CLC number: R593.1
On-line Access: 2024-08-27
Received: 2023-10-17
Revision Accepted: 2024-05-08
Crosschecked: 2015-06-10
Cited: 0
Clicked: 4269
Citations: Bibtex RefMan EndNote GB/T7714
Hui-ying Wang, Yi-hong Shen, Xu-yan Yang, Lan-fang Tang, Jian-ying Zhou, on behalf of the Zhejiang Provincial Academy of Allergy . Diagnosis and treatment of allergic diseases in Zhejiang Province: a cross-sectional survey[J]. Journal of Zhejiang University Science B, 2015, 16(7): 640-650.
@article{title="Diagnosis and treatment of allergic diseases in Zhejiang Province: a cross-sectional survey",
author="Hui-ying Wang, Yi-hong Shen, Xu-yan Yang, Lan-fang Tang, Jian-ying Zhou, on behalf of the Zhejiang Provincial Academy of Allergy ",
journal="Journal of Zhejiang University Science B",
volume="16",
number="7",
pages="640-650",
year="2015",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1400284"
}
%0 Journal Article
%T Diagnosis and treatment of allergic diseases in Zhejiang Province: a cross-sectional survey
%A Hui-ying Wang
%A Yi-hong Shen
%A Xu-yan Yang
%A Lan-fang Tang
%A Jian-ying Zhou
%A on behalf of the Zhejiang Provincial Academy of Allergy
%J Journal of Zhejiang University SCIENCE B
%V 16
%N 7
%P 640-650
%@ 1673-1581
%D 2015
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1400284
TY - JOUR
T1 - Diagnosis and treatment of allergic diseases in Zhejiang Province: a cross-sectional survey
A1 - Hui-ying Wang
A1 - Yi-hong Shen
A1 - Xu-yan Yang
A1 - Lan-fang Tang
A1 - Jian-ying Zhou
A1 - on behalf of the Zhejiang Provincial Academy of Allergy
J0 - Journal of Zhejiang University Science B
VL - 16
IS - 7
SP - 640
EP - 650
%@ 1673-1581
Y1 - 2015
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1400284
Abstract: Background: The specialty of allergy developed quickly in western countries because of the rapid increase of allergic diseases, whereas it developed relatively slowly in China. The prevalence of allergen sensitization and allergic diseases in Zhejiang Province of China is high and improving the medical services for these diseases is critically needed. Objective: To investigate the working status of the diagnosis and treatment of allergic diseases, including doctor resources, diagnostic methods, and allergen-specific immunotherapy in patients of Zhejiang Province, and to provide instructions for the strategic development of subspecialties of allergic diseases. Methods: First we defined the doctors who treat allergic diseases, and designed a comprehensive questionnaire to collect personal and hospital information for these doctors. The questionnaires were distributed to hospitals with different ranks and from different areas in the province. The general condition of doctor’s resources, carryout of diagnostic methods, and allergen-specific immunotherapy were described and variations in the different specialties, hospitals, and areas were further analyzed. Results: Doctors in their thirties with bachelor’s degrees were the mainstream for diagnosing and treating allergic diseases. The main specialties of the doctor resources were the specialties of Ear, Nose and Throat (ENT), Respirology, Pediatrics, and Dermatology. The Pediatrics specialty had a more reasonable infrastructure of doctor resources with more young doctors working in this subspecialty. The development of allergy subspecialty varied within hospitals at different levels or from different areas. The carryout of the skin prick test (SPT), serum specific IgE (ssIgE), and subcutaneous immunotherapy (SCIT) was best performed in provincial hospitals, while sublingual immunotherapy (SLIT) was prescribed most commonly in municipal hospitals. The performance of SPT and ssIgE in Hangzhou, Jiaxing, and Wenzhou areas was much better than that in other places. The performance of SCIT and SLIT was best in Wenzhou. Conclusions: Our survey revealed a very initial and unbalanced development for the allergy subspecialty in Zhejiang Province. Doctor resources for allergic diseases were mainly from the specialties of ENT, Respirology, and Pediatrics, and the performance of diagnosis and treatment was mainly focused on provincial and municipal hospitals. Continuous education of allergies could be extended to primary healthcare centers and more efforts should be directed to those areas with poor medical resources.
