Prevalence and Risk Factors of Food Allergy and Its Association With Asthma Coexistence and Severity in Bangladeshi Schoolchildren: A GIS ‐Based Cross‐Sectional Study

ABSTRACT

Food allergies are a critical health issue that increases susceptibility to a range of allergic disorders. However, there is limited understanding of the burden of food allergies in Bangladeshi schoolchildren. This study aimed to determine the prevalence of food allergies and their risk factors among schoolchildren in Bangladesh and to examine the relationship between food allergies and the coexistence and severity of asthma. A cross‐sectional study was conducted among schoolchildren aged 12–18 years, with 828 participants (54.5% girls and 45.5% boys) enrolled in schools across all divisions of Bangladesh. Food allergies and current asthma status were determined based on patients' clinical histories. Associations were examined using Poisson regression with robust variance estimation, yielding adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs). Among schoolchildren, the 12‐month prevalence of study‐defined food allergies was 29.3% and the prevalence of current asthma was 15.9%. The most commonly reported locally significant offending food allergens were vegetables (76.1%), beef (61.3%), and shellfish (58.0%). Food allergies were more common among girls, older adolescents, lower‐income families, and children residing in Barisal, Sylhet, or Rajshahi. Asthma and food allergies frequently coexist (8.1%), with asthma cases being twice as likely to report food allergies. Food allergies were also associated with higher asthma severity, particularly wheezing and sleep‐disturbing symptoms. GIS mapping revealed marked regional variation, with the greatest coexistence observed in the Barisal and Sylhet divisions. This study demonstrated the significant burden of food allergies and their frequent coexistence with asthma among Bangladeshi school children. Targeted awareness campaigns, early diagnosis, and region‐specific interventions are critical for reducing the dual burden of food allergies and asthma, particularly in high‐prevalence areas, such as Barisal and Sylhet.