Pediatric anaphylaxis management in schools: Current issues and challenges in Asia and Hong Kong. A scoping review

Abstract

Hong Kong has the highest prevalence of food allergies compared with Mainland China, Russia, and India. There has been a twofold increase in anaphylaxis incidence between 2009 and 2019, of which 20% occur in day-care and school settings. A scoping systemic search was performed with the aim of reviewing existing literature in the Asia-Pacific region regarding food allergy management in the school setting. Current loopholes and inadequacies on governmental policy regarding school anaphylaxis management were explored. 28 articles from MEDLINE-OVID were compared with a PRISMA scoping review published in 2022 having similar search terms but focusing on Western countries. Furthermore, current loopholes and inadequacies on governmental policy regarding school anaphylaxis management in Hong Kong were explored. An Internet search was later conducted to supplement the information on governmental policies for school anaphylaxis management. Most publications identified focused on assessing food allergy prevalence and causative agents. However, there is an evident lack of literature on emergency action plans and school training programs. Existing governmental policies regarding school anaphylaxis were reviewed and compared. Hong Kong currently lacks legal protection for bystanders and policies, encouraging school staff training for anaphylaxis management. Governmental regulations and subsidization are also absent in encouraging schools to purchase backup stocks of unassigned epinephrine autoinjectors. Raising awareness and improving guidelines and policies in schools are integral in the management of food-induced adverse events and anaphylaxis. Governmental support through policymaking and legislation can significantly enhance and hasten the process, thus minimizing the impact adverse food reactions bring to the pediatric population.