Nut allergy prevalence and differences between Asian-born children and Australian-born children of Asian descent: a state-wide survey of children at primary school entry in Victoria, Australia

• Published in: Clinical and experimental allergy Vol. 46; no. 4; pp. 602 - 609
• Main Authors: Panjari, M., Koplin, J. J., Dharmage, S. C., Peters, R. L., Gurrin, L. C., Sawyer, S. M., McWilliam, V., Eckert, J. K., Vicendese, D., Erbas, B., Matheson, M. C., Tang, M. L. K., Douglass, J., Ponsonby, A.-L., Dwyer, T., Goldfeld, S., Allen, K. J.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.04.2016; Wiley Subscription Services, Inc
• Subjects: Arachis hypogaea; Child; Child, Preschool; Emigration and Immigration; Ethnic Groups; Female; food allergy; Geography; Humans; Male; migration; nut allergy; Nut Hypersensitivity - epidemiology; peanut allergy; Population Surveillance; Prevalence; Risk Factors; Rural Population; Socioeconomic Factors; Surveys and Questionnaires; tree nut allergy; Urban Population; Victoria - epidemiology; tree nut allergy; migration; peanut allergy; prevalence; nut allergy; food allergy
• ISSN: 0954-7894; 1365-2222; 1365-2222
• DOI: 10.1111/cea.12699

Summary Background Asian infants born in Australia are three times more likely to develop nut allergy than non‐Asian infants, and rates of challenge‐proven food allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate the risk factors for nut allergy, we assessed the whole‐of‐state prevalence distribution of parent‐reported nut allergy in 5‐year‐old children entering school. Methods Using the 2010 School Entrant Health Questionnaire administered to all 5‐year‐old children in Victoria, Australia, we assessed the prevalence of parent‐reported nut allergy (tree nut and peanut) and whether this was altered by region of residence, socio‐economic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders. Results Parent‐reported nut allergy prevalence was 3.1% (95% CI 2.9–3.2) amongst a cohort of nearly 60 000 children. It was more common amongst children of mothers with higher education and socio‐economic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian‐born mothers (aOR 2.67, 95% CI 2.28–3.27) were more likely to have nut allergy than non‐Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of nut allergy (aOR 0.1, 95% CI 0.03–0.31). Conclusion Migration from Asia after the early infant period appears protective for the development of nut allergy. Additionally, rural regions have lower rates of nut allergy than urban areas.