Allergic rhinitis in Latin America: knowledge, attitudes, and clinical practices of specialists in allergy and clinical immunology— CAPRA-SLAAI study

Kuschnir, F , Mérida-Palacio, J , Arruda-Chaves, E et al. Allergologia Et Immunopathologia, 54(3), 141-154. https://doi.org/10.15586/aei.v54i3.1659

Abstract

Allergic rhinitis (AR) is highly prevalent in Latin America (LA), impairing quality of life and often coexisting with asthma. In spite of dissemination of international guidelines, regional differences in diagnosis and management persist. The “Conductas, Actitudes y Prácticas de la Sociedad Latinoamericana de Alergia e Inmunología” (CAPRA–SLAAI) study aimed to assess the knowledge, attitudes, and practices on AR of allergists and clinical immunologists affiliated with SLAAI. Between November 2022 and March 2023, a standardized ARIA-adapted questionnaire (validated in Spanish/Portuguese) was distributed online to specialists from 24 countries; 784 were eligible for analysis. Nearly three-quarters were from Brazil (49.7%) and Mexico (25.8%), with a mean age of 50 years. Awareness of ARIA guidelines was almost universal; however, only 41% knew the MASK-air® digital tool, and fewer than 12% reported regular use, with low uptake in Brazil. 

Multivariate analysis of the main knowledge about ARIA guidelines/mask-air according to the study groups

Brazilian (BR) specialists more often reported extra-nasal symptoms and greater impact on daily activities, suggesting differences in presentation or reporting. Diagnostic strategies varied: BRs relied more on serum IgE and anterior rhinoscopy, whereas others used skin tests and imaging. Pharmacological treatment was similar across LA, with the use of second-generation antihistamines and intranasal corticosteroids. Immunotherapy approaches differed: subcutaneous and sublingual immunotherapy were more common outside BR, where pollinosis results in a greater variety of extracts. Conversely, allergen extracts are more standardized in Brazil. This survey reveals important regional contrasts and underscores the need for training, access to diagnostic tools, harmonized strategies, and greater integration of digital health solutions to optimize AR management in LA.

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