Development of a tool for screening adverse food reactions and food allergy in Portuguese children
Main Article Content
Keywords
Adverse food reaction, Children, Consistency, Food allergy, Questionnaire, Reproducibility, Temporal stability
Abstract
Introduction and objectives: A standardised questionnaire may be an excellent tool for epidemiological studies aiming at screening children with suspected food allergies. Thus, the aim of the present study was to develop a screening questionnaire for assessing children with suspected food allergy and to analyse its reproducibility.
Materials and methods: A questionnaire of adverse food reactions was developed by literary review of similar questionnaires validated in other countries as well as less well-defined, nonvalidated Portuguese questionnaires. Peer review of the questionnaire by a panel of specialists and subsequent exploratory analysis was carried out by applying the questionnaire in children with confirmed food allergy. Test-retest analysis was performed by giving a face-to-face questionnaire to 159 children with suspected adverse food reactions, aged between three and 11 years. Temporal stability using Spearman Rho correlation test and reproducibility was studied using Cohen’s Kappa index.
Results: 115 children confirmed adverse food reactions that occurred with one or more foods. Retest was given about three weeks after the test, to 50 of these children who were randomly selected. The questionnaire showed good temporal stability (Spearman correlation coefficient of 0.834), and good reproducibility (only two of the 27 items had a Kappa index <0.60).
Conclusions: This questionnaire showed good temporal stability and reproducibility. Its validation for screening children with suspected food allergy will allow a standardised approach to diagnosis and comparison of results obtained in different centres.
References
2. Sicherer SH, Sampson H. Food allergy. J Allergy Clin Immunol. 2006;117:S470-5.
3. Sicherer SH. Epidemiology of food allergy. J Allergy Clin Immunol. 2011;127:594-602.
4. Boyce JA, Assaad ´ A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126:S1-58.
5. Santos AF, Lack G. Food allergy and anaphylaxis in pediatrics: update 2010-2012. Pediatr Allergy Immunol. 2012;23:698-706.
6. Niggemann B. Special aspects of food allergy in children. Hautarzt. 2012;63:288-93.
7. Sampson HA, Mendelson L, Rosen JP. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med. 1992;327:380-4.
8. Eigenmann PA. Do we still need oral food challenges for the diagnosis of food allergy? Pediatr Allergy Immunol. 2018;29:239-42, http://dx.doi.org/10.1111/pai.12845.
9. Carrapatoso I, Falcão H, Cunha L, Jordão F, Sampaio G, Costa AC, et al. Alergia alimentar. Rev Port Imunoalergol. 2009;17 Suppl. 1:5-40.
10. Muraro A, Werfel T, Hoffmann-Sommergruber K, Roberts G, Beyer K, Bindslev-Jensen C, et al. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 2014;69:1008-25.
11. Nwaru BI, Hickstein L, Panesar SS, Muraro A, Werfel T, Cardona V, et al. The epidemiology of food allergy in Europe: a systematic review and meta-analysis. Allergy. 2014;69:62-75.
12. Mills EN, Mackie AR, Burney P. The prevalence, cost and basis of food allergy across Europe. Allergy. 2007;62:717-22.
13. Keil T. Epidemiology of food allergy: what’s new? A critical appraisal of recent population-based studies. Curr Opin Allergy Clin Immunol. 2007;7:259-63.
14. Nissen SP, Kjaer HF, Høst A, Nielsen J, Halken S. The natural course of sensitization and allergic diseases from childhood to adulthood. Pediatr Allergy Immunol. 2013;24:549-55.
15. Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, et al. The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007;120:638-46.
16. Pereira B, Venter C, Grundy G, Clayton CB, Arshad SH, Dean T. Prevalence of sensitization to food allergens, reported adverse reaction to foods, food avoidance, and food hypersensitivity among teenagers. J Allergy Clin Immunol. 2005;116:884-92.
17. Shu SA, Chang C, Leung PS. Common methodologies in the evaluation of food allergy: pitfalls and prospects of food allergy prevalence studies. Clin Rev Allergy Immunol. 2014;46:198-210.
18. Hoyos-Bachiloglu R, Ivanovic-Zuvic D, Álvarez J, Linn K, Thöne N, de los Ángeles Paul M, Borzutzky A. Prevalence of parent-reported immediate hypersensitivity food allergy in Chilean school-aged children. Allergol Immunopathol. 2014;42: 527-32.
19. Farias Júnior JC, Lopes AS, Mota J, Santos MP, Ribeiro JC, Halla PC. Validade e reprodutibilidade de um questionário para medida de atividade física em adolescentes. Rev Bras Epidemiol. 2012;15:198-210.