[1]Antunes, J., Borrego, L., Romeira, A., et al., 2009. Skin prick tests and allergy diagnosis. Allergol. Immunopathol., 37(3):155-164.
[2]Asher, M.I., Montefort, S., Bjorksten, B., et al., 2006. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet, 368(9537):733-743.
[3]Bauer, C.S., Rank, M.A., 2014. Comparative efficacy and safety of subcutaneous versus sublingual immunotherapy. J. Allergy Clin. Immunol., 134(3):765-765.e2.
[4]Bergmann, K.C., 2014. Milestones in the 20th century. In: Bergmann, K.C., Ring, J. (Eds.), History of Allergy. Chem Immunol Allergy. Basel, Karger, Vol. 100, p.27-45.
[5]Bernstein, I.L., Li, J.T., Bernstein, D.I., et al., 2008. Allergy diagnostic testing: an updated practice parameter. Ann. Allergy Asthma Immunol., 100(3 Suppl. 3):S1-S148.
[6]Bousquet, J., Chanez, P., Chanal, I., et al., 1990. Comparison between RAST and Pharmacia CAP system: a new automated specific IgE assay. J. Allergy Clin. Immunol., 85(6):1039-1043.
[7]Bousquet, J., Khaltaev, N., Cruz, A.A., et al., 2008. Allergic rhinitis and its impact on asthma (ARIA) 2008. Allergy, 63(S86):8-160.
[8]Bousquet, J., Heinzerling, L., Bachert, C., et al., 2012. Practical guide to skin prick tests in allergy to aeroallergens. Allergy, 67(1):18-24.
[9]Braman, S.S., 2006. The global burden of asthma. Chest, 130(1_Suppl.):4S-12S.
[10]Burks, A.W., Calderon, M.A., Casale, T., et al., 2013. Update on allergy immunotherapy: American Academy of Allergy, Asthma & Immunology/European Academy of Allergy and Clinical Immunology/PRACTALL consensus report. J. Allergy Clin. Immunol., 131(5):1288-1296.e3.
[11]Cox, L., Esch, R.E., Corbett, M., et al., 2011. Allergen immunotherapy practice in the United States: guidelines, measures, and outcomes. Ann. Allergy Asthma Immunol., 107(4):289-299.
[12]Fornadley, J.A., 2014. Skin testing for inhalant allergy. Int. Forum Allergy Rhinol., 4(Suppl. 2):S41-S45.
[13]Hurwitz, S.H., 1953. The development of specialization in allergy: a historical review and a view ahead. Calif. Med., 78(3):216-221.
[14]International Association of Allergology, 1977. Training and specialization in allergology (clinical allergy). Clin. Allergy, 7(3):205-209.
[15]James, L.K., Shamji, M.H., Walker, S.M., et al., 2011. Long-term tolerance after allergen immunotherapy is accompanied by selective persistence of blocking antibodies. J. Allergy Clin. Immunol., 127(2):509-516.e5.
[16]Jutel, M., Angier, L., Palkonen, S., et al., 2013. Improving allergy management in the primary care network—a holistic approach. Allergy, 68(11):1362-1369.
[17]Kroegel, C., 2009. Global Initiative for Asthma (GINA) guidelines: 15 years of application. Expert Rev. Clin. Immunol., 5(3):239-249.
[18]Krouse, J.H., Mabry, R.L., 2003. Skin testing for inhalant allergy 2003: current strategies. Otolaryngol. Head Neck Surg., 129(4):S33-S49.
[19]Li, J., Sun, B., Huang, Y., et al., 2009. A multicentre study assessing the prevalence of sensitizations in patients with asthma and/or rhinitis in China. Allergy, 64(7):1083-1092.
