Health-related quality of life in children and adolescents after systemic sting reaction

Abstract

Introduction and objectives. Insect stings are the second trigger of anaphylaxis in children and adolescents, causing a potentially life-threatening reactions. Hence health-related quality of life (HRQoL) is an important issue for Hymenoptera venom allergy (HVA) patients. The aim of this cross-sectional study was to evaluate the impact of HVA on young patients' HRQoL, including their socio-demographic characteristics. Materials and method. The study sample included 102 patients aged 8-17 (Mean 12.5 years, SD=3.0), who were under diagnosis or venom immunotherapy due to systemic reaction after an insect sting in one of the tertiary referential centers in Poland. They were mostly boys (70%), and mainly from rural areas (63%). HRQoL of studied patients was measured with the Children's Hymenoptera Venom Allergy Quality of Life Scale, a questionnaire covering 6 dimensions: anxiety, caution, limitations, discomfort, support received from parents and a feeling of safety, each measured from 1 to 5. Independent predictors of HRQoL were estimated using the Generalized Linear Model. Results. In the group of children being dermal reactors, girls reported a higher level of anxiety (B=1.17, 95%CI=(0.30;2.03), p=0.008). In the group of children with grade 2 it was the girls who reported lower anxiety (B=-1.33, 95%CI=(-2.38;-0.29), p=0.013). Boys treated longer than 3 years had their level of anxiety significantly lower than those studied at diagnosis (B=-0.65, 95%CI=(-1.23;-0.07), p=0.028). The feeling of safety was higher in children living in villages than in those living in towns (B=0.30, 95%CI=(0.03;0.56), p=0.031). Conclusions. The gender, treatment duration and stage of anaphylactic reaction influenced level of anxiety. The level of feeling of safety was related to the place of living.

S3 Guideline Allergy Prevention

“…Complementary to this, numerous epidemiological and prospective studies have shown that the development of allergic diseases might subsequently increase the probability of developing psychological stress and associated diseases [ 246 , 247 , 248 , 249 , 250 , 251 ] (phobias, depression, ADHD), which can possibly be reduced by good disease control but which, on the other hand, can also impair disease control [ 252 ]. In the case of comorbidity of allergy and mental illness, a higher disease severity and lower quality of life and the development of further complications can be expected, which can be prevented by simultaneous diagnosis and treatment of mental comorbidity in allergy [ 253 , 254 , 255 ].…”

Health‐related quality of life in food and venom induced anaphylaxis and role of influencing factors

“…Also, an association between the level of caution and the place of residence was revealed, showing that adolescents from a rural area had lower levels of caution 5,6 . This might be caused by a higher accustomation to hymenoptera but also by a higher number of beekeepers in rural areas 5 and another study in children and adolescents found no difference in the levels of limitations due to wasp allergy between patients living in rural or urban areas 4 …”

“…A significant association between the severity of the anaphylactic reaction (Mueller's grade IV compared to grade III) and anxiety was reported, 5 but not confirmed by others 69 . Several studies showed a significant positive relationship between anxiety and caution as well as caution, limitations and discomfort, meaning that the more anxious the patient feels about a future reaction to an insect sting, the more measures they will invest in its avoidance, and therefore, they will experience more limitations 4–6 . The level of parental caution seemed to decrease slightly with increasing age of the venom allergic child 6 .…”

Influence of allergen immunotherapy on the quality of life in patients with asthma, allergic rhinitis and insect venom allergy

“…Uzyskane za pomocą tych skal wyniki badań zmieniają dotychczasowe spojrzenie na oryginalny indeks autorów holenderskich. Wskazują na wielowymiarowy charakter jakości życia dzieci i młodzieży z alergią na jad owadów błonkoskrzydłych oraz ich rodziców oraz umożliwiają zastosowanie tych skal w populacji ogólnej [73,74].…”