Jarungchit Ngamphaiboon

A Population-Based Study of Fish Allergy in the Philippines, Singapore and Thailand

Background: Fish allergy is the third most common food allergy after milk and egg in parts of Europe, but there is little data about prevalence in South East Asia where it is an important part of regular diets. Objective: We aimed to obtain an estimate of the population prevalence of fish allergy among older children in the Philippines, Singapore and Thailand. Methods: The population prevalence of fish allergy in 14- to 16-year-old children in the 3 countries was evaluated using a structured written questionnaire which was distributed to students of randomly selected secondary schools. An extended questionnaire to determine convincing fish allergy on the basis of typical clinical manifestations within 2 h of ingestion was administered to those with positive responses. Results: From acohort of 25,842 students, responses were 81.1% in the Philippines (n = 11,434), 67.9% in Singapore (n = 6,498) and 80.2% (n = 2,034) in Thailand. Using criteria for convincing food allergy, fish allergy was much higher in the Philippines [2.29%, 95% confidence interval (CI) 2.02–2.56] than in Singapore (0.26%, 95% CI 0.14–0.79) and Thailand (0.29%, 95% CI 0.06–0.52). Weighted multiple logistic regression analyses showed that compared to the Philippines, prevalence rates were lower in Singapore [odds ratio (OR) 0.40, 95% CI 0.27–0.60, p < 0.0001] and Thailand (OR 0.13, 95% CI 0.05–0.33, p < 0.0001). Females were more likely to have fish allergy compared to males for all children combined (OR 1.32, 95% CI 1.11–1.58, p = 0.002). Most allergies appeared mild, as only 28% of cases sought medical consultation at the time of the reaction and 31.2% of cases reported continued exposure despite allergic symptoms. Conclusion: Fish allergy in late childhood is more common in the Philippines compared to Singapore and Thailand. Differences in food processing, dietary habits and other cultural practices might be important risk factors for the development of fish allergy in these populations.

Component-resolved diagnostics for the evaluation of peanut allergy in a low-prevalence area.

Major allergenic components of peanut from distinct geographical regions are widely dispersed. Most of the diagnostic studies are from countries with a high prevalence. There have been only few reports of allergen component sensitizations from countries with a low prevalence of peanut allergy. We aimed to investigate roles of component‐resolved diagnostic (CRD) to differentiate peanut allergy and peanut tolerance in the Asian population from a country with low prevalence of peanut allergy.

Direct medical costs associated with atopic diseases among young children in Thailand

Abstract Objective: Allergic diseases are the most common childhood illness in Thailand. Their prevalence has been rising over time, with several studies having revealed substantial economic burden. However, no such study had yet been conducted for Thailand. The aim of this study was to estimate direct medical costs associated with atopic diseases among children aged 0–5 years in Thailand. Research design and methods: A cost-of-illness model was constructed to estimate the total direct medical costs of atopic diseases comprising atopic dermatitis, chronic rhinitis, asthma (i.e., recurrent wheeze), and cow’s milk allergy. The model employed a prevalence-based approach, considering a total number of atopic cases in 2010. Direct medical costs were estimated using a bottom-up analysis with the estimation of the quantity of healthcare resource use and the unit costs. Epidemiological data were obtained from literature and Thai surveys, whereas treatment unit costs were from either a hospital database or Thai standard cost list. Expert opinion informed type, frequency, and quantity of medical resources utilized. Key limitations included lack of data-driven evidences on severity distribution for this particular age group, indirect costs, and medical resource use associated with each condition. Results: Total direct cost was estimated to be THB 27.8 billion (US

Recurrent purpura fulminans associated with drug-resistant Streptococcus pneumoniae infection in an asplenic girl.

899 million). Treatments contributed largest to the total costs (46%), followed by inpatient care (37%), outpatient care (12%), and monitoring and labs (5%). Costs per treated patient were highest in cow’s milk allergy (THB 64,383; US

Effects of inactivated influenza vaccine on respiratory illnesses and asthma-related events in children with mild persistent asthma in Asia

2077), followed by rhinitis (THB 12,669; US

Dust mite infestation in cooking flour: experimental observations and practical recommendations

409), asthma (THB 9633; US

The efficacy of partially hydrolyzed formulas for allergy prevention in children under five years

312), and atopic dermatitis (THB 5432; US

Sensitivity and specificity of MAST chemiluminescence assay of allergen-specific immunoglobulin in allergic Thai children: comparison to the skin prick test

175). Conclusion: Atopic diseases in young children are associated with substantial burden in direct medical costs to Thailand. These costs can be diminished through nutritional intervention recognized to effectively decrease the incidence of atopic diseases.

Cow's milk allergy in Thai children.

We report a case of purpura fulminans associated with drug-resistant Streptococcus pneumoniae that responded to ceftriaxone therapy. Ultrasonography of the abdomen and splenic scan revealed the absence of a spleen.

Comparison of salbutamol efficacy in children--via the metered-dose inhaler (MDI) with Volumatic spacer and via the dry powder inhaler, Easyhaler, with the nebulizer--in mild to moderate asthma exacerbation: a multicenter, randomized study.

BACKGROUND Acute asthmatic exacerbation and readmission may be associated with severe influenza infection and asthmatic children are a priority group for influenza vaccination. To date, our study is the first to evaluate the outcome of the influenza vaccine in asthmatic Asian children. OBJECTIVE To analyze the outcomes of inactivated influenza vaccine in children with mild persistent asthma METHODS A cross sectional non-randomized study was performed on 93 mild persistent asthmatic children who attended the Pediatric Allergy clinic between June 2012 in Chiang Rai Hospital and August 2013. Forty eight patients were immunized with 2 doses of inactivated influenza vaccine at one month interval. Respiratory illnesses and asthma-related events were compared between the immunized and the un-immunized groups. RESULTS The two study groups had similar demographic and clinical characteristic except with regards to eczema, including asthma controllers and skin prick testing results. One year after the vaccine was administered, the immunized group had significantly reduced acute respiratory tract illnesses, asthma exacerbations, ER visits, bronchodilator usage and systemic steroid administrations. Hospitalizations (p < 0.001) and their duration (p < 0.034) were also reduced in the immunized group. CONCLUSIONS Immunization of inactivated influenza vaccine in children with mild persistent asthma decreased respiratory illnesses and asthma-related events.