Food and Respiratory Allergy in Zimbabwe Professor Elopy Sibanda Asthma Allergy and Immune Dysfunction Clinic Zimbabwe
[email protected] Introduction • There is a world wide increase in allergic diseases. • First wave was that of inhaled allergies and these were documented by the series of ISAAC studies. Small studies in Zimbabwe were concurrent. – Kambarami et al. 1999; Sibanda, 1999; Westritschnig et al., 2003 • Second wave is emerging and being recognized in Europe, North America and Asia Boyce et al, 2010; Wandg and Simpson • Evidence from Africa is limited. • This presentation will draw from the experiences of the Asthma Allergy and Immune Dysfunction Clinic, a private sector clinic in Harare Zimbabwe. Background • Few studies of food and respiratory allergy in Africa • Limitations are a result of limited numbers of specialists and interested physicians – No academic departments of allergy in many countries. • The absence of allergy reports does not reflect the absence of disease. This report • Report focuses on patients whose symptoms were severe enough to warrant referral to a specialist. • Data do not represent a population survey. Patients • 981 patients • Born between 1920 and 2013 • Presented for diagnosis and management of suspected allergic diseases • Report audits the allergic diagnoses entertained Clinical Conditions at Presentation • Allergic rhinitis • Asthma • Allergic conjunctivitis • Atopic dermatitis • Urticaria/angioedema • Suspected food allergies (gluten, etc.) Immunological basis of allergy • Diseases of the immune system respect the immunological sequence of events. • Allergic symptoms are preceded by the elaboration of immune responses to an allergen source. No allergen, no allergic disease! • The key intervention in allergology is: 1. to identify and 2.