Mapping the Burden and Risk Factors of Allergic Diseases and Asthma Among Aboriginal and Torres Strait Islander People: A Scoping Review.

Abstract

Allergic diseases and asthma are significant public health concerns in Australia and globally. However, comprehensive data on the burden among Aboriginal and Torres Strait Islander people are scarce. This scoping review aimed to systematically map existing evidence on the burden and risk factors of allergic diseases and asthma among Aboriginal and Torres Strait Islander people. MEDLINE, Scopus, Embase and Web of Science Core Collection were systematically searched through March 2024. We included studies that reported allergic diseases and asthma among Aboriginal and Torres Strait Islander people. Study characteristics and outcome data were tabulated and evidence was synthesised narratively. Fifty-four studies involving an estimated 176,792 Aboriginal and Torres Strait Islander people were included. These studies reported on asthma (n = 48), eczema (n = 10), allergic rhinitis (n = 6), atopy (n = 3), mixed allergies (combining food, drug and other undefined allergies) (n = 2), and anaphylaxis (n = 1). No studies solely investigating food allergies were found. The majority of studies were from Western Australia (WA, n = 15) and the Northern Territory (NT, n = 14). Estimates of allergy prevalence varied widely between studies, with eczema ranging from 2.0% to 44.4%, allergic rhinitis from 0.2% to 37.3%, and atopy from 1.7% to 36.4%. Asthma prevalence ranged from 2.0% to 50.5%. Risk factors for asthma included exposure to smoke and lower socioeconomic status, while a family history of allergy was associated with an increased risk of allergic rhinitis. In conclusion, Aboriginal and Torres Strait Islander people face a potentially significant burden of allergic diseases and asthma, yet they remain underrepresented in research. Culturally responsive studies are needed to address this substantial evidence gap.