Ten-Year Review of Allergology Consultations in Abidjan: Clinical, Immunological, and Environmental Profiles in a Sub-Saharan Context

Abstract

Introduction : In sub-Saharan Africa, allergic diseases are increasing, but their management remains limited due to a lack of specialized centers, appropriate diagnostic tools, and local epidemiological data. To address these challenges, an immunology-allergology unit was established at Cocody University Hospital in Abidjan. Objective : To describe the clinical, immunological, and environmental characteristics of patients consulting for suspected allergy over a ten-year period. Methods : A retrospective, descriptive, and analytical study was conducted using 350 patient records from the allergology outpatient clinic between January 2015 and December 2024. Sociodemographic, clinical, and environmental data, along with results from skin, biological, and functional allergy tests, were analyzed using Epi Info version 7.2.4. A p-value < 0.05 was considered statistically significant. Results : Cutaneous symptoms were the most common (46.3%), followed by respiratory manifestations (33.1%). An atopic background was identified in 92.6% of patients. Skin prick tests, performed in 85.3% of cases, revealed polysensitization in 67.1%, mainly to aeroallergens (44.6%) such as Blomia tropicalis and Glycyphagus domesticus , and to food allergens (16.9%) such as peanut, egg, and crab. Biological (total/specific IgE, eosinophils) and functional (spirometry, provocation tests) assessments were infrequently available. Allergen avoidance, antihistamines, and corticosteroids were the most prescribed treatments. Allergen immunotherapy was initiated in 5.1% of cases. Conclusion: This ten-year review highlights the predominance of perennial tropical allergens and the high rate of polysensitization in an urban context. It underscores the need to improve access to specialized allergy diagnostics and to strengthen local capacities in allergology.