Summary, Authors, Affiliations & Acknowledgements
Background Methods Results Conclusion Contribution Keywords Authors Affiliations Acknowledgements Background Allergic rhinitis (AR) has a significant impact on the community as a whole with regard to quality of life and its relationship to allergic multi-morbidities. Appropriate diagnosis, treatment and review of the efficacy of interventions can ameliorate these effects. Yet, the importance of A
Background
Allergic rhinitis (AR) has a significant impact on the community as a whole with regard to quality of life and its relationship to allergic multi-morbidities. Appropriate diagnosis, treatment and review of the efficacy of interventions can ameliorate these effects. Yet, the importance of AR is often overlooked, and appropriate therapy is neglected. The availability of effective medications and knowledge as to management are often lacking in both public and private health systems.
Methods
This review is based on a comprehensive literature search and detailed discussions by the South African Allergic Rhinitis Working Group (SAARWG).
Results
The working group provided up-to-date recommendations on the epidemiology, pathology, diagnosis and management of AR, appropriate to the South African setting.
Conclusion
Allergic rhinitis causes significant, often unappreciated, morbidity. It is a complex disease related to an inflammatory response to environmental allergens. Therapy involves education, evaluation of allergen sensitisation, pharmacological treatment, allergen immunotherapy (AIT) and evaluation of the success of interventions. Regular use of saline; the important role of intranasal corticosteroids, including those combined with topical antihistamines and reduction in the use of systemic steroids are key. Practitioners should have a thorough knowledge of associated morbidities and the need for specialist referral.
Contribution
This review summarises the latest developments in the diagnosis and management of AR such that it is a resource that allows easy access for family practitioners and specialists alike.
Keywords
Allergic rhinitis; intranasal corticosteroids; antihistamines; immunotherapy; saline rinse.
Authors
Guy A. Richards1, Marinda McDonald2, Claudia L. Gray3,4, Pieter de Waal5,6, Ray Friedman7, Maurice Hockman8, Sarah J. Karabus9, Cornelia M. Lodder10, Tshegofatso Mabelane11, Sylvia M. Mosito12, Ashen Nanan13, Jonny G. Peter14, Traugott H.C. Quitter15, Riaz Seedat16, Sylvia van den Berg17,18, Andre van Niekerk18,19,20 , Eftyhia Vardas21,22, Charles Feldman23
Affiliations
1Department of Pulmonology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
2The Allergy Clinic, Blairgowrie, Johannesburg, South Africa
3Department of Paediatric Allergy, Faculty of Child Health, University of Cape Town, Cape Town, South Africa
4Department of Paediatric Allergy, Private Practice, Vincent Palotti Hospital, Cape Town, South Africa
5Department of Allergy, Pulmonology and Immunology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
6Private Practice, Mediclinic Panorama, Cape Town, South Africa
7Department of Otorhinolaryngology, Private Practice, Mediclinic Sandton, Sandton, South Africa
8Johannesburg Cochlear Implant Programme, Netcare Linksfield Hospital, Johannesburg, South Africa
9Allergy Division, Faculty of Health Sciences, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
10Department of Allergy and Asthma Clinic, Private Practice, George, South Africa
11Department of Internal Medicine, Faculty of Health Sciences, Sefako Makgato Health Sciences University, Pretoria, South Africa
12Department of Otolaryngology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
13Department of Otorhinolaryngology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
14Department of Medicine, Faculty of Health sciences, University of Cape Town, Cape Town, South Africa
15Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
16Department of Otorhinolaryngology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
17Department of Immunology, Ampath Laboratories, Pretoria, South Africa
18Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
19Departments of Inborn Errors of Immunity and Allergology, Faculty of Sciences, University of Pretoria, Pretoria, South Africa
20Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
21Department of Clinical Virology, Faculty of Health Sciences, University of Stellenbosch, Stellenbosch, South Africa
22Department of Virology Allergy and Immunology, Lancet Laboratories, Johannesburg, South Africa
23Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Corresponding author: Guy Richards, guy.richards@wits.ac.za
Dates: Received: 02 Aug. 2023 | Accepted: 19 Sept. 2023 | Published: 30 Oct. 2023
How to cite this article: 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
Copyright: © 2023. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
Acknowledgements
Competing interests
C.F. has received speakers fees from Aspen, MSD, Astra Zeneca, Aurogen, Procter and Gamble. G.A.R. has received speakers fees from Glenmark, Aspen, MSD, Astra Zeneca, Novartis, Cipla, Acino, Sandoz, and consultative fees from Cipla. C.M.L. has received speakers fees from Glenmark, Astra Zeneca, Norvartis, Cipla, Acino, Sandoz, and consultative fees from Cipla. R.F. has received speakers fees from Aspen and Glenmark. M.H. has received speakers fees from GSK, Aspen, Pharmacare, Glenmark, Medel and SouthernENT. J.P. has received support for pollen monitoring across South Africa from Novartis, Glenmark, Clicks, Pharmadynamics, Dr Reddy’s, Thermofischer Scientific, Twinsaver and A Vogel Echinaforce and speakers fees from Glenmark, Johnson and Johnson, Sanofi and Astra Zeneca. T.M. has received speakers fees from Aspen, Astra Zeneca and Cipla. A.v.N. has received speakers fees from Acino, Actor Pharma, Aspen, Astra Zeneca and Glenmark, MSD, Organon, Sanofi and Takeda. C.L.G. has received speaker’s fees from Aspen, Astra Zeneca, Cipla, Glenmark and Organon. M.M. has received speakers fees from Glenmark, Cipla, Aspen, Sanofi, Proctor and Gamble, Thermo Scientific, Lancet laboratories and Immunospec. A.N., P.d.W., S.K., R.S., S.v.d.B., C.Q., S.M. and E.V. have no disclosures.
Authors’ contributions
All members participated in the SAARWG meeting except C.F., and thereafter, each member contributed portions to the manuscript, which was consolidated by G.A.R. and C.G. C.F. provided consultative advice.
Ethical considerations
This article followed all ethical standards for research without direct contact with human or animal subjects.
Funding information
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Data availability
The authors confirm that the data supporting the findings of this study are available within the article.
Disclaimer
The views and opinions expressed in this article are those of the authors and do not necessarily reflect those of any agency or organisation of the authors.
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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