Allergies costing SA economy over half a billion per year

The cost of allergies to the South African economy is in excess of R606-million a year with healthcare expenditure and lost productivity being the biggest contributing factors.

Experts warn that should the unmet needs and strategies to prevent the burgeoning “allergy epidemic” not be addressed, it could soon overwhelm the country’s already fragile healthcare system.

Wilmi Hudsonberg, spokesperson of leading allergy pharmaceutical firm, Pharma Dynamics says as things stand, most South Africans have to wait months to see a specialist, if they are fortunate enough to access care at all.

“This is largely due to a very low base of registered allergists in the country – of which there are only ten – and only four dedicated allergy clinics at Pietersburg Hospital (Limpopo), Tygerberg Hospital, Groote Schuur Hospital and the Red Cross Children’s Hospital in Cape Town.

“South Africa has one of the highest prevalence rates of allergic disorders in the developing world and we are fast catching up to developed countries such as the US, New Zealand, Australia and Europe. Statistics also show that the prevalence of allergies is increasing more rapidly in disadvantaged communities and that this population group tends to be more heavily burdened by severe allergic conditions,” says Hudsonberg.

SA’s current allergy rates among children and young adults are as follows:

Asthma – 1.8 million children in SA have asthma. In the Global Initiative for Asthma report, SA ranked 4th for asthma mortality in the 5 – 34 year-old age group and 5th for asthma case fatality rates, which is alarming.

Eczema and allergic rhinitis (hayfever) – the most recent International Study on Asthma and Allergy in Childhood (ISAAC), which examined eczema and allergic rhinitis in teenagers, found that 33.2% experienced problems with allergic rhinitis and 11.9% suffered from eczema. These figures are among the highest in the world when compared to other international studies.

Food allergy data is scant, but a study conducted by the South African Food Sensitisation and Food Allergy (SAFFA), has preliminary data showing a true food allergy rate at 2.5% among 1 – 3 year-olds. This translates to 50 000 children with food allergy in this age group alone. Egg was the most common allergen, followed by peanuts, cow’s milk and fish.

Allergic rhinitis (the most commonly reported allergy) affects as many as 16 million people in South Africa. Some suffer from seasonal hayfever, but many suffer from perennial rhinitis, making it one of the most common chronic illnesses in the country.

The prevalence of allergy in South Africa is higher than even commonly reported diseases like tuberculosis (TB) and HIV/AIDS. Other atopic conditions, such as eczema, allergic conjunctivitis and asthma, often co-occur, thereby increasing the burden of the disease.

Estimates of the annual direct medical costs of allergic rhinitis in South Africa is in excess of R559-million, rising to R606-million when indirect costs, such as lost productivity and absenteeism, as a result of the condition, are included. Direct cost estimates are based on information on the use of antihistamines and doctor’s visits per annum, but excludes additional healthcare costs often associated with the condition, such as hospitalisation due to complications.

Hudsonberg points out that allergies mostly affect children and young adults and have a negative impact on quality of life. “In children allergic disorders affect sleep, impair learning, memory and behaviour. Children with food allergies are also at significant risk, and the condition means extra stress for their families over issues such as care at school, risk of death and the need for emergency medication in the form of injectable adrenaline in case of a severe allergic attack, also known as anaphylaxis, which could be fatal.

“Currently, there is no legislation in place to protect children with allergies at SA schools. Many schools refuse to stock or administer the life-saving medication, leaving parents no choice but to home-school their children, which isn’t always a viable option. Most of these children are also not allowed to participate in extra-curricular activities, because of the risk of exposure to the allergen(s) it poses, leaving them feeling isolated.”

Hudsonberg says among the unmet needs is the inadequate number of allergy specialists. Presently only the University of Cape Town offers training in the field of Allergology. Plenty more are needed to meet the population’s existing and future healthcare demands.

“Other concerns include inadequate services in public health facilities; lack of posts for allergists in national health plans, insufficient support for chronic allergy related diseases at primary; secondary and tertiary levels; gaps in food allergen labelling legislation and inadequate continual medical education regarding allergy prevention and treatment.”

South African patients with allergies currently spend over R480-million a year across allergy medications, and unit sales figures from last year to this year have more than doubled – pointing to a significant increase in allergic conditions in the country.


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