The burden of food allergy among children with asthma at the Korle-Bu Teaching Hospital: a case-control study

Background: Children with asthma (CWA) tend to have food allergies due to the common risk factors and underlying pathologies of asthma and food allergies. In their clinical management, the potential comorbidity with food allergies is often ignored. Little is known about the prevalence and clinical symptoms of food allergies among CWA in Ghana. Objective: This study determined the prevalence and clinical symptoms of food allergies among CWA at the Korle-Bu Teaching Hospital compared with their non-asthmatic controls Methods: The study design was a matched case-control involving 118 CWA and 118 non-asthmatic controls recruited from the Korle-Bu Teaching Hospital and a public school, respectively. Sampling was consecutive and purposive. The Allergy-Focused Diet History Questionnaire was used to determine the prevalence and presentation of food allergy in both groups. Descriptive statistics was used to analyse data. Statistical significance was set at p ≤ 0.05. Results: The mean age was 7.5 ± 2.8 years (61% males, 39% females). The prevalence of food allergies among CWA was higher than those without asthma (23.7% vs 2.5%; p < 0.001), with the majority (53.6%) of the former having multiple allergies and 71.4% reporting symptoms in their upper and lower respiratory airway. Conversely, non-asthmatics mostly showed symptoms of food allergy in the skin (66.7%). Peanut allergy was the commonest among children with asthma (24.5%). Conclusion: The prevalence of food allergy was significantly higher among CWA. Clinical symptoms were mainly upper and lower respiratory symptoms and could potentially trigger asthmatic attacks. Food allergy investigations should be part of routine asthma management and should be effectively managed by the health care team, including registered dietitians. Adrenaline pens may be prescribed for asthma patients who may be at a higher risk of severe crisis due to greater sensitisation to food allergens to reduce the potential disease burden.