Pediatric Spectrum of Allergic Diseases and Asthma in a Tertiary Level Hospital in Botswana: an Exploratory Retrospective Cross-Sectional Study

Abstract

Alemayehu Mekonnen Gezmu,1 Shiang-Ju Kung,2 Jemal Zeberga Shifa,3 Britt Nakstad,1,4 Merrian Brooks,1,5 Dipesalema Joel,1 Tonya Arscott-Mills,1,5 Edelis Castellanos Puerto,6 Jūratė Šaltytė Benth,7,8 Endale Tefera1 1Department of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana; 2Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA; 3Department of Surgery, Faculty of Medicine, University of Botswana, Gaborone, Botswana; 4Institute of Clinical Medicine and Centre of Global Health, University of Oslo, Oslo, Norway; 5Center for Global Health, Children’s Hospital of Philadelphia, Philadelphia, PA, USA; 6Department of Allergy and Immunology, University Hospital Calixto Garcia, Havana, Cuba; 7Institute of Clinical Medicine, Campus Ahus, University of Oslo, Blindern, Norway; 8Health Services Research Unit, Akershus University Hospital, Lørenskog, NorwayCorrespondence: Alemayehu Mekonnen GezmuDepartment of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Private Bag UB00713, Gaborone, BotswanaTel [phone]Fax [phone]Email [email protected]: This study aims to describe the spectrum of allergic diseases of children and adolescents in a single allergy treatment centre in Botswana, over a period of 8 years.Patients and Methods: A retrospective cross-sectional study was conducted using medical records of all patients aged 18 years or younger, seen at an allergy treatment centre in Botswana. Data were presented descriptively. Association between variables was explored by χ2-test.Results: Four hundred and seven patients with a mean age of 5.8 years (SD 4.4) at the time of presentation included 239 (58.7%) females and 365 (87.5%) black Africans. The most common diseases were asthma (n=249, 61.2%) followed by allergic rhinitis (AR) (n=232, 57.0%) and atopic dermatitis (AD) (n=165, 40.5%). One hundred and fifteen cases (46.2%) of asthmatic patients were skin prick test positive; sensitized to grass, moulds, dust mites and animal dander, in decreasing frequency, whereas those with allergic rhinitis (AR) and allergic conjunctivitis (AC) were sensitized to trees and all allergens identified in asthmatics. Concomitant asthma was diagnosed in 171 (73.7%) with AR, 71 (68.3%) with AC, 75 (45.5%) with AD and 42 (47.7%) with food allergy. The most common triggers for asthma exacerbations include upper respiratory tract infections, weather changes, and exposure to passive cigarette smoke. Paternal allergy and allergic disease in grandparents are predisposing factors for asthma (p=0.016 and p=0.001, respectively). Paternal allergy is also predisposed to AR (p=0.007), while maternal history of allergic disease was associated with AD (p=0.019).Conclusion: The most common chronic pediatric conditions seen in our allergic disease study were asthma, allergic rhinitis and atopic dermatitis with the most common triggers being viral upper respiratory tract infections, weather changes and exposure to cigarette smoke, all of which are modifiable risk factors. This exploratory study lays the foundation for future interventional studies that may be directed towards the spectrum of allergic diseases.Keywords: pediatric allergy, asthma in children, allergic rhinitis, atopic dermatitis

Keywords

• pediatric allergy
• asthma in children
• allergic rhinitis
• atopic dermatitis