Overview of registries for anaphylaxis: a scoping review.

OBJECTIVE: This review aimed to describe the scope and operational features of anaphylaxis registries, and to assess their contribution to improving knowledge of anaphylaxis and care of patients who experience anaphylaxis by measuring their research output. INTRODUCTION: Structured data collection and reporting systems, such as registries, are needed to better understand the burden of anaphylaxis and to protect the growing number of patients with severe allergy. There is a need to characterize current anaphylaxis registries to identify their value in anaphylaxis surveillance, management, and research. Information synthesized in this review will provide knowledge on benefits and gaps in current registries, which may inform the implementation and global standardization of future anaphylaxis reporting systems. INCLUSION CRITERIA: This scoping review considered literature describing registries worldwide that enroll patients who have experienced anaphylaxis. Published and gray literature sources were included if they described the scope and operational features of anaphylaxis registries. METHODS: This review followed the JBI methodology for scoping reviews. Embase, MEDLINE, Scopus, and CINAHL were searched for relevant articles. Identified keywords and index terms were adapted for searches of gray literature sources, using Google advanced search functions. Only full-text studies in English were considered for inclusion. Two independent reviewers conducted title and abstract screening and those that did not meet the inclusion criteria were excluded. The full text of potentially relevant articles were retrieved; full-text screening and data extraction were also conducted by two independent reviewers. Any discrepancies were resolved through discussion or with a third reviewer. Tables and a narrative summary were used to describe and compare the scope and features (eg, inclusion criteria, patient demographics, clinical symptoms) of the identified anaphylaxis registries, and to outline their output to assess their contribution to research and clinical practice for anaphylaxis. RESULTS: A total of 77 full-text publications and eight gray literature sources were used to extract data. The literature search identified 19 anaphylaxis registries, with sites in 28 countries including Europe, the United Kingdom, Canada, the United States, Korea, and Australia. The main purposes of the identified registries were to collect clinical data for research; provide clinical support tools to improve patient care; and operate as allergen surveillance systems to protect the wider community with allergies. Differences in inclusion and health care settings exist, with 11 collecting data on anaphylaxis of any cause, two on food reactions alone, three on fatal anaphylaxis, one on perioperative anaphylaxis, and two on allergic reactions (including anaphylaxis). Five registries enroll cases in allergy centers, five in hospital settings, one in schools, and others target a combination of general practitioners, specialists in emergency departments, and other relevant hospital departments and allergy outpatient clinics. Only three registries operate under a mandatory framework. A total of 57 publications were considered research outputs from registries. All registries except two have published studies from collected data, with the greatest number of articles published from 2019 to the present. Publications mostly addressed questions regarding demographic profile, causes and cofactors, severity, fatal reactions, and gaps in management. CONCLUSIONS: This review demonstrated that anaphylaxis registries differ in their scope and operation, having been established for different purposes. Importantly, registries have contributed significantly to research, which has highlighted gaps in anaphylaxis management, provoking allergens, and informed targets for prevention for severe and fatal events. Beyond this, registries relay information about anaphylaxis to clinicians and regulatory bodies to improve patient care and protect the community. The ability to link registry data with other health datasets, standardization of data across registries, and incorporation of clinical care indicators to promote quality health care across the health system represent important targets for future systems.

Nip allergies in the Bub: a qualitative study for a public health approach to infant feeding for allergy prevention.

OBJECTIVE: To identify a brand, key messages and resources to underpin a public health approach to food allergy prevention. METHODS: A focus group design was used to explore perceptions and opinions of potential brands, infant feeding messages and resources for providing standardised food allergy prevention information. Focus groups were conducted in February 2018 using interview guides and were transcribed verbatim. A content analysis of the transcripts was undertaken using thematic analysis software. The University of Western Australia provided ethics approval: RA/4/20/4280. RESULTS: Seven focus groups with 39 participants were conducted. Four slogans and styles of imagery were considered. 'Nip Allergies in the Bub' was the most favoured slogan and images of babies with food were most favoured. Participant feedback was sought regarding messages and supporting messages were considered important. Participants were consulted about useful resources and a website was identified. CONCLUSIONS: Conducting focus groups assisted the selection of a brand, messages and resources to underpin a public health approach to implementing allergy prevention guidelines. IMPLICATIONS FOR PUBLIC HEALTH: This is the first focus group research undertaken for food allergy prevention. Identification of a meaningful brand, key messages and resources will support a public health approach to implementing allergy prevention guidelines.

An International First: Stakeholder Consensus Statement for Food Allergen Management in Packaged Foods and Food Service for Australia and New Zealand.

