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Review
. 2023 Dec 12:4:1249280.
doi: 10.3389/falgy.2023.1249280. eCollection 2023.

Population-based incidence of all-cause anaphylaxis and its development over time: a systematic review and meta-analysis

Vanessa Pühringer  1 , Bernd Jilma  1 , Harald Herkner  2
Affiliations
Review

Population-based incidence of all-cause anaphylaxis and its development over time: a systematic review and meta-analysis

Vanessa Pühringer et al. Front Allergy. .

Abstract

Introduction: It is extremely difficult to compare studies investigating the frequency of anaphylaxis making it challenging to satisfactorily assess the worldwide incidence rate. Using a systematic review and meta-analysis, this publication aims to determine the current incidence of all-cause anaphylaxis worldwide. Additionally, we investigated whether the incidence of anaphylaxis has changed over time and which factors influence the rates determined by individual studies.

Methods: A literature search was performed in four databases. All articles that reported relevant information on population-based incidence rates of all-cause anaphylaxis were included. The protocol was published on INPLASY, the International Platform of Registered Systematic Review and Meta-analysis Protocols.

Results: The database query and screening process resulted in 46 eligible articles on anaphylaxis. The current incidence worldwide was found to be approximately 46 cases per 100,000 population per year (95% CI 21-103). Evaluating confounding factors showed that studies using allergy clinics and hospitalizations as data source result in comparably low rates. Moreover, children are less prone to develop anaphylaxis compared to the general population. Using a random effects Poisson model we calculated a yearly increase of anaphylaxis incidence by 7.4% (95% CI 7.3-7.6, p < 0.05).

Discussion: This seems to be the first approach to analyze every reported all-cause anaphylaxis incidence rate until 2017 for an at most accurate determination of its epidemiology. Based on these results, future research could investigate the underlying causes for the rising incidence in order find ways to decrease the condition's frequency.

Systematic review registration: inplasy.com, identifier [INPLASY202330047].

Keywords: anaphylaxis; epidemiology; incidence; meta-analysis; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram illustrating the database search process and the subsequent article screen. CINAHL: Cumulative Index to Nursing and Allied Health Literature; LILACS: Latin American and Caribbean Health Science Information Database.
Figure 2
Figure 2
Development of all-cause anaphylaxis incidence (per 100,000 population per year) over time. Each data point represents an annual rate reported by the original articles. The larger bubble, the higher weighted the data point is.
See this image and copyright information in PMC

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