Bee- and Wasp-Venom Sensitization in Schoolchildren of High- and Low-Socioeconomic Status Living in an Urban Area of Indonesia

Int Arch Allergy Immunol. 2021;182(11):1036-1045. doi: 10.1159/000516155. Epub 2021 May 5.

Abstract

Background: There is not much known about venom allergy in tropical regions. Here, we studied the prevalence of specific IgE (sIgE) and skin prick test (SPT) reactivity and reported sting-related symptoms, in high- and low-socioeconomic status (SES) schoolchildren living in urban city of Makassar in Indonesia.

Methods: Children from high- (n = 160) and low- (n = 165) SES schools were recruited. Standardized questionnaires were used to record information on allergic disorders as well as sting-related symptoms. Parasitic infection, SPT reactivity, and sIgE to Apis mellifera (bee-venom) as well as Vespula spp. (wasp-venom) were assessed.

Results: SPT reactivity to bee- and wasp-venom was 14.3 and 12.7%, while the prevalence of sIgE was 26.5 and 28.5%, respectively. When SES was considered, prevalence of SPT to bee- and wasp-venom was higher in high-SES than in low-SES schoolchildren (bee: 22.8 vs. 5.7%, p < 0.001; and wasp: 19.6 vs. 5.7%, p < 0.001). Conversely, sIgE to both venoms was lower in high-SES than in low-SES (bee: 19 vs. 34%, p = 0.016; and wasp: 19 vs. 38%, p = 0.003). Furthermore, among SPT positive subjects, considerable proportion had no detectable sIgE to bee- (65.85%) or wasp-venom (66.67%). Altogether the sensitizations were rarely translated into clinical reaction, as only 1 child reported significant local reaction after being stung. No association with parasitic infections was found.

Conclusions and clinical relevance: Sensitization against bee- or wasp-venom is quite prevalent among schoolchildren in Indonesia. The discordance between SPT and sIgE might suggest the direct (non-IgE) effect of venoms in skin reactivity. Recorded sensitizations had poor clinical relevance as they rarely translated into clinical symptoms.

Keywords: Developing country; Epidemiology; Pediatrics; Urban; Venom and insect allergy.

MeSH terms

  • Allergens / immunology*
  • Animals
  • Bee Venoms / immunology*
  • Child
  • Cities / epidemiology
  • DNA, Helminth / analysis
  • Feces / parasitology
  • Female
  • Humans
  • Hypersensitivity / blood
  • Hypersensitivity / diagnosis
  • Hypersensitivity / epidemiology*
  • Hypersensitivity / immunology
  • Immunoglobulin E / blood
  • Indonesia / epidemiology
  • Male
  • Parasites / genetics
  • Parasites / isolation & purification
  • Prevalence
  • Skin Tests
  • Social Class
  • Wasp Venoms / immunology*

Substances

  • Allergens
  • Bee Venoms
  • DNA, Helminth
  • Wasp Venoms
  • Immunoglobulin E