20. Orhan F, Karakas T, Cakir M, Aksoy A, Baki A, Gedik Y. Prevalence of immunoglobulin E-mediated food allergy in 6-9-year-old urban schoolchildren in the eastern Black Sea region of Turkey. Clin Exp Allergy. 2009;39:1027-35.
21. Kummeling I, Mills ENC, Clausen M, Dubakiene R, Fernández Pérez C, Fernández-Rivas M, et al. The EuroPrevall surveys on the prevalence of food allergies in children and adults: background and study methodology. Allergy. 2009;64:1493-7.
22. Kavaliunas A, Surkienè G, Dubakienè R, Stukas R, Zagminas K, Saulitè J, et al. EuroPrevall Survey on prevalence and patterns of self-reported adverse reactions to food and food allergies among primary schoolchildren in Vilnius, Lithuania. Medicina (Kaunas). 2012;48:265-71.
23. Lyra NRS, Motta MEFA, Rocha LAR, Solé D, Peixoto DM, Rizo JA, et al. Adverse reactions to foods and food allergy: development and reproducibility of a questionnaire for clinical diagnosis. J Allergy. 2013;2013:1-7.
24. Morais-Almeida M, Prates S, Pargana S, Arêde C, Godinho N, Tavares C, et al. Alergia alimentar em crianc¸as numa consulta de imunoalergologia. Rev Port Imunoalergol. 1999;7: 167-71.
25. Bento ML, Armando F, Cesar-Ramos JM. Epidemiology of food allergy in Portugal. Pediatr Pulmonol. 2001; Suppl. 23:38-40.
26. Rancé F, Grandmottet X, Granjean H. Prevalence and main characteristics of schoolchildren diagnosed with food allergies in France. Clin Exp Allergy. 2005;35:167-72.
27. Venter C, Pereira B, Grundy J, Clayton CB, Arshad SH, Dean T. Prevalence of sensitization reported and objectively assessed food hypersensitivity amongst six-year-old children: a population-based study. Pediatr Allergy Immunol. 2006;17:356-63.
28. Zuberbier T, Edenharter G, Worm M, Ehlers I, Reimann S, Hantke T, et al. Prevalence of adverse reactions to food in Germany - a population study. Allergy. 2004;59:338-45.
29. Van der Velde JL, Flokstra-de Blok BM, Vlieg-Boerstra BJ, Oude Elberink JN, Dunn Galvin A, Hourihane JO, et al. Development, validity and reliability of the food allergy independent measure (FAIM). Allergy. 2010;65:630-5.
30. Kanny G, Moneret-Vautrim DA, Flabbee J, Beaudoin E, Morisset M, Thevenin F. Population study of food allergy in France. J Allergy Clin Immunol. 2001;108:133-40.
31. Sandin A, Annus T, Björkstén B, Nilsson L, Riikjärv M-A, van Hage-Hamsten M, et al. Prevalence of self-reported food allergy and IgE antibodies to food allergens in Swedish and Estonian schoolchildren. Eur J Clin Nutr. 2005;59:399-403.
32. Sampson HA. Anaphylaxis and emergency treatment. Pediatrics. 2003;111:1601-8.
33. Sampson HA. Food allergy - accurately identifying clinical reactivity. Allergy. 2005;60 Suppl. 79:19-24.
34. Cerda J, Villarroel L. Evaluación de la concordancia interobservador en investigación pediátrica: Coeficiente de Kappa. Rev Chil Pediatr. 2008;79:54-8.
35. Watson PF, Petrie A. Method agreement analysis: a review of correct methodology. Theriogenology. 2010;73:1167-79.
36. Prous MJGY, Salvanés FR, Ortells LC. Validation of questionnaires. Reumatol Clin. 2009;5:171-7.
37. Rodriguez MC, Maeda Y. Meta-analysis of coefficient alpha. Psychol Methods. 2006;11:306-22.
38. Lozoya-Ibánez ˜ C, Morgado-Nunes S, Rodrigues A, Lobo C, Taborda-Barata L. Prevalence and clinical features of adverse food reactions in Portuguese adults. Allergy Asthma Clin Immunol. 2016;12:36, http://dx.doi.org/10.1186/s13223-016-0139-8.
39. Eggesbø M, Botten G, Halvorsen R, Magnus P. The prevalence of CMA/CMPI in young children: the validity of parentally perceived reactions in a population-based study. Allergy. 2001;56:393-402.
40. Van Zyl Z, Maslin K, Dean T, Blaauw R, Venter C. The accuracy of dietary recall of infant feeding and food allergen data. J Hum Nutr Diet. 2016;29:777-85, http://dx.doi.org/10.1111/jhn.12384.
41. Rouquette A, Falissard B. Sample size requirements for the internal validation of psychiatric scales. Int J Methods Psychiatr Res. 2011;20:235-49.
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