[Clinical characteristics and influencing factors of children with parent-reported food allergy].

Objective: To analyze the clinical characteristics and influencing factors of children with parent-reported food allergy (FA), thus providing empirical evidence for facilitating the effective utilization of medical history information and promoting better health education for parents. Methods: A cross-sectional study was conducted, recruiting all 596 children under 3 years of age who underwent physical examinations from July to August 2019 at the Department of Child Health Care, Children's Hospital of Chongqing Medical University. Children were carried out with questionnaires, skin prick test, and diagnosed with FA through oral food challenge (OFC) by pediatricians. The parent-reported incidence rate, symptoms of FA, and the possible influencing factors, including demographic characteristics, family history of allergy, in-utero exposure to smoke and antibiotic use, feeding methods after birth, and residential environment were collected by questionnaire. The differences of clinical characteristics between parent-reported FA and medically diagnosed FA were analyzed by chi-square test. Logistic regression was used to analyze the factors associated with parent-reported FA. Results: A total of 596 children (316 boys and 280 girls) were recruited for this study. The incidence rate of FA by parent-report (22.0%, 131/596) was higher than that by medical diagnosis (9.9%, 59/596) (χ²=32.46, P<0.001). There were 36.6% (48/131) of children with parent-reported FA and 2.4% (11/465) of children without parent-reported FA receiving medical diagnosis of FA. Among children with parent-reported allergic symptoms, 37.5% (24/64) of those with gastrointestinal symptoms and 31.5% (23/73) of those with skin symptoms received medical diagnosis of FA, respectively. Six out of 7 children with co-presenting cutaneous and gastrointestinal symptoms were diagnosed with FA. Univariate Logistic regression analysis showed that family history of allergy (OR=1.83 (95%CI 1.22-2.73), P=0.003) and damp living environments (OR=2.33 (95%CI 1.13-4.79), P=0.022) were associated with higher likelihood of parent-reported FA. Conclusions: The incidence rate of parent-reported FA is higher than medically diagnosed FA. Clinicians should be highly suspicious of the possibility of FA in children with both cutaneous and gastrointestinal symptoms. Family history of allergy and damp living environments may increase the possibility of parent-reported FA.

[Status survey and training efficiency of food allergy knowledge among pediatric medical worker].

Objective: To investigate the status and influencing factors of diagnosis and treatment of food allergy knowledge in pediatric medical workers, and formulate a targeted training course for pediatricians to evaluate its training effect. Methods: A web-based questionnaire survey was conducted to investigate the current situation of food allergy knowledge among some pediatric medical workers nationwide from April 22 to 24, 2019. Then a 2.5-day training course was designed based on the survey. General pediatricians and primary care pediatricians were recruited into the offline training from November 8 to 10, 2019. The short-term and long-term effects of the training were evaluated through three online questionnaires before, at the end of the training and two months after the training, respectively. The characteristics of the respondents, the correct rate and the qualification rate of questions (more than 60% correct answers) were analyzed. Logistic regression model was used to assess the influencing factors of the qualified rate of food allergy knowledge. Chi-square test was used to analyze the difference of the qualified rate at different time point of the training. Results: Totally 1 187 participants from 28 provinces of China completed the web-based survey. The average correct rate of knowledge related to diagnosis and treatment of food allergy was 38.8% (461/1 187) and 28.8% (342/1 187), respectively. The correct rate of each knowledge related to food allergy ranged from 18.6% (221/1 187) to 63.4% (753/1 187), while the qualified rate was only 12.6% (150/1 187); 86.7% (1 029/1 187) participants could recognize the early symptoms of severe anaphylaxis and 93.3% (1 107/1 187) of them chose epinephrine as a first-line drug for severe anaphylaxis. Logistic regression analysis showed that the professional title (OR 1.427, 95% CI 1.119-1.818) and hospital level (OR 1.866, 95%CI 1.378-2.527) were the independent risk factors for the correct rate of food allergy knowledge. Sixty-nine pediatricians participated in the targeted training. There was a significant difference regarding the qualified rate of food allergy knowledge among the trainees before training (45.5% (20/44)), at the end of training (78.0% (46/59)) and two months after training (13/14) (χ(2)=16.8, P<0.01). Conclusions: The knowledge of food allergy on diagnosis and management among Chinese pediatric medical workers is unsatisfactory. Targeted offline training could continuously improve the level of diagnosis and treatment in a long period.