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The developing countries are in most cases at a stage where developed countries were some years back relative to allergic disorders
offer an opportunity to understand the underlying mechanisms of allergic disorders
SPT with house dust mite, cockroach, peanut, and some additional locally important foods (Fresh local foods mango, orange, papaya, pineapple, banana & apple by prick to prick ) IgE serology for house dust mite, cockroach and peanut plus some additional locally important foods extract
Study Population
Schoolchildren (2287) aged between 5 and 16 years for whom informed consents was received from parents.
Infections
439(39.0%) Intensity, (N=1948) + ++ +++ Helminth Infection Any Helminth Any Geohelminth Hookworm Trichuris Ascaris S.haematobium Intensity - Median(IQR) Hookworm Trichuris Ascaris S.haematobium 280(120-760) 200(80-610) 2040(500-8740) 24(7-78) 451(40.3%) 324(28.3%) 199(17.4%) 26(2.3%) 121(10.6%) 201(16.2%) 250(22.5%) 124(11.1%) 48(4.3%)
34(7.3%)
14(3.8%)
487(24.8%)
Results
%w ith inc a te g o ry
M an go B an an a P ap ay a O ra ng e P in ea pp le
Food Type
Pineapple and peanut are the most frequent SPT positives across area categories though Mango is just as high in the Urban public children.
A pp le P ea nu t
F oo d co nsum ption patterns am o ng our rural and urb an stud y p articip ants.
F oo d Ru ral N. ST APLES Rice No Yes Corn No Yes PRO T EINS Ch icken No Yes F ish No Yes Eg gs No Yes G rou nd n ut daily No Yes CO O KING O IL S In du strial O il No Yes Ho m em ade Palm o il No Yes (%) N. Area Urb an (%) P value
Results
0.657
0.000
0.001
0.000
0.000
0.000
0.172
0.000
With the exception of rice and industrially prepared oils, there are urban rural differences in food consumption.
Results
So which of these reported reactions are due to food allergy? -Time of reaction after consumption? -Type of reaction?
Results
As a Percentage % of all reported symptoms 19.35 33.64 10.6 7.37 8.29 4.61 5.07 5.07 4.15 1.84 100
The most frequent symptoms associated with food consumption are Primarily vomiting and diarrhoea Followed by Itching, tingling or swelling in the mouth, lips and throat Foods reported to cause reactions within minutes are the same ones most prevalent for any adverse reaction
Results
% all food
While cassava and beans are responsible for vomiting and diarrhoea symptoms.
Results
All 105 food SPT positives are cases who are age, sex and school matched with two controls for each of the food types
Results
Foods reported to Cause Reaction CASES Fruits eg.Banana, Orange Potato, Fresh fruit, Herrings Mango Gari (dried cassava), Rice porridge Pineapple, Banana Pineapple Groundnut, oily foods, Pineapple Pawpaw and pineapple Pineapple CONTROLS Okro soup and kenkey* Okro soup, stew, gari Soybeans Okro No Food Listed? Fresh fish Rice Konkonte and pork
Reaction time within: Minutes Hours Hours Minutes Minutes Minutes Hours Minutes Minutes
25 20 15 10 5 0
cases
controls
AB133 AB147 AN033 DY062 GP001 GP031 GP065 TP073 TP076 TP080 TP086
Hours Minutes Hours Minutes Hours Hours Hours Minutes Minutes Minutes Minutes
!!! Limited Data Cases have double the proportion of reported food reactions than controls 5 out of 10 cases are SPT reactive to the same reported food causing reaction, 4 of whom are also IgE sensitised
mango
100 10
100 10
peanut
IgE (kU/L)
1 0.1 0.01
SP T+ SP T-
IgE (kU/L)
1 0.1 0.01
SP T+ SP T-
orange
100 10 100 10
banana
IgE (kU/L)
1 0.1 0.01
SP TSP T+
IgE (kU/L)
1 0.1 0.01
SP T+ SP T-
pineapple
100 10 100 10
apple
IgE (kU/L)
1 0.1 0.01
SP TSP T+
IgE (kU/L)
1 0.1 0.01
pawpaw
100 10
IgE (kU/L)
1 0.1 0.01
SP T+ SP T-
SP T+
SP T-
Collaborators
NMIMR
Abena Amoah, Benedicta Obeng
LUMC
Prof. Maria Yazdanbakhsh & team
University of Amsterdam
Dr Ronald van Ree
IFR
Clare Mills
THANK YOU
GHANA TEAM