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Vieira SCF, Santos VS, Franco JM, Nascimento-Filho HM, Barbosa KDOESS, Lyra-Junior DPD, Bastos KDA, Cipolotti R, Wayhs MLC, Vieira MC, Solé D, de Morais MB, Gurgel RQ. Brazilian pediatricians' adherence to food allergy guidelines-A cross-sectional study. PLoS One 2020; 15:e0229356. [PMID: 32092100 PMCID: PMC7039437 DOI: 10.1371/journal.pone.0229356] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 02/04/2020] [Indexed: 12/20/2022] Open
Abstract
Food allergy is an emerging clinical condition in pediatrics, so recommendations on its management have been widely published. Studying pediatricians' adherence to these clinical practice guidelines (CPG) and understanding the reasons for their non-compliance can help to promote better management of this condition. A cross-sectional study was conducted by a survey among Brazilian pediatricians, randomly selected during the 38th Brazilian Congress of Pediatrics, which took place in October, 2017. A validated questionnaire with 16 questions addressing knowledge and practice on food allergy, as well as self-reported adherence to international guidelines was applied. Of the total of 415 pediatricians from all regions of the country who were surveyed, only 69 (16.7%) had a satisfactory adherence rate (≥80%). Adequate adherence to the guidelines was associated with the variables: 'evaluating more than 10 children with suspected cow's milk allergy (CMA) per month'; 'having read the Brazilian consensus'; or 'being aware of any international food allergy guideline'. In 8 of the 10 questions that assessed conscious adherence, a minority of those surveyed (20.3-42.3% variation) stated that they knew that their response was in line with the guidelines. This finding was statistically significant (p<0.05) in 7 of these 8 questions. The self-reported adherence of Brazilian pediatricians to international food allergy guidelines was low. Pediatricians who evaluated a higher number of children with suspected CMA or who were aware of the recommendations, had a higher rate of adherence. The results of the survey found that lack of resource was the major reported barrier to guideline adherence but lack of awareness must be a relevant non perceived barrier. This study shows the pediatricians´ self-reported adherence to food allergy guidelines in a widely overview for the first time in Brazil. More studies are necessary to investigate adherence to guidelines by pediatricians in other countries and to develop strategies to improve adherence.
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Affiliation(s)
- Sarah Cristina Fontes Vieira
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Reference Center for Food Allergy of Sergipe, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - Jackeline Motta Franco
- Reference Center for Food Allergy of Sergipe, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | | | | | - Kleyton de Andrade Bastos
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Rosana Cipolotti
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Mônica Lisboa Chang Wayhs
- Department of Pediatrics, Federal University of Santa Catarina, Florianópolis-Santa Catarina, Brazil
| | - Mário César Vieira
- Center for Pediatric Gastroenterology, Hospital Pequeno Príncipe, Curitiba, Paraná, Brazil.,Department of Pediatrics, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Dirceu Solé
- Department of Pediatrics, Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | | | - Ricardo Queiroz Gurgel
- Graduate Program in Health Science, Federal University of Sergipe, Aracaju, Sergipe, Brazil.,Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil
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Sánchez J, Sánchez A. Epidemiologic studies about food allergy and food sensitization in tropical countries. Results and limitations. Allergol Immunopathol (Madr) 2019; 47:401-408. [PMID: 30670296 DOI: 10.1016/j.aller.2018.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/28/2018] [Accepted: 11/15/2018] [Indexed: 11/26/2022]
Abstract
The variety of foods and methods of preparation are part of the cultural identity of each population, and thus the main foods that cause symptoms vary among different regions. Due to their increasing frequency, Adverse Reactions to Food (AFR) have been the subject of extensive study, especially in North America and Europe but few studies have been conducted in other areas, especially in populations located in the tropics and subtropics. In this article, we review available information on the epidemiology of food sensitization and food allergies in tropical regions and explore the different epidemiological data considering the major food involved, the underlying immune mechanism and clinical symptoms partners. In addition, we identify the possible limitations and questions that arise from studies conducted in tropical countries, which helps to generate objectives for future research.
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Sánchez J, Sánchez A. Epidemiology of food allergy in Latin America. Allergol Immunopathol (Madr) 2015; 43:185-95. [PMID: 24207003 DOI: 10.1016/j.aller.2013.07.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 07/20/2013] [Indexed: 11/16/2022]
Abstract
Food allergy is growing worldwide at an alarming rate. A group of eight foods account for over 90% of the reactions in Europe and the United States. However, little is known about the frequency of sensitization to these foods in Latin American, and if other native foods from this region are an important source of sensitization. The objective of this review was to analyse the epidemiological studies in Latin America about food allergy and to compare them with the studies in the United States and Europe.
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Affiliation(s)
- J Sánchez
- Foundation for the Development of Medical and Biological Sciences, (FUNDEMEB), Cartagena, Colombia; Group of Experimental Allergy and Immunogenetic, Institute of Immunological Research, University of Cartagena, Cartagena, Colombia; Group of Clinical and Experimental Allergy (GACE), University of Antioquia, Medellín, Colombia.
| | - A Sánchez
- Foundation for the Development of Medical and Biological Sciences, (FUNDEMEB), Cartagena, Colombia; Group of Experimental Allergy and Immunogenetic, Institute of Immunological Research, University of Cartagena, Cartagena, Colombia
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