
Author: Bee Wah Lee

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