Screening for Cow Milk Allergy among Young Egyptian Children

Abstract

Background: There are no sufficient published data on the prevalence of cow's milk protein allergy in Egypt. Aim of the Work: The aim of this study is to estimate the frequency of cow’s milk protein allergy (CMPA) among young Egyptian children in a trial to delineate the magnitude of the problem in Egypt. Patients and Methods: A cross-sectional, observational study with nonsystemic random sampling was conducted on 500 young Egyptian children from the general population with an age from 6 months to 5 years, comprising 200 males and 300 females. Each included child was subjected to clinical history taking based on the UK NICE guidelines and clinical examination, and suspected cases with suggestive clinical symptoms of CMPA were subjected to skin prick test and oral challenge test. Results: In the present study, 6.2% of screened children had positive clinical history suggestive of CMPA, 35.5% of children with clinical symptoms suggestive of CMPA had positive SPT and 51.6% of them had positive OCT. Based on clinical history and OCT as a gold standard for diagnosis of CMPA 3.2% were documented CMPA, 3% were undocumented CMPA or low probability of CMPA and 93.8% had no CMPA, there was a male predominance among the documented CMPA group (56.3% males and 43.8% females). We found that infants weaned were more affected than those un-weaned (81.3% of the confirmed CMPA cases were weaned and 18.7% were un-weaned). The clinical manifestations in infants with suspected CMPA were variable, and the main presenting feature was gastrointestinal tract manifestations (42% of the cases). Conclusion: The frequency of CMPA in Egyptian children with an age (<5ys) was 3.2%, as confirmed by positive oral food challenge tests, and the IgE-mediated CMPA was more common, as 56.3% of cases had IgE-mediated CMPA.