title: Nut allergy prevalence and differences between Asian-born children and Australian-born children of Asian descent: a state-wide survey of children at primary school entry in Victoria, Australia.
abstract: BACKGROUND
  Asian infants born in Australia are three times more likely to develop nut allergy than non-Asian infants, and rates of challenge-proven food allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate the risk factors for nut allergy, we assessed the whole-of-state prevalence distribution of parent-reported nut allergy in 5-year-old children entering school.
  
  
  METHODS
  Using the 2010 School Entrant Health Questionnaire administered to all 5-year-old children in Victoria, Australia, we assessed the prevalence of parent-reported nut allergy (tree nut and peanut) and whether this was altered by region of residence, socio-economic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders.
  
  
  RESULTS
  Parent-reported nut allergy prevalence was 3.1% (95% CI 2.9-3.2) amongst a cohort of nearly 60 000 children. It was more common amongst children of mothers with higher education and socio-economic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian-born mothers (aOR 2.67, 95% CI 2.28-3.27) were more likely to have nut allergy than non-Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of nut allergy (aOR 0.1, 95% CI 0.03-0.31).
  
  
  CONCLUSIONS
  Migration from Asia after the early infant period appears protective for the development of nut allergy. Additionally, rural regions have lower rates of nut allergy than urban areas.
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.
authors.forename: M
authors.initials: M
authors.lastname: Panjari
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.|The Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Vic., Australia.
authors.forename: J J
authors.initials: JJ
authors.lastname: Koplin
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.|The Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Vic., Australia.
authors.forename: S C
authors.initials: SC
authors.lastname: Dharmage
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.|The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.
authors.forename: R L
authors.initials: RL
authors.lastname: Peters
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.|The Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Vic., Australia.
authors.forename: L C
authors.initials: LC
authors.lastname: Gurrin
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.|The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.|Centre for Adolescent Health, Royal Children's Hospital, Parkville, Vic., Australia.
authors.forename: S M
authors.initials: SM
authors.lastname: Sawyer
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.|The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.|The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Vic., Australia.
authors.forename: V
authors.initials: V
authors.lastname: McWilliam
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.
authors.forename: J K
authors.initials: JK
authors.lastname: Eckert
authors.affiliation: La Trobe University, Bundoora, Vic., Australia.
authors.forename: D
authors.initials: D
authors.lastname: Vicendese
authors.affiliation: La Trobe University, Bundoora, Vic., Australia.
authors.forename: B
authors.initials: B
authors.lastname: Erbas
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.|The Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Vic., Australia.
authors.forename: M C
authors.initials: MC
authors.lastname: Matheson
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.|The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.|The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Vic., Australia.
authors.forename: M L K
authors.initials: ML
authors.lastname: Tang
authors.affiliation: The Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, University of Melbourne, Parkville, Vic., Australia.
authors.forename: J
authors.initials: J
authors.lastname: Douglass
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.
authors.forename: A-L
authors.initials: AL
authors.lastname: Ponsonby
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.|George Institute for Global Health, United Kingdom School of Psychology and Public Health, University of Oxford, Oxford, UK.
authors.forename: T
authors.initials: T
authors.lastname: Dwyer
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.|The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.|The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Vic., Australia.
authors.forename: S
authors.initials: S
authors.lastname: Goldfeld
authors.affiliation: The Murdoch Childrens Research Institute, Parkville, Vic., Australia.|The Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia.|The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Vic., Australia.|Institute of Inflammation and Repair, University of Manchester, Manchester, UK.
authors.forename: K J
authors.initials: KJ
authors.lastname: Allen
mesh_terms: D002648:Child; D002675:Child, Preschool; D004641:Emigration and Immigration; D005006:Ethnicity; D005260:Female; D005843:Geography; D006801:Humans; D008297:Male; D021184:Nut Hypersensitivity / Q000453:epidemiology*; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population; D014739:Victoria / Q000453:epidemiology
keywords: food allergy; migration; nut allergy; peanut allergy; prevalence; tree nut allergy