Amoah, A.S.Obeng, B.B.Larbi, I.A.Versteeg, S.A.Aryeetey, Y.Akkerdaas, J.H.Zuidmeer, L.Lidholm, J.Fernandez-Rivas, M.Hartgers, F.C.Boakye, D.A.van Ree, R.Yazdanbakhsh, M.2018-11-152018-11-152013-06-12http://dx.doi.org/10.1016/j.jaci.2013.04.023http://ugspace.ug.edu.gh/handle/123456789/25541ArticleThe prevalence of peanut allergy has increased in developed countries, but little is known about developing countries with high peanut consumption and widespread parasitic infections. Objective: We sought to investigate peanut allergy in Ghana. Methods: In a cross-sectional survey among Ghanaian schoolchildren (n 5 1604), data were collected on reported adverse reactions to peanut, peanut sensitization (serum specific IgE and skin reactivity), consumption patterns, and parasitic infections. In a subset (n 5 43) IgE against Ara h 1, 2, 3, and 9 as well as cross-reactive carbohydrate determinants (CCDs) was measured by using ImmunoCAP. Cross-reactivity and biological activity were investigated by means of ImmunoCAP inhibition and basophil histamine release, respectively. Results: Adverse reactions to peanut were reported in 1.5%, skin prick test reactivity in 2.0%, and IgE sensitization (>0.35 kU/L) in 17.5% of participants. Moreover, 92.4% of those IgE sensitized to peanut (>0.35 kU/L) had negative peanut skin prick test responses. Schistosoma haematobium infection was positively associated with IgE sensitization (adjusted odds ratio, 2.29; 95% CI, 1.37-3.86). In the subset IgE titers to Ara h 1, 2, 3, and 9 were low (<1.3 kU/L), except for 6 moderately strong reactions to Ara h 9. IgE against peanut was strongly correlated with IgE against CCDs (r 5 0.89, P < .0001) and could be almost completely inhibited by CCDs, as well as S haematobium soluble egg antigen. Moreover, IgE to peanut showed poor biological activity. Conclusions: Parasite-induced IgE against CCDs might account largely for high IgE levels to peanut in our study population of Ghanaian schoolchildren. No evidence of IgE-mediated peanut allergy was found. (J Allergy Clin Immunol 2013;132:639-47.)enPeanut allergyskin prick testingIgESub-Saharan AfricaIgE cross-reactivitycross-reactive carbohydrate determinantshelminth infectionsbasophil histamine releaseEuroPrevallArticle