Parameters Needed to Estimate the Global Burden of Peanut Allergy: Systematic Literature Review.
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2012-04
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Abstract
Background: The Foodborne Disease Burden Epidemiology Reference Group (FERG)
established by the World Health Organization (WHO) is dedicated at estimating the global
burden of a selection of foodborne diseases. Peanut allergy has been included in this
initiative because of the severe and potentially fatal symptoms that can be induced.
Peanuts are highly nutritious and consumed all over the world. In a small proportion of the
population, consumption of peanuts can lead to peanut allergy, which is an overreaction of
the immune system caused by otherwise harmless peanut proteins. Peanut allergy
develops at an early age, in the majority of patients between 14 and 24 months and it is in
almost all cases a life-long problem. Peanut allergy has a large impact on the quality of life
of the allergic individuals and their families, since peanuts together with tree nuts, are the
most common causes of fatal or near fatal food allergic reactions in children and
adolescents.
Aims: To define parameters which are essential to estimate the burden of peanut allergy
and to make an inventory of the available data for these parameters. Approach: Systematic literature search focused on prevalence and incidence data,
duration and severity of the disease, numbers of cases that recover, case fatalities and
impact on quality of life. Prevalence data of studies assessing self-reported peanut allergy
(questionnaires or interviews), peanut sensitization (positive skin prick tests or peanutspecific
IgE antibodies) or clinically confirmed peanut allergy (oral peanut challenges)
were all included in this report.
Results: Prevalence data were predominantly available from developed countries (UK,
Western Europe, Scandinavia, USA, Canada and Australia). There were no data from
Africa and New-Zealand and limited data from East and South Europe, Asia, and South
America. In Western countries the prevalence of peanut allergy ranges from 0.5%-1.5%. In
some countries the prevalence was low or even zero, as has been shown for Israel and
Turkey, respectively. This suggests that geographical differences do exist, but it is unclear
which genetic, environmental or dietary factors can explain these differences. The
symptoms that are elicited when patients accidentally eat peanuts can vary from mild to
severe and occur very rapidly after exposure and have a short duration. Due to this short
duration, severity of disease is considered to be irrelevant in the burden calculation.
Several studies have shown that living with a peanut allergy has a considerably impact on
quality of life. One study showed that quality of life was significantly poorer in peanut
allergic children compared to children with diabetes mellitus. Compared to allergic asthma,
the quality of life score was higher. Quality of life is an important parameter to consider
when estimating the burden of peanut allergy. There are limited data on the mortality rate
of peanut-induced anaphylaxis and studies report a case-fatality rate between 0.00125 to
0.017 deaths per 100,000 subjects per year. Hence, peanut allergy can be fatal but this
occurs rarely.
Conclusions: This systematic review has found relevant data that can be used to
calculate the burden of disease of peanut allergens in developed countries. The most
important parameters were found to be the prevalence and the impact of peanut allergy on
quality of life. The mortality rate for peanut allergens is low and probably has a limited
impact on the disease burden. Co-morbidities, such as other allergies, might have an
impact as well. In the future it should be explored how quality of life and co-morbidities can
be included in the calculation of the burden of peanut allergy.
The complete RIVM report can be downloaded for free from
https://www.rivm.nl/en/Library/Scientific/Reports/2012/april/Parameters_needed_to_estimat
e_the_global_burden_of_peanut_allergy_Systematic_literature_review.
Full report is also available as ‘Supplementary File’.
Description
Keywords
Peanut allergy, prevalence, burden of disease quality of life
Citation
Ezendam Janine, Loveren Henk van. Parameters Needed to Estimate the Global Burden of Peanut Allergy: Systematic Literature Review. European Journal of Nutrition & Food Safety. 2012 Apr-Jun; 2(2): 46-48.