4.6 Article

Children of Asian ethnicity in Australia have higher risk of food allergy and early-onset eczema than those in Singapore

Journal

ALLERGY
Volume 76, Issue 10, Pages 3171-3182

Publisher

WILEY
DOI: 10.1111/all.14823

Keywords

Asian children; eczema; food allergy; GUSTO; healthnuts

Funding

  1. Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme [NMRC/TCR/004-NUS/2008, NMRC/TCR/012-NUHS/2014]
  2. National Medical Research Council [NMRC/CSA/022/2010, NRF370062-HUJ-NUS]
  3. Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore
  4. UK Medical Research Council [MC_UU_12011/4]
  5. National Institute for Health Research (NIHR) [NF-SI-0515-10042]
  6. NIHR Southampton Biomedical Research Centre [IS-BRC-1215-20004]
  7. National Medical Research Council (NMRC) [MH 095:003\008-225]
  8. NMRC, Singapore [MOH-000269]
  9. National Health & Medical Research Council (NHMRC) of Australia
  10. Ilhan Food Allergy Foundation
  11. AnaphylaxiStop
  12. Victorian Government's Operational Infrastructure Support Program
  13. NHMRC Centre for Food and Allergy Research

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Asian children in Australia had a higher prevalence of food allergy and early-onset eczema compared to those in Singapore. The presence of early-onset eczema was associated with an increased risk of food allergy in both countries. Further research with larger sample sizes is needed to confirm and expand on these findings.
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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