Prevalence, Incidence and Associated Risk Factors of Adverse Reaction to Food in Cuban Infants. a Population-Based Prospective Study

Background: The paediatric population is known to have high rates of asthma, eczema and allergic rhinitis, but little is known about food allergy and intolerance. The objective was determining prevalence, incidence and risk factors of Adverse reaction to food in paediatric population.

Methods: A random sample of 1543 children aged 3 years old living in Havana was included in the data base of study Natural History of Wheezing in a Cohort of Cuban Infants (HINASIC). Data were collected using questionnaires administered by researchers. Adverse reaction to food was defined by medical diagnosis reported by parents. Nutritional status of mother during pregnancy was defined by Cuban charts for this group. The data were analysed by dichotomous logistic regression using a step-wise modelling approach. The study protocol was approved by National Institute of Hygiene, Epidemiology and Microbiology Ethical and the Scientific Committee Havana in Cuba and also by the University of Nottingham Medical School Ethics Committee in the United Kingdom. The oral and written consent was obtained from the baseline by the legal guardians of children.

Results: The prevalence of adverse reaction to any food were 5.7%, 4,0% and 2,5% at age 1, 2 and 3 years respectively. The annual incidence of new food sensitivity in the previous year was 5.7%, 1.9% and 0.8% at age 1, 2 and 3 years respectively. The most common food involved was cow milk (44.6 %). Frequent systems affected are gastrointestinal tract and skin. The most important associated risk factors were: consumption of allergenic foods (OR: 2.33; 95% confidence intervals CI: 1.28-4.25), use of antibiotics (OR: 1.88; CI: 1.09-3.23), factors related to presence of environmental allergens such as cocking in child room (OR: 1.75; CI: 1.24-2.47) and mold at home (OR:1.65; CI: 1.18-2.31), maternal history of overweight defined by Cuban standard for nutritional evaluation of weight during pregnancy (OR: 1.64; CI: 1.08-2.49) and insect sting allergy (OR: 1.55; CI: 1.05-2.29).

 Conclusions:Adverse reaction to food is a significant clinical problem in a Cuban paediatric population. Modifiable risk factors were identified, although it is unclear if these associations are causal. Better understanding of these associations will help inform the implementation of effective intervention strategies in the future.