Risk factors of delayed tolerance in children with cow milk protein allergy attending gastroenterology clinic in Alexandria University Children’s Hospital

Objectives:To describe a nosocomial outbreak ofSalmonellaserotype Saintpaul gastroenteritis and to explore risk factors for infection.Design:Case-control study.Setting:A 208-bed, university-affiliated children's hospital.Participants:Patients hospitalized at Children's Hospital and Regional Medical Center, Seattle, Washington, during February 2001 who had stool specimens obtained for culture at least 24 hours after admission. Case-patients (n = 11) were patients with an indistinguishable strain ofSalmonellaSaintpaul cultured from their stool. Control-patients (n = 41) were patients hospitalized for problems other than gastroenteritis whose stool cultures were negative forSalmonella.Methods:Risk factors were evaluated using the chisquare test or Fisher's exact test. Continuous variables were compared using the Mann–Whitney U test. A multivariable analysis was performed using logistic regression. The predictor of interest was the receipt of enteral feeding formula mixed by the hospital.Results:Case-patients were more likely than control-patients to have received formula mixed by the hospital (OR, 4.2; 95% confidence interval, 1.04 to 17.16). Other variables evaluated were not significant predictors ofSalmonellaSaintpaul infection.Conclusions:Formula mixed by the hospital appears to have been the source of thisSalmonellaoutbreak. Strict sanitation measures must be ensured in formula preparation and delivery, and bacterial pathogens should be included in the differential diagnosis for nosocomial gastroenteritis.

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Prevalence, Risk Factors, Clinical Manifestation, Diagnosis Aspects and Nutrition Therapy in Relation to both IgE and IgG Cow’s Milk Protein Allergies among a Population of Saudi Arabia: A Literature Review

Current Research in Nutrition and Food Science Journal ◽

10.12944/crnfsj.9.2.02 ◽

2021 ◽

Vol 9 (2) ◽

pp. 375-389

Author(s):

Mashail A Baghlaf ◽

Noura M S Eid

Keyword(s):

Risk Factors ◽

Saudi Arabia ◽

Food Allergy ◽

Clinical Manifestation ◽

Milk Protein ◽

Immunoglobulin E ◽

Cow Milk ◽

Cow’S Milk ◽

Cow's Milk ◽

Cow’S Milk Protein

Cow milk protein allergy (CMPA) becoming a major public health issue that has attracted the attention of health professionals and researchers. This paper aimed to review the important aspects of both IgE and IgG types of cow’s milk protein allergy in terms of prevalence, clinical manifestation, risk factors, other health-related issues and nutritional therapy proposed for such allergies in the adult and pediatric population in Saudi Arabia. A search on “cow’s milk allergy” was done using PubMed, Google Scholar and Scopus Engine for published papers between 1993 and 2020 to find studies yielding knowledge on that context. The prevalence of cow’s milk protein allergy (CMPA) among infants is now in the range of 2–3%. This type of allergy is also detected in adulthood but less frequently. CMPA is defined as an immunological reaction to specific proteins in milk. CMPA is classified based on its type as an immunoglobulin E (IgE)-mediated form and an immunoglobulin G (IgG)-mediated form, each type representing different immunological pathways. The presence of Genetic aspects, family history and short duration of breastfeeding in the infant are among the risk factors contributing to this form of allergy. Its manifestations mainly present as skin presentation, followed by the gastrointestinal and respiratory presentation in most cases in addition to a life-threatening anaphylactic reaction that may occur in 12% of cases. food allergy committees have developed strict diagnosis criteria, including blood testing for food-specific immunoglobulin E (sIgE), a skin prick test and double-blind placebo-controlled food challenges (DBPCFC) as the gold standard. A diet free of cow’s milk protein (CMP) allergen and including the appropriate alternative milk formula is the first line of prevention recommended by many organizations and food allergy experts. As for Saudi Arabia, more research and clinical trials are required to discuss the various aspects of adult and pediatric CMPA and to provide a better understanding along with good control strategies implementation.

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