Allergies are on the rise in Africa, but with too few specialists to treat them, and a parallel increase in immune deficiency diseases, the situation is worse than we thought. According to researchers from Ain Shams University in Egypt in an article in The Journal of Allergy and Clinical Immunology, the answer is more funding, motivated governments and better scientific partnerships.
Their work has been selected by an international scientific committee to receive this month’s Atlas Award, selected from 10 nominated articles that have demonstrated the potential impact on people's lives around the world. The winning research is presented alongside interviews, expert opinions, multimedia and much more on the Atlas website.
Across Africa, many communities are faced daily with sewage-contaminated water supplies, unsanitary living conditions and parasite infestations. But rather than strengthening their immune responses, as the hygiene hypothesis would suggest, allergic disease is on the rise. What little data there is suggests allergies and asthma are getting more prevalent and more severe; statistics from Cape Town, Nairobi, the urban Ivory Coast and other areas reveal asthma rates of 18-20 percent, which is comparable to rates seen in the West.
“This tremendous increase in allergy in Africa cannot simply be explained by the change in public hygiene, as there are many pre-hygiene situations across the continent with sewage contaminated water supply, helminth infestations, bare footedness and poor housing, and still there is growing prevalence of allergic disease,” said Dr. Elham Hossny, Professor of Pediatrics at the Children’s Hospital, Ain Shams University in Egypt and one of the authors of the study. “This may argue against the hygiene hypothesis in our country.”
According to the hygiene hypothesis, a lack of exposure can even suppress the immune system. But what, then, is the explanation for the huge increase in allergies in Africa?People in Africa can be exposed to many risk factors that can trigger severe asthma and allergic reactions, including foods, animals and birds, house dust mites, mold spores, stinging insects and aeroallergens like smoke and pollen. But because it was assumed the rates of allergy were low across the continent, there is very little data showing just how big the problem is.
The rise in allergies alone would provide enough of a challenge, but the increase in diseases that compromise the immune system, such as HIV and primary immunodeficiency diseases (PIDs) is exacerbating the problem. The rate of new HIV infections in high-prevalence areas across Africa is still very high, and although only 2,500 patients have been diagnosed with PIDs, the number is estimated to be more like 988,000.
All the while the data and diagnoses do not reflect the real situation, the support will not be forthcoming. Dr. Hossny and her colleagues highlight an urgent need to establish PID registries, stem cell transplantation facilities and neonatal screening programs, and to boost the study and practice of allergy medicine and immunology in Africa.
“We need to deliver a message to the policy makers in Africa and in everywhere in the world to help us promote our specialty and support our patients and perform the required research at a global standard,” she said. “In order for African allergists and immunologists to provide better care for their patients and to be able to perform cutting-edge research in the field, they need to be empowered by motivated governments, dedicated funds, and compassionate scientific partnerships.”
All of these vital solutions will require dedication and funding – something Dr. Hossny and her colleagues are seeking in collaboration with researchers and healthcare providers.
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Notes for editors
The article is "Allergy and immunology in Africa: Challenges and unmet needs," by Yehia M. El-Gamal, Elham M. Hossny, Zeinab A. El-Sayed, Shereen M. Reda (https://doi.org/10.1016/j.jaci.2017.09.004). It appears in The Journal of Allergy and Clinical Immunology, volume 140, (November, 2017), published by Elsevier.
Full text of the article is available to credentialed journalists upon request, contact newsroom@elsevier.com.
About The Journal of Allergy and Clinical Immunology
The Journal of Allergy and Clinical Immunology publishes high-impact, cutting-edge clinical and translational research papers for allergists, immunologists, dermatologists, gastroenterologists, and other physicians and researchers interested in allergic diseases and clinical immunology. Articles cover topics such as asthma, food allergy, primary immune deficiencies and other allergic and immunologic diseases, and include clinical trials and mechanistic studies that report on novel therapies and other discoveries that will ultimately improve the diagnosis and management of patients.
About Atlas
Science impacts everyone's world. With over 1,800 journals publishing articles from across science, technology and health, our mission is to share some of the stories that matter. Each month Atlas will showcase research that can (or already has) significantly impact people's lives around the world and we hope that bringing wider attention to this research will go some way to ensuring its successful implementation.
With so many worthy articles published the tough job of selecting a single article to be awarded "The Atlas" each month comes down to an Advisory Board. The winning research is presented alongside interviews, expert opinions, multimedia and much more on the Atlas website: http://www.elsevier.com/connect/atlas.
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