2012 Volume 61 Issue 1 Pages 41-50
Background: Even though allergic diseases continue to increase among children, it is unclear as to how many of these children are receiving appropriate medical care. Purpose: To establish the number of schoolchildren being diagnosed and receiving consultation for their allergic diseases and to determine if their disease status is associated with their total and allergen-specific IgE levels. Additionally, the study examined whether providing information on the total and allergen-specific IgE levels to the parents resulted in improvement of the medical care their children received. Methods: A total of 618 out of the 627(94.5%) parents of 11-year-old schoolchildren living in Ohmi-Hachiman City, Shiga, Japan, answered a questionnaire designed to determine the presence of allergic diseases (bronchial asthma, atopic dermatitis, allergic rhinitis, and allergic conjunctivitis) and the status of medical care in their children. Levels of total IgE, mite-specific IgE, and three pollen-specific IgEs were measured at the same time that the questionnaires were filled out. Information from the questionnaires was used to analyze the relationships between the questionnaire data and IgE levels. After parents were given the IgE results, medical consultations were recommended for those children having allergic symptoms and positive allergen-specific IgEs. One year after providing the information, a follow-up survey was performed to determine whether parents took any actions in response to their children's test results. Results: The mean total IgE level was 138IU/ml, with a total of 62.8% of the children sensitized to one or more allergens. Even among those without any allergic disease, 49.2% or the children sensitized to one or more allergens. In children with bronchial asthma, diagnosis and consultation rates were 100% and 81 %, respectively. However, the diagnosis and consultation rates among those with other types of allergic diseases were significantly lower, ranging from 44 to 88% for diagnosis and 28 to 52% for consultation. A total of 63% of the parents with children having allergic diseases indicated they undertook further efforts designed to improve their child's allergy disease symptoms after they were informed of the total and allergen-specific IgE levels. Conclusion: Results of the present survey demonstrated that significant numbers of children with atopic dermatitis, allergic rhinitis or allergic conjunctivitis were not given appropriate medical care. In order to conclusively determine whether total and allergen-specific IgE screening at schools is useful in ensuring that children receive appropriate medical care, further evaluations will need to be conducted.