Food-allergic consumers encounter inadequate, confusing, and ambiguous allergen information for packaged and unpackaged foods. Key Australian and New Zealand allergy organizations convened multiple forums to facilitate discussions among consumers, food manufacturers, food retailers, regulatory bodies, researchers, and health professionals to develop a unified approach to improving food allergen management. The following stakeholder consensus statement provides a foundation for advocacy for improved food allergen management and safety. It is the responsibility of consumers to: 1. declare their food allergies and read food labels (including ingredient lists and allergen declaration statements), and 2. ultimately make their own judgment about the foods they choose to consume. We consider that to enable consumers to make informed decisions about their safety, It is the responsibility of packaged food manufacturers to: 1. follow robust allergen management practices including quantitative risk assessment, and 2. use clear, consistent labeling to inform consumers about that food's allergen content, including the possible presence of unintended allergens. It is the responsibility of food service establishments and providers to: 1. follow robust allergen management practices, and 2. ensure that staff understand and can inform consumers about the allergen content of the food they provide, including the possible presence of unintended allergens.

Overview of registries for anaphylaxis: a scoping review protocol.

OBJECTIVE: This review will describe the scope and operational features of global registries for anaphylaxis and assess their contribution to improving knowledge and care of anaphylaxis by measuring their research output. INTRODUCTION: The incidence of anaphylaxis is increasing around the world. Structured reporting systems, such as patient registries, are needed to better understand the burden of anaphylaxis and protect the growing number of allergic patients. INCLUSION CRITERIA: The concept to be mapped is registries across the world that enroll patients who have experienced anaphylaxis. Published and gray literature sources will be considered if they describe the scope and operational features of anaphylaxis registries. Only full-text studies published in English will be included. There will be no date restriction. METHODS: The JBI methodology for scoping reviews will be followed. Embase, MEDLINE, Scopus, and CINAHL will be searched from inception date for relevant articles. Identified keyword and index terms will be adapted for searches of gray literature sources, using Google advanced search functions. The authors and developers of identified registries will be contacted, where possible, to obtain additional information about the development and structure of systems. Data will be extracted by two independent reviewers. Any discrepancies will be resolved by a third reviewer. Tables and a narrative summary will be used to describe and compare the scope and features of anaphylaxis registries and outline their output to assess their contribution to research, clinical practice, and public health policy for anaphylaxis.

Scaling Up of an Innovative Intervention to Reduce Risk of Dengue, Chikungunya, and Zika Transmission in Uruguay in the Framework of an Intersectoral Approach with and without Community Participation.

To contribute to the prevention of dengue, chikungunya, and Zika, a process of scaling up an innovative intervention to reduce Aedes aegypti habitats, was carried out in the city of Salto (Uruguay) based on a transdisciplinary analysis of the eco-bio-social determinants. The intervention in one-third of the city included the distributions of plastic bags for all households to collect all discarded water containers that were recollected by the Ministry of Health and the Municipality vector control services. The results were evaluated in 20 randomly assigned clusters of 100 households each, in the intervention and control arm. The intervention resulted in a significantly larger decrease in the number of pupae per person index (as a proxy for adult vector abundance) than the corresponding decrease in the control areas (both areas decreased by winter effects). The reduction of intervention costs ("incremental costs") in relation to routine vector control activities was 46%. Community participation increased the collaboration with the intervention program considerably (from 48% of bags handed back out of the total of bags delivered to 59% of bags handed back). Although the costs increased by 26% compared with intervention without community participation, the acceptability of actions by residents increased from 66% to 78%.

Improved dengue fever prevention through innovative intervention methods in the city of Salto, Uruguay.

BACKGROUND: Uruguay is located at the southern border of Aedes aegypti distribution on the South American sub-continent. The reported dengue cases in the country are all imported from surrounding countries. One of the cities at higher risk of local dengue transmission is Salto, a border city with heavy traffic from dengue endemic areas. METHODS: We completed an intervention study using a cluster randomized trial design in 20 randomly selected 'clusters' in Salto. The clusters were located in neighborhoods of differing geography and economic, cultural and social aspects. RESULTS: Entomological surveys were carried out to measure the impact of the intervention on vector densities. Through participatory processes of all stakeholders, an appropriate ecosystem management intervention was defined. Residents collected the abundant small water holding containers and the Ministry of Public Health and the Municipality of Salto were responsible for collecting and eliminating them. Additional vector breeding places were large water tanks; they were either altered so that they could not hold water any more or covered so that oviposition by mosquitoes could not take place. CONCLUSIONS: The response from the community and national programme managers was encouraging. The intervention evidenced opportunities for cost savings and reducing dengue vector densities (although not to statistically significant levels). The observed low vector density limits the potential reduction due to the intervention. A larger sample size is needed to obtain a statistically significant difference.

Mosquito-producing containers, spatial distribution, and relationship between Aedes aegypti population indices on the southern boundary of its distribution in South America (Salto, Uruguay).

A study was conducted in the city of Salto, Uruguay, to identify mosquito-producing containers, the spatial distribution of mosquitoes and the relationship between the different population indices of Aedes aegypti. On each of 312 premises visited, water-filled containers and immature Ae. aegypti mosquitoes were identified. The containers were counted and classified into six categories. Pupae per person and Stegomyia indices were calculated. Pupae per person were represented spatially. The number of each type of container and number of mosquitoes in each were analyzed and compared, and their spatial distribution was analyzed. No significant differences in the number of the different types of containers with mosquitoes or in the number of mosquitoes in each were found. The distribution of the containers with mosquito was random and the distribution of mosquitoes by type of container was aggregated or highly aggregated.