1. The other side of food allergies
Dr. Elizabeth Kiragu
Paediatric Allergy Specialist
Aga Khan University Hospital, Nairobi
KPA Conference 10th April 2019

2. The journey

3. Patient
Family
Food industry
Community
School

4. the home front

5. Young mother, much older father Closely surrounded by extended family
2 year old girl
Severe cow milk allergy on EHCMF
Multi trigger wheezer controlled on ICS
Young mother, much older father
Closely surrounded by extended family
English reading and oral skills limited
Issue – frequent accidental exposure to milk in the home

6. Allergen avoidance Educate all care givers Define the allergen
Forms of that allergen
Reading labels
Hidden antigens
Age appropriate behaviour modification

7. An accident waiting to happen

8. 4 year old boy
Severe cow milk allergy
Uncontrolled asthma not on treatment
Family of 2 boys, older child also has asthma not on any treatment and food allergies
Dad is a doctor

9. Issues
Parties, outings, restaurant visits present a risk of reaction
Delay in recognition of severity of reaction
Unprepared to manage a reaction
False sense of security

10. Bidat E.
The ability of a parent to assess risk and manage their child’s condition is highly dependent on their own knowledge, attitude and beliefs about food allergy

11. Take home Family education Regular follow up-
Assess food allergy status
Manage associated conditions
Re evaluate use of emergency medication

12. Fighting the good fight

13. 9 year old boy
Ex prem 34/ 40
Severe uncontrolled asthma on maximal therapy
Anaphylaxis to egg, moderate immediate reactions to fish, beans
EOE – dairy,
FTT
Eczema, Allergic rhinitis

14. Model food allergic patient
Particular about his food
Recognise an allergic reaction immediately
Institute emergency treatment

15. Challenges at school
School acceptance – administration, parents and other children
Policy to prevent exposure to allergens
System to manage acute reactions
Class parties, trips, games, fun days, hospital admissions
Bullying

16. Growing older with food allergies

17. 14 year old girl
Uncontrolled asthma
Allergic rhinitis
Moderate atopic eczema
Severe allergy – Peanut, Hazelnut, shell fish

18. issues Poor adherence to asthma & rhinitis treatment
Deliberate exposure to food allergens
Delay in using emergency treatment

19. High risk group Getting more independent
Easily influenced by peer pressure
Desperate to fit in
Risk taking behavior
Food allergies in later childhood are more severe
Augmenting factors

20. Way forward Engage them in their management
Figure out their priorities
Re - emphasize the dangers
Involve family and friends
Counselling