title: Anaphylaxis and ethnicity: higher incidence in British South Asians.
abstract: BACKGROUND
  The incidence of anaphylaxis in South Asians (Indian, Pakistani and Bangladeshi ethnicity) is unknown. Birmingham is a British city with a disproportionately large population of South Asians (22.5%) compared with the rest of the UK (4.9%). The main aims of this study were to determine the incidence and severity of anaphylaxis in this population and to investigate the differences between the South Asian and White populations.
  
  
  METHODS
  A retrospective electronic search of emergency department attendances at three hospitals in Birmingham during 2012 was carried out. Wide search terms were used, medical notes were scrutinized, and the World Allergy Organization diagnostic criteria for anaphylaxis were applied. Patients' age, sex, ethnicity and home postal code were collected, reactions were graded by severity, and other relevant details including specialist assessment were extracted. Multivariate analysis was undertaken using 2011 UK census data.
  
  
  RESULTS
  Age-, sex- and ethnicity-standardized incidence rate of anaphylaxis was 34.5 per 100 000 person-years. Multivariate logistic regression which controlled for the confounders of age, sex and level of socioeconomic deprivation showed that incidence was higher in the South Asian population (OR 1.48, P = 0.005). Incidence rate in the South Asian population was 58.3 cases per 100 000 person-years compared to 31.5 in the White population. South Asian children were more likely to present with severe anaphylaxis (OR 5.31, P = 0.002).
  
  
  CONCLUSIONS
  Incidence of anaphylaxis is significantly higher in British South Asians compared to the white population. British South Asian children are at a greater risk of severe anaphylaxis than White children.
authors.affiliation: Department of Allergy and Immunology, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Buka
authors.affiliation: Warwick Medical School, University of Warwick, Warwick, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Crossman
authors.affiliation: Department of Allergy and Immunology, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: C L
authors.initials: CL
authors.lastname: Melchior
authors.affiliation: Department of Allergy and Immunology, Heart of England NHS Foundation Trust, Birmingham, UK.|School of Immunity and Infection, University of Birmingham, Birmingham, UK.
authors.forename: A P
authors.initials: AP
authors.lastname: Huissoon
authors.affiliation: Department of Paediatric Infectious Diseases and Immunology, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: S
authors.initials: S
authors.lastname: Hackett
authors.affiliation: Department of Emergency Medicine, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: S
authors.initials: S
authors.lastname: Dorrian
authors.affiliation: Warwick Medical School, University of Warwick, Warwick, UK.|Department of Emergency Medicine, Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: M W
authors.initials: MW
authors.lastname: Cooke
authors.affiliation: Department of Allergy and Immunology, Heart of England NHS Foundation Trust, Birmingham, UK.|Warwick Medical School, University of Warwick, Warwick, UK.|School of Life & Health Sciences, Aston Medical School, Aston University, Birmingham, UK.
authors.forename: M T
authors.initials: MT
authors.lastname: Krishna
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000707:Anaphylaxis / Q000453:epidemiology*; D044466:Asian People; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D006113:United Kingdom / Q000453:epidemiology; D044465:White People; D055815:Young Adult
keywords: South Asian; anaphylaxis; epidemiology; ethnicity; incidence