Current situation of diagnosis and treatment of children food allergy in Chongqing

Abstract:

Objective：To explore the current situation of clinical diagnosis and treatment of children food allergy，and to analyze ex－isting problems，so as to provide reference for improving levels of diagnosis and treatment of children food allergy. Methods：Self-de－signed questionnaires were used to investigate the situation of diagnosis and treatment of children food allergy in 40 maternal and child health hospitals in Chongqing，including the diagnostic criteria，diagnostic methods，treatment methods，problems and demands. Results：Among the 40 maternal and child health hospitals，24 hospitals（60%） conducted the diagnosis of children food allergy，19 （79.17%） hospitals carried out the skin prick test，21 hospitals（87.5%） carried out detection of specific IgE，5 hospitals（20.83%） carried out detection of IgG，7 hospitals（29.17%） carried out elimination diets and 1 hospital conducted the open food stimulation test. In 2018，a total of 19641 cases of SPT tests and 1922 cases of sIgE were conducted in Chongqing maternal and child health care institutes. The survey of doctors revealed：91.9% doctors of child health care thought that patient’s clinical history was the most im－portant in diagnosis of food allergy；69.80% primary doctors thought that positive SPT or sIgE results combined with symptoms of skin or digestive tract（whether closely related to food or not） could diagnose food allergy without elimination diets and food challenge；89.5% doctors thought that negative SPT and sIgE results sug－gested non-food allergy；65.08% doctors believed that IgG was significant in the diagnosis of food allergy. Ninety-five percent parents didn’t know SPT/sIgE and thought that the negative results were not allergic. If the child was considered to be cow’s milk protein allergy，11.11% doctors would advise mothers to stop breastfeeding；25.40% doctors suggested to change to partial hydrolysis formula. If the children were allergic to eggs，7.94% doctors advised the use of partial hydrolysis formula while stopping eggs，and 26.98% doctors advised the use of deep hydrolysis formula. Some doctors applied the food elimination or replacement，but the time was different Doctors in primary levels have high expectations for standardized diagnosis and treatment training and operational processes of food allergy. Conclusion：The diagnosis and treatment of food allergy in children is not standardized in primary medical institutions. Therefore，comprehension of recent food allergy guidelines and consensus in doctors should be strengthened，the training of the diagnosis and treatment can be carried out at different levels and the diagnosis and treatment of food allergy should be standardized，so as to improve the level of diagnosis and treatment of food allergy.