| Objective: To understand the situation of food allergy among children with non-infectious diarrhea in a hospital in Yan’an,and to analyse the factors affecting food allergy in children with non-infectious diarrhea,in order to provide a basis for prevention,early diagnosis and treatment of these children in the region and to lay the foundation for longterm health.Methods: From December 31,2021 to December 31,2022,a total of 209 children aged 0-3 years with non-infectious diarrhea,107 males and 102 females,who were seen in the pediatric department of the Affiliated Hospital of Yan’an University,were selected for this study.The children with suspected FA were tested with serum allergen-specific Ig E,food avoidance test and food challenge test to determine the presence of FA,and those who were positive for FA were used as the case group,while those who were negative for FA and those with non-infectious diarrhoea of other etiologies were used as the control group.The questionnaire was completed after obtaining informed consent from the families.The questionnaire included general information about the child,personal history,breastfeeding status,diarrhoea,skin,respiratory and gastrointestinal symptoms,nutrition,maternal pregnancy status,family history of allergies,family and family members situation.A one-wayχ~2 test was performed on the independent variables,and further multi-factor binary logistic regression analysis was performed if the differences were statistically significant in the one-way analysis.Results: 1.A series of 209 non-infectious diarrhoea children were gathered in this study,51 were FA-positive and 158 were FA-negative,with a detection rate of 24.40%.2.The FA detection rate was 21.50% for males and 27.45% for females,with no statistically significant difference(P>0.05).3.The detection rate of FA in children with non-infectious diarrhoea varied by age,with 33.33% in children <6 months,34.04% in children 6 months to 1 year and 18.25% in children 1 year to 3 years.4.Univariate analysis results showed that FA in children with non-infectious diarrhea was related to age,birth history,feeding style,time of supplemental foods,milk spillage,milk vomiting and milk rejection without reason,eczema,25-hydroxyvitamin D level of children,antibiotic use by the mother during pregnancy,second-hand smoke exposure by the mother during pregnancy,maternal allergic disease,maternal food allergy,paternity food allergy and family residence,with statistically significant differences(P<0.05).Factors with statistically significant differences in the univariate analysis were further analysed by binary logistic regression,and the results showed that normal 25-hydroxyvitamin D levels(P=0.030,OR=0.246,95% CI: 0.069-0.872)was a protective factor for FA in children with non-infectious diarrhea,and artificial feeding(P=0.023,OR=3.325,95%CI:1.181-9.365),timing of complementary feeding >6 months of age(P=0.021,OR=5.146,95% CI:1.283-20.636),eczema(P=0.022,OR=2.769,95% CI:1.157-6.626),and maternal food allergy(P=0.040,OR=3.948,95% CI: 1.065-14.636)were risk factors for FA in children with non-infectious diarrhoea.5.Of the 209 children with non-infectious diarrhoea in this study,127 were tested for serum allergens,of which 21 were positive for ingested allergens,with milk,egg whites,beef,lamb,peanuts,marine fish and soy being the common allergenic foods in that order.34 were positive for inhaled allergens,with Artemisia,cat,common ragweed,mite combinations,house dust,tree combinations,hops and dog in that order,with 4 of the FA children also being sensitized to Artemisia.6.Ig E-mediated FA accounted for 41.17%(21/51)and non-Ig E or mixed-mediated FA accounted for 58.82%(30/51)of children with non-infectious diarrhoea,suggesting that FA-induced non-infectious diarrhoea was predominantly non-Ig E or mixed-mediated.Conclusion: 1.In this study,the detection rate of FA in children with non-infectious diarrhoea was 24.40%;non-infectious diarrhoea caused by FA is predominantly non-Ig E or mixed-mediated.2.Through the analysis of influencing factors of FA in children with non-infectious diarrhea,it is suggested that normal levels of 25-hydroxyvitamin D were protective factors for FA in children with non-infectious diarrhoea;artificial feeding,timing of complementary feeding >6 months of age,eczema and maternal food allergy were risk factors for FA in children with non-infectious diarrhea.3.In this study,the positive serum allergens were milk,egg white,beef,lamb,peanut,marine fish and soybean in the order of ingested allergens,and inhalant allergens were Artemisia,cat,common ragweed,mite combination,house dust,tree combination,hops and dog in the order of inhalant allergens,with 4 of the FA children also sensitized to Artemisia. |
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