FOOD ALLERGY IN SOUTH AFRICA: JOINING THE FOOD ALLERGY EPIDEMIC?

The last 10-15 years have seen a steep rise in food allergies in westernised countries. South Africans, especially those of black descent, have traditionally enjoyed a low rate of food allergy and have long been thought to be protected against the food allergy epidemic. Previous food allergy prevalence studies in South Africa have focused on sensitisation and questionnaires which are not a true reflection of clinically relevant food allergy. A recent food allergy prevalence study in eczematous patients in Cape Town has shown a surprisingly high rate of challenge-proven food allergies in children of both Xhosa and mixed descent. These findings suggest that South Africa may not be spared from the food allergy epidemic. A large study investigating the prevalence of food allergy in an unselected group of young children is currently being planned, focusing on differences between urban and rural areas and between ethnic groups. Various factors which may contribute to the expression or suppression of food allergy, including exposure to foods, genetics, infections, diet and intestinal microbiota need further study. A better understanding of factors contributing towards food allergy expression will help us to define preventative strategies to curb the rise in food allergy.