Introduction
Allergic rhinitis (AR) is one of the most common chronic conditions with a prevalence of 10% – 40%. 1,2,3,4,5,6,7,8 It can cause significant discomfort and a marked reduction in productivity and quality of life (QoL). 8 Moreover, its consequences can be serious, including contributing to asthma exacerbations and comorbidities such as rhinosinusitis and otitis media; increasing susceptibility
Allergic rhinitis (AR) is one of the most common chronic conditions with a prevalence of 10% – 40%.1,2,3,4,5,6,7,8 It can cause significant discomfort and a marked reduction in productivity and quality of life (QoL).8 Moreover, its consequences can be serious, including contributing to asthma exacerbations and comorbidities such as rhinosinusitis and otitis media; increasing susceptibility to viral illnesses and impacting on taste, smell and sleep quality.7,8,9,10 Poor sleep quality can result in chronic fatigue, daytime sleepiness and learning problems in children.11 Allergic rhinitis can also aggravate mood disorders such as depression and decrease the ability to concentrate.12,13 Despite this, it is significantly underdiagnosed and sub-optimally treated, particularly in children where AR symptoms may be attributed to viral infections.7
Allergic rhinitis and asthma often coexist (united airway concept), and AR is a risk factor for the development of asthma.14 In patients with asthma, AR may be associated with poor control of the disease.14,15 Appropriate treatment of AR can result in a significant improvement in patients’ QoL, as well as improve the control of comorbid conditions such as asthma.14,15 This can reduce the overall cost of asthma treatment and reduce the number of patients with uncontrolled asthma requiring treatment at the hospital level.
Both the prevalence and consequences of AR have led the World Allergy Organization to label it ‘a global public health concern’.16 Excellent comprehensive guidelines are available9,17,18,19,20,21 but are generally written in, and for, high-income countries; whereas they are mostly universally applicable, there are local factors in South Africa (SA) that call for some unique recommendations, including:
- Economic issues: South Africa represents a resource-poor setting with priority given to infectious diseases and diseases considered to be more severe. Funds for medications for AR are frequently not a priority in the public health sector. However, untreated or poorly treated AR may have a greater economic cost as a result of absenteeism or reduced productivity.22
- Practical issues: Distance to hospital or clinic, single-parent households and inability to take time off work make clinic visits difficult.
- Understanding of health-related issues: This may be affected by poor health literacy and dominant traditional beliefs, negatively affecting compliance.
The aim of this consensus document, produced by the SAARWG, is to review up-to-date recommendations for AR applicable to SA.
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Richards GA, McDonald M, Gray CL, et al. Allergic rhinitis: Review of the diagnosis and management: South African Allergic Rhinitis Working Group. S Afr Fam Pract. 2023;65(1), a5806. https://doi.org/10.4102/safp.v65i1.5806