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. 2020 Nov 19;10(1):51.
doi: 10.1186/s13601-020-00355-6.

Increasing incidence of anaphylaxis in Hong Kong from 2009 to 2019-discrepancies of anaphylaxis care between adult and paediatric patients

Philip Hei Li  1 , Agnes S Y Leung  2 , Rebecca M Y Li  2 , Ting-Fan Leung  2 , Chak-Sing Lau  3 , Gary W K Wong  2
Affiliations

Increasing incidence of anaphylaxis in Hong Kong from 2009 to 2019-discrepancies of anaphylaxis care between adult and paediatric patients

Philip Hei Li et al. Clin Transl Allergy. .

Abstract

Background: Anaphylaxis has been increasing in developed countries but there is very little published data on the burden of anaphylaxis and the pattern of adrenaline autoinjector (AAI) prescription from Asia. We aim to determine the incidence rates of anaphylaxis and prescription rates of AAI over the past decade in Hong Kong.

Methods: Using a centralized electronic database of Hong Kong's sole public-funded healthcare provider, we obtained and analysed all patients between 2009 and 2019 with physician-reported diagnosis of anaphylaxis. Incidence rates were calculated using population statistics as the denominator. Patients' prescriptions on discharge were collected to determine the AAI prescription rates.

Results: The overall 10-year estimated incidence rate of anaphylaxis was 3.57 per 100,000 person-years. An increasing trend over time across both paediatric and adult populations from 2009 to 2014 was found, which remained stable until 2019. This was more marked among the paediatric population (paediatric vs adult incidence rate ratio in 2019: 3.51 [95% CI 1.12-2.66] vs 1.82 [95% CI 1.05-1.60]). There was an overall increasing rate of AAI prescription for patients admitted for anaphylaxis, but the overall AAI prescription rate was less than 15% and was significantly less likely to be prescribed for the adult compared to paediatric patients (36.5% vs. 89.4%, p < 0.001).

Conclusions: An increasing trend of anaphylaxis incidence rates over the past decade is evident in Asian populations, with a discrepantly low rate of AAI prescription, particularly in the adult patients.

Keywords: Adrenaline autoinjector; Allergy; Anaphylaxis; Epidemiology; Incidence.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Number of admissions for anaphylaxis (by cluster) and rate of AAI prescription from 2009–2019. HKE  Hong Kong East Cluster, HKWC Hong Kong West Cluster, KEC Kowloon Central Cluster, KEC Kowloon Easter Cluster, KWC Kowloon West Cluster, NTEC New Territories Easter Cluster, NTWC New Territories Easter Cluster
Fig. 2
Fig. 2
Incidence rates of anaphylaxis (by age group) and rates of AAI prescription from 2009–2019
See this image and copyright information in PMC

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