Allergy

Clinical activities

The allergy and asthma clinic provides a tertiary level diagnostic and treatment service for thousands of children each year.  While the vast majority of patients attending the clinic come from the Western Cape, a significant number from the other provinces are also seen.  By far the largest numbers of children seen are from disadvantaged backgrounds.  Considerable emphasis is laid on patient and parent education in the clinic.  This has resulted in much improved understanding by parents of the nature of the problem facing their children and the need for regular medication.  The number of children with asthma who require admission for acute severe episodes is showing a considerable decline.

New challenges are continually being faced by the clinic staff - allergic diseases are on the increase in the black population and may masquerade as other more prevalent diseases, such as TB and HIV/AIDS.  The spectrum of diseases has changed, with less minor allergic diseases (isolated allergic rhinitis, mild asthma, eczema and urticaria) and more complex cases, particularly food allergy cases, comprising a much higher number of consultations. Adverse reaction to drugs is emerging as a significant problem in HIV/AIDS and several children have been referred to the Allergy Clinic for evaluation of these drug reactions and for desensitization.  Collaborations with other divisions/services including gastroenterology, dietetics, dermatology, pulmonology, ophthalmology, ENT and infectious diseases are well established.  An area of expertise for which there is increasing demand is in the field of controlled food allergy testing and food challenges.

Outpatient clinics

09h00: Mondays, Tuesday, Wednesdays, Thursdays, Fridays
14h00: Mondays, Wednesdays

Other clinical activities

Teaching and training

Undergraduate Teaching

Clinical teaching/tutorials weekly to fifth year medical students (small group) and seminar every 8 weeks to the whole group of students assigned to the Paediatric Block. Bedside tutorials regularly to student interns. The clinical educator holds weekly sessions on practical aspects of allergy diagnosis and treatment for 5th year medical students.

Postgraduate Teaching

Dr Levin is responsible for training of the Allergy Senior Registrar as a specialist in Allergology.  One general registrar rotates through allergy to receive appropriate training in this discipline. He also lectures on allergy-related topics to medical officers preparing for the Diploma in Child Health (2 lectures/year) and Fellowship in Paediatrics (1-2 lecture/year).  Training is also provided for skin-prick testing, lung function testing and patient education for candidates preparing for the Diploma in Allergology.

Online training in allergy is available on request via luvuyo@mweb.co.za.  To join our mailing list in allergy related educational activities email heidi@riversister.com.

Meetings

Specific allergy meetings include the fortnightly divisional meeting for case history discussions / clinic management issues on Thursdays at 11:30. Regular scheduled "Allergy in Africa" allergy lectures / webinars are held at 8am on Friday mornings.

To join our mailing list for allergy related educational activities email heidi@riversister.com

Research projects (completed/in progress)

• Prevalence of penicillin allergy in children.
• Total IgE in urban black South African children; the influence of atopy and helminth infection.
• Associations between Asthma and Bronchial Hyper-responsiveness with Allergy and Atopy Phenotypes in Urban Black South African Teenagers.
• Associations between Asthma, Bronchial Hyper-responsiveness and Atopy Phenotypes with Genetic polymorphisms in Urban Black South African Teenagers.
• A prospective, descriptive study to determine the prevalence of IgE-mediated food allergy in South African children with atopic dermatitis attending a tertiary medical centre
• Peanut allergy in black children
• The SAFFA (South African Food sensitisation and Food Allergy) study
• The impact of demographic, environmental, nutritional and infectious influences on the expression of allergy and atopy within the Drakenstein birth-cohort study
• The kinetics of the swallowed slurry used to deliver topical corticosteroids in patients with eosinophilic oesophagitis

Allergy talks

• Severe asthma Kerbelker
• Natural History of Allergy and Asthma Githinji
• Hygiene Hypothesis Coovadia
• Approach to a child with recurrent infections Le Roux
• Regulation and Hyper IgE Syndrome Naidoo
• Eosinophilic syndromes Levin
• Mucosal immunity Reddy
• IgE mediated food allergy Gray
• Eosinophillic oesophagitis Hendricks
• Anaphylaxis Levin
• The young child with recurrent cough and wheeze Zampoli
• Management of Acute Asthma in Children Kling

Useful contacts

Allergy Foundation of South Africa:  www.allergyfoundation.co.za

Allergy Society of South Africa: www.allergysa.org

National Asthma Education programme: www.asthma.co.za

Patient information

Patient support: Allergy Foundation of South Africa : A new patient focussed facebook page has been launched where people with severe food allergies and anaphylaxis can network and get more information.  Please send your friends, colleagues and patients to Allergy Foundation of South Africa: @SAAllergy for facebook and twitter support.

World Allergy Week Talk:  

The talk on emergency and ongoing management of kids with severe allergies and anaphylaxis is now available as a podcast.  Please go to http://meeting.uct.ac.za/p93355419/ to view it.