¹Professor, ³Associate Professor, Department of Paediatrics, JIIU’s IIM SandR, Warudi, Jalna, Maharashtra, INDIA.

²Associate Professor, Department of Paediatrics, PCMC’S PGI YCMH, Pimpri, Pune, Maharashtra, INDIA.

Email: drseemasoni@gmail.com

RESULTS

The total number of the patients included in the study were 130, of which 71 (54.62%) were males and 59 (45.38%) females. The study group is divided into three age groups, 2-4 Years (30%), 5- 7 Years (45.38%) and 8-10 Years (24.62%). The frequency of each group is shown in Table-1

Table 1: Distribution of Study Subject (N=130)

Table 2: Association of Study Variables and allergen sensitization

Out of 130 children in the study, 87 children were found sensitive to at least one aeroallergen and 43 were not sensitive to any of the aeroallergens. Out of the children sensitive to at least one of the aeroallergens 49 (69.01%) were males and 38 (64.41%) were females and 22 (30.99%) males and 21 (35.59%) females were not sensitivity to any of the aeroallergens. Moreover, 42 (71.19%) of patients with positive tests were in the age group 5-7 years and 25 (78.13%) were in the age group of 8-10 Yrs. Only 20 (51.28%) were found in the age group 2-4 years (Table 2).

Table 3: Skin sensitivity to allergens

The highest prevalence of positive skin reaction was recorded for mite allergens like Dermatophytosis pteronyssinus (60.92%), D. farinae (34.48%), Among Fungi group, Aspergillus fumigates (4.60%), Alternaria alternate (4.60%), Cat epithelia and Dog epithelia showed positive in 1 (1.15%) case respectively. Among Pollen group Parthenium hysterophorus (6.90%). The frequency of positive tests to an individual allergen is depicted in the Table 3.

DISCUSSION

Aeroallergens are the prominent causes of allergic symptoms in patients with recurrent wheeze. Sensitivity to aeroallergens increased significantly with age. The frequency of sensitization was 23.3% among children aged 2 years to 4 years, 45% in the age group of 5-7 years and 31.6% in the age group of 8-10 years. This is similar to the results of Sonnappa S et al.⁸

The study showed a prevalence of positive skin prick tests of 69.01% in males and 64.41% in females. Thus, it shows boys had a slightly greater prevalence of any positive skin-test (69.01% vs 64.41%). In this study, 66.9% of patients were sensitive to aeroallergen but 33.1% had negative skin prick tests. The negative reactions may be probably because of the patient’s sensitization to other particular allergens. This high percent of sensitization was also shown by Mohammadi K et al.⁹ 81% of their patients had positive skin reactivity to aeroallergens, which were also comparable to 68% in Farhoudi A et al.¹⁰ Mites were the most common aeroallergen in patients with allergic diseases in the current study which is similar to studies of Spycher BD et al.¹¹ As against our study, pollens were the most common cause of sensitization in study by Sobel ME et al.¹² This difference also was expected since mites tend to require high humidity and moderate temperatures to thrive, whereas pollens require a dry climate and a high temperature. In many humid countries, dust mites were the most important cause of sensitization in allergic children because mites tend to thrive in high humidity.¹³ Surprisingly, mite allergens were also reported in hot and dry regions, like Kuwait.¹⁴ and Iran.¹⁵ It might be related to the wide use of air conditioners which make good conditions for mites to grow and increase susceptibility to indoor allergens. Among mites, D.pteronyssinus had the highest rate of sensitization and D.farine were next in importance. In a similar study, house dust mites were reported to have the highest rate of sensitization among Malaysian asthmatic patients¹⁶ and patients with allergic rhinitis in Thailand.¹⁷ Bloomia also showed a significant reaction in many wheezers which is shown by studies of Martinez FD et al.¹⁸ Their study showed that there is a rising trend in the sensitization pattern of bloomia. Among the fungi, in our study Aspergillus fumigatus (4.6%) being the most common sensitizer followed by Alternaria Alternate and (4.6%). Similarly, Aspergillus fumigates had been identified as a major fungal allergen in the study of Prasad et al.¹⁹ Nelson HS studied the sensitivity of asthmatics to cockroach allergens in children from 6 months to 12 years old and reported a 29% rate of positive skin tests in these children.²⁰ Results of a study in northern Iran have also reported the prevalence of sensitivity to cockroach allergen in patients with asthma as 12.7 percent.²¹ This study result had shown that there is less sensitivity to animal dander. In contrast, Western and European countries²² show a higher percent of sensitization because of the incidence of domestic pets in their homes more than our country. In this study, according to the highest prevalence of allergies to mites, proper training of the patients about avoiding contact with these agents as the most important way to prevent the wheezing symptoms. Informing about allergy symptoms is effective in prevention and reduction of the severity of symptoms in patients. Furthermore, using immunotherapy for desensitization to common allergens will have a significant effect on the symptoms to completely disappear. In our study, only 6 patients had positive pricks test to pollen extract. These results contrast with other studies in areas such as Virginia and the United States, where authors found high levels of sensitivity to pollen in young children. It showed a positive prick test in 29% of children aged 1 to 2 years, and it increases to 50% in those in the range of 3 to 4 years.²³ A greater number of pollinic seasons are required to sensitize to young children. The major indoor allergenic proteins that have been characterized are house dust mite allergens, cat antigens, dog dander antigens, mouse antigens, cockroach antigens, and certain fungal allergens.

CONCLUSION

The sensitivity to aeroallergens increases with age. In children the sensitivity to indoor allergens is more prevalent than sensitivity to outdoor allergens. Sensitivity to pollen was found in older children more than 5 years of age. Further, this study may also be helpful in controlling and/or avoiding allergens causing allergic disease.

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