title: Diagnosis and treatment of allergic diseases in Zhejiang Province: a cross-sectional survey.
abstract: BACKGROUND
  The specialty of allergy developed quickly in western countries because of the rapid increase of allergic diseases, whereas it developed relatively slowly in China. The prevalence of allergen sensitization and allergic diseases in Zhejiang Province of China is high and improving the medical services for these diseases is critically needed.
  
  
  OBJECTIVE
  To investigate the working status of the diagnosis and treatment of allergic diseases, including doctor resources, diagnostic methods, and allergen-specific immunotherapy in patients of Zhejiang Province, and to provide instructions for the strategic development of subspecialties of allergic diseases.
  
  
  METHODS
  First we defined the doctors who treat allergic diseases, and designed a comprehensive questionnaire to collect personal and hospital information for these doctors. The questionnaires were distributed to hospitals with different ranks and from different areas in the province. The general condition of doctor's resources, carryout of diagnostic methods, and allergen-specific immunotherapy were described and variations in the different specialties, hospitals, and areas were further analyzed.
  
  
  RESULTS
  Doctors in their thirties with bachelor's degrees were the mainstream for diagnosing and treating allergic diseases. The main specialties of the doctor resources were the specialties of Ear, Nose and Throat (ENT), Respirology, Pediatrics, and Dermatology. The Pediatrics specialty had a more reasonable infrastructure of doctor resources with more young doctors working in this subspecialty. The development of allergy subspecialty varied within hospitals at different levels or from different areas. The carryout of the skin prick test (SPT), serum specific IgE (ssIgE), and subcutaneous immunotherapy (SCIT) was best performed in provincial hospitals, while sublingual immunotherapy (SLIT) was prescribed most commonly in municipal hospitals. The performance of SPT and ssIgE in Hangzhou, Jiaxing, and Wenzhou areas was much better than that in other places. The performance of SCIT and SLIT was best in Wenzhou.
  
  
  CONCLUSIONS
  Our survey revealed a very initial and unbalanced development for the allergy subspecialty in Zhejiang Province. Doctor resources for allergic diseases were mainly from the specialties of ENT, Respirology, and Pediatrics, and the performance of diagnosis and treatment was mainly focused on provincial and municipal hospitals. Continuous education of allergies could be extended to primary healthcare centers and more efforts should be directed to those areas with poor medical resources.
authors.affiliation: Department of Allergy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; Department of Respirology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China; Department of Rheumatology and Clinical Immunology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; Department of Respirology, Children's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
authors.forename: Hui-ying
authors.initials: HY
authors.lastname: Wang
authors.forename: Yi-hong
authors.initials: YH
authors.lastname: Shen
authors.forename: Xu-yan
authors.initials: XY
authors.lastname: Yang
authors.forename: Lan-fang
authors.initials: LF
authors.lastname: Tang
authors.forename: Jian-ying
authors.initials: JY
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000486:Allergy and Immunology / Q000706:statistics & numerical data; D002681:China / Q000453:epidemiology; D002983:Clinical Competence / Q000706:statistics & numerical data*; D005260:Female; D019981:Health Care Sector; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D007167:Immunotherapy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D000078329:Workforce
keywords: Allergen-specific immunotherapy; Allergy; Diagnosis; Treatment