Parents' estimate of food allergy prevalence and management in Italian school-aged children

Background: Despite the increasing prevalence of food allergy, few studies have assessed the prevalence of perceived food-induced symptoms among school-aged children. There is also a paucity of data on how children with food reactions are managed. We investigated the frequency and characteristics of perceived food reactions in school-aged children. Methods: Children aged 5-14 years were included in this cross-sectional study. A standardized self-administered questionnaire on food reactions was handed out to 900 parents. Results: We achieved a response rate of 69%. The lifetime prevalence of parental perceived allergic reactions to food was 10.5%; the point prevalence was 1.6%. Medical care included a call to a general practitioner in 54% of cases, self-management in 37%, an emergency call in 6%, and hospitalization in 3%. Antihistamines were administered in 45% of food reactions, topical steroids in 24%, oral or parenteral steroids in 16%, and epinephrine in 1.5%. In children who reported food reactions, skin prick tests for foods were performed in 54% of cases; the oral food challenge test was performed in 7.5%. Conclusion: Parent perception of food allergic disorders is common in school-aged children. Few children have undergone diagnostic tests to ascertain clinical food hypersensitivity. This is warranted to avoid unnecessarily restricted diets. Efforts should be made to train primary care physicians to manage food-allergic children.