Introduction: Food allergy (FA) is a global health problem with an ongoing rise in prevalence, especially in developed countries. It has been reported to be most prevalent in children, although cases in adults have been increasing as well. FA may lead to life-threatening clinical manifestations. Data in Lebanon and the Middle East are limited. To our knowledge, few studies tackled its prevalence in children in this region. Aim: This study aims at determining self-reported prevalence of FA in schoolchildren (ages 3–17 years) in Lebanon and describes its characteristics. Method: Throughout this cross-sectional study, 5 schools from 3 different governorates in Lebanon (Beirut, Mt. Lebanon, and Beqaa) were contacted to participate and 5,312 questionnaires were sent out to be completed by the parents and sent back to the school during May 2019. Results: 2,610 questionnaires were collected (49.13%). A hundred and forty-eight (6%) children reported to have FA, 58% were males. 80% of them were breastfed, 51% were diagnosed between the ages of 2 and 14 years. Common allergens included cow’s milk and milk products (22.46%), fruits and vegetables (16.58%), eggs (8.02%), and nuts (5.88%). Allergic symptoms included skin reactions (45.08%), gastrointestinal (GI) symptoms (29.53%), respiratory symptoms (14.51%), and systemic symptoms (10.88%). 82% of the population with FA has sought professional advice, out of which 54% were confirmed by a physician. Common methods of diagnosis were IgE test (35.71%), food elimination (27.92%), and skin prick test (18.83%). χ2 analysis has shown that a higher percentage of children with FA had skin reactions (58.8%, p = 0.033) and GI symptoms (30.41%, p = 0.047). A higher percentage of children with allergies were breastfed. No relation between the presence of FA and delivery mode was observed. Conclusion: This study has shown that the self-reported prevalence of FA among Lebanese schoolchildren is 6%, and it was correlated with skin and GI symptoms. The most common allergen was cow’s milk. A higher proportion of children with FA were breastfed. No association between the mode of delivery and FA was found. Larger studies are needed to confirm the above findings.

Keywords:
Prevalence, Schoolchildren, Food allergy
1.
Sampson HA. 9. Food allergy.
J Allergy Clin Immunol
. 2003;111(2):S540–S547.
2.
Sicherer SH, Sampson HA. Food allergy.
J Allergy Clin Immunol
. 2010;125(2):S116–S125.
3.
Food and Drug Administration.
FDA approves first drug for treatment of peanut allergy for children
: PR newswire; 2020.
4.
Prescott SL, Pawankar R, Allen KJ, Campbell DE, Sinn JK, Fiocchi A, et al. A global survey of changing patterns of food allergy burden in children.
World Allergy Organ J
. 2013;6(1):21.
5.
Wang J, Sampson HA. Food anaphylaxis.
Clin Exp Allergy
. 2007;37(5):651–60.
6.
Branum AM, Lukacs SL. Food allergy among U.S. children: trends in prevalence and hospitalizations.
NCHS data brief
. 2008(10):1.
7.
Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, et al. The prevalence, severity, and distribution of childhood food allergy in the United States.
Pediatrics
. 2011;128(1):e9–e17.
8.
Pouessel G, Turner PJ, Worm M, Cardona V, Deschildre A, Beaudouin E, et al. Food-induced fatal anaphylaxis: from epidemiological data to general prevention strategies.
Clin Exp Allergy
. 2018;48(12):1584–93.
9.
Rance F, Kanny G, Dutau G, Moneret-Vautrin D. Aspects cliniques de l'allergie alimentaire.
French J Allergy Clin Immunol
. 1998;38(10):900–5.
10.
Xian M, Li J. Allergic diseases of the skin and drug allergies – 2029. Prevalence and factors of food allergy among school-age children in Southern China.
World Allergy Organ J
. 2013;6(1):P115.
11.
Al-Hammadi S, Al-Maskari F, Bernsen R. Prevalence of food allergy among children in Al-Ain City, United Arab Emirates.