[20]Li, J.T., 2002. Allergy testing. Am. Fam. Physician, 66(4):621-624.
[21]Liccardi, G., D'Amato, G., Canonica, G.W., et al., 2006. Systemic reactions from skin testing: literature review. J. Investig. Allergol. Clin. Immunol., 16(2):75-78.
[22]Marshall, G.D., 2007. The status of US allergy/immunology physicians in the 21st century: a report from the American Academy of Allergy, Asthma & Immunology Workforce Committee. J. Allergy Clin. Immunol., 119(4):802-807.
[23]Newson, R.B., van Ree, R., Forsberg, B., et al., 2014. Geographical variation in the prevalence of sensitization to common aeroallergens in adults: the GA2LEN survey. Allergy, 69(5):643-651.
[24]Ozdoganoglu, T., Songu, M., 2012. The burden of allergic rhinitis and asthma. Ther. Adv. Respir. Dis., 6(1):11-23.
[25]Reid, M.J., Lockey, R.F., Turkeltaub, P.C., et al., 1993. Survey of fatalities from skin testing and immunotherapy 1985-1989. J. Allergy Clin. Immunol., 92(1):6-15.
[26]Ring, J., Gutermuth, J., 2011. 100 years of hyposensitization: history of allergen-specific immunotherapy (ASIT). Allergy, 66(6):713-724.
[27]Roche, A.M., Wise, S.K., 2014. Subcutaneous immunotherapy. Int. Forum Allergy Rhinol., 4(Suppl. 2):S51-S54.
[28]Sampson, H.A., 2001. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J. Allergy Clin. Immunol., 107(5):891-896.
[29]Scadding, G.W., Shamji, M.H., Jacobson, M.R., et al., 2010. Sublingual grass pollen immunotherapy is associated with increases in sublingual Foxp3-expressing cells and elevated allergen-specific immunoglobulin G4, immunoglobulin A and serum inhibitory activity for immunoglobulin E-facilitated allergen binding to B cells. Clin. Exp. Allergy, 40(4):598-606.
[30]Schatz, M., Leung, D.Y.M., Goldstein, S., 2006. Consultation and referral guidelines citing the evidence: how the allergist-immunologist can help. J. Allergy Clin. Immunol., 117(2 Suppl. 3):S495-S523.
[31]Siles, R.I., Hsieh, F.H., 2011. Allergy blood testing: a practical guide for clinicians. Cleve. Clin. J. Med., 78(9):585-592.
[32]van Metre, T.E.Jr., 1979. Presidential address. The advancement of the knowledge and practice of allergy. J. Allergy Clin. Immunol., 64(4):235-241.
[33]Warner, J.O., Kaliner, M.A., Crisci, C.D., et al., 2006. Allergy practice worldwide: a report by the World Allergy Organization Specialty and Training Council. Int. Arch. Allergy Immunol., 139(2):166-174.
[34]Wen, L.P., 2013. Summary of 2013 annual congress of Chinese Allergy Society. Chin. J. Allergy Clin. Immunol., 8(1):83-85 (in Chinese).
[35]Ye, S.T., 2001. The start and development of allergy specialty in China. Chin. J. Microbiol. Immunol., 21(Suppl.):1-3 (in Chinese).
[36]Yin, J., 2014. A new turning point for the development of allergy specialty in China. Chin. J. Allergy Clin. Immunol., 8(1):1-2 (in Chinese).
[37]Zhejiang Provincial Bureau of Statistics, 2014. 2013 annual communique of the statistics of Zhejiang provincial economy and society development. Stat. Theory Pract., 3:4-10 (in Chinese).
[38]Zuberbier, T., Lotvall, J., Simoens, S., et al., 2014. Economic burden of inadequate management of allergic diseases in the European Union: a GA2LEN review. Allergy, 69(10):1275-1279.
Open peer comments: Debate/Discuss/Question/Opinion
<1>