Significance of Peanut Allergy

The prevalence of peanut allergy (PA) in Africa is unknown but anecdotal reports suggest the prevalence to be lower than that experienced in developed countries, which report a prevalence of approximately 1.5%. Countries in Africa and Asia, as well as Israel, where the early consumption of high-dose peanut protein is routinely practised, have enjoyed a low prevalence of peanut allergy, e.g. 0.04% in Israel. There is evidence that the prevalence of peanut allergy continues to increase among high-risk atopic infants, as well as among children in the general population. The prevalence of tree nut allergy has not been independently assessed among general populations, but studies of adults and children with peanut allergy suggest a high co-prevalence. Peanuts and tree nuts, often generically referred to as ‘nuts’, combine to form an important protein source in Africa, particularly during vulnerable growth periods such as weaning and early childhood. Given the accessibility, affordability and acceptability of peanuts as a food source, they now constitute the main source of protein used in feeding schemes throughout the world. Peanuts are also consumed by certain ethnic groups in the cultural belief that the early consumption of peanut increases virility. Given the steadily rising prevalence of allergic disease among all African populations, and with global evidence that a rise in food allergies has accompanied the overall increase in allergies, we should anticipate a rise in the prevalence of peanut and tree nut allergies in Africa. Anecdotally our observation in an inner-city London hospital is that the rates of peanut allergy have increased remarkably in ethnic populations in whom peanut allergy was not a problem 5-10 years ago.