Int Arch Allergy Immunol
. 2010;151(4):336–42.
12.
Ziyab AH. Prevalence of food allergy among schoolchildren in Kuwait and its association with the coexistence and severity of asthma, rhinitis, and eczema: a cross-sectional study.
World Allergy Organ J
. 2019;12(4):100024.
13.
Simon AK, Hollander GA, McMichael A. Evolution of the immune system in humans from infancy to old age.
Proc Biol Sci
. 2015;282(1821):20143085.
14.
Christie L, Hine RJ, Parker JG, Burks W. Food allergies in children affect nutrient intake and growth.
J Am Diet Assoc
. 2002;102(11):1648–51.
15.
Soller L, Ben-Shoshan M, Harrington DW, Fragapane J, Joseph L, Pierre SY, et al. Overall prevalence of self-reported food allergy in Canada.
J Allergy Clin Immunol
. 2012;130(4):986–8.
16.
Steinke M, Fiocchi A, Kirchlechner V, Ballmer-Weber B, Brockow K, Hischenhuber C, et al. Perceived food allergy in children in 10 European nations. A randomised telephone survey.
Int Arch Allergy Immunol
. 2007;143(4):290–5.
17.
Sicherer SH, Sampson HA. Food allergy: a review and update on epidemiology, pathogenesis, diagnosis, prevention, and management.
J Allergy Clin Immunol
. 2018;141(1):41–58.
18.
Lee SI, Shin MH, Lee HB, Lee JS, Son BK, Koh YY, et al. Prevalences of symptoms of asthma and other allergic diseases in korean children: a nationwide questionnaire survey.
J Korean Med Sci
. 2001;16(2):155.
19.
Sampson HA, Ho DG. Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents.
J Allergy Clin Immunol
. 1997;100(4):444–51.
20.
Ramesh S, Ramesh S. Food allergy overview in children.
Clin Rev Allergy Immunol
. 2008;34(2):217–30.
21.
Bahna SL. Diagnosis of food allergy.
Ann Allergy Asthma Immunol
. 2003;90(6):77–80.
22.
Sampson HA, Gerth van Wijk R, Bindslev-Jensen C, Sicherer S, Teuber SS, Burks AW, et al. Standardizing double-blind, placebo-controlled oral food challenges: American academy of allergy, asthma & immunology – European academy of allergy and clinical immunology practall consensus report.
J Allergy Clin Immunol
. 2012;130(6):1260–74.
23.
Schneider L.
National eczema association
; 2020. Available from: https://donate.nationaleczema.org/give/193995/.
24.
Werfel T, Breuer K. Role of food allergy in atopic dermatitis.
Current Opin Allergy Clin Immunol
. 2004;4(5):379–85.
25.
Werfel T, Ballmer-Weber B, Eigenmann PA, Niggemann B, Rancé F, Turjanmaa K, et al. Eczematous reactions to food in atopic eczema: position paper of the EAACI and GA2LEN: eczematous reactions to food in AE.
Allergy
. 2007;62(7):723–8.
26.
Sweeney A, Sampath V, Nadeau KC. Early intervention of atopic dermatitis as a preventive strategy for progression of food allergy.
Allergy Asthma Clin Immunol
. 2021:17.
27.
Mathias JG, Zhang H, Soto-Ramirez N, Karmaus W. The association of infant feeding patterns with food allergy symptoms and food allergy in early childhood.
Int Breastfeed J
. 2019;14(1):43.
28.
Eggesbø M, Botten G, Stigum H, Nafstad P, Magnus P. Is delivery by cesarean section a risk factor for food allergy?
J Allergy Clin Immunol
. 2003;112(2):420–6.
29.
Bager P, Wohlfahrt J, Westergaard T. Caesarean delivery and risk of atopy and allergic disesase: meta-analyses.
Clin Exp Allergy
. 2008;38(4):634–42.
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