Allergic diseases are increasing in both first world and lower and middle income countries. A third of South Africans will suffer from some allergic disease during their life. 40% of allergy sufferers are children.
The commonest conditions are eczema, asthma, allergic rhinitis (hay fever), urticaria, food allergy and anaphylaxis. Other allergic diseases include occupational allergies, drug allergies, venom allergy and other hypersensitivity diseases. Orphan diseases include hereditary angioedema, complement deficiency and others.
Allergic diseases are the commonest chronic diseases of childhood, markedly affect quality of life and learning potential and can be fatal.
Asthma. Asthma is the commonest life threatening chronic disease of childhood. Asthma cannot be cured, however with regular treatment asthma can be controlled and symptoms prevented. Asthma causes absenteeism through its requirement for regular preventative doctors’ visits as well as unscheduled absenteeism if symptoms occur. Asthma may limit children’s participation in classroom activities, sports and academic events.
South Africa has the 3rd highest asthma death rate in the world (statistics taken from the latest Global Asthma Network report 2018), yet well managed asthmatics should be able to live a normal life. Asthma is presently the 3rd most common illness resulting in hospitalisation, which clearly contributes significantly to healthcare costs in both the public and private sector alike. As many as 80% of asthmatics will also have allergic rhinitis.
Allergic Rhinitis. This is not a trivial disease. It is a major cause of failure to learn. Inadequate control of allergic rhinitis has been proven to reduce school achievement, with sedating antihistamines exacerbating the learning disability, but treatment with intranasal steroids and second generation antihistamines abolishing it. Allergic rhinitis occurs in 20-30% of the population, and as many as 40% may also have asthma, often undiagnosed.
Anaphylaxis. Anaphylaxis is a severe, life threatening allergic reaction that is rapid in onset and requires immediate medical attention and may result in death. It can be caused by exposure to a variety of allergens such as food, insect stings, medications and latex, amongst others. Learners at risk of anaphylaxis suffer from lack of access to treatment and care which limits their freedom to attend school safely.
Food Allergies. A food allergy occurs when the immune system identifies a food protein as dangerous and releases substances into the blood which results in the symptoms of a food allergic reaction. Reactions can vary from mild rashes and swelling to life threatening anaphylaxis. The amount required to trigger a reaction varies between individuals, however some individuals react to tiny “trace amounts”. Those students who struggle with both food allergy and asthma are more at risk of a fatal allergic reaction
Atopic Dermatitis. Atopic eczema is a common, chronic, itchy skin rash that tends to affect people with other allergies like hayfever and asthma. These children do not sleep well at night and may not focus optimally at school. The rash often impacts on their cosmetic appearance and may become offensive when infected. Atopic dermatitis sufferers are frequently teased, bullied and excluded from social groups. They suffer physical and emotional consequences resulting in failure to learn to their full potential. Eczema requires frequent regular preventative emollient therapy to achieve optimal control.
Insect Stings and Bites. Severe, life threatening allergic reactions (anaphylaxis) to insects are caused by the learner having an allergy to the insect venom. Bee venom is the most common cause of anaphylaxis due to insect stings in South Africa.