{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T16:12:18Z","timestamp":1778170338843,"version":"3.51.4"},"reference-count":60,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"crossref","award":["KK.01.1.1.07.0074"],"award-info":[{"award-number":["KK.01.1.1.07.0074"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"crossref"}]},{"name":"European Union Horizon 2020 IMPTOX","award":["965173"],"award-info":[{"award-number":["965173"]}]},{"name":"Croatian Science Foundation project Poll-FoodAll","award":["IP-2025-02-9052"],"award-info":[{"award-number":["IP-2025-02-9052"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Food allergy (FA) is a substantial health burden in children. FA is often associated with malnutrition and malabsorption, due to restrictive food avoidance diets, which can significantly impair the patient\u2019s and their family\u2019s quality of life. To this date, population-based data combining sensitization and clinical allergy remain limited. This study aimed to assess the patterns of sensitization rates to food and food allergy prevalence rates in Croatian children and to evaluate differences according to age, sex, and region of origin. Materials and Methods: In this cross-sectional study, 1948 preschool and school-aged children from three Croatian regions (Zagreb, Dalmatia, and Slavonia) were included. Participants underwent skin prick testing to common food and inhalant allergens. Data on personal and family medical history were collected using questionnaires and medical records. FA prevalence was evaluated using self-reported data in school-aged children and physician-diagnosed FA data in preschool children. Results: Overall, 41% of participants were sensitized to at least one allergen, while 13% were sensitized to at least one food allergen. Tree nuts\u2014particularly hazelnut\u2014were the most common food-derived sensitizers, followed by hen\u2019s egg, cow\u2019s milk, and fish. Boys exhibited higher total sensitization rates than girls (44.2% vs. 37.5%; p = 0.001), higher food allergen sensitization rates (14.7% vs. 11.4%; p = 0.037), and higher total polysensitization rates (30.7% vs. 22.6%; p &lt; 0.001). School-aged children showed higher total sensitization (44.8% vs. 33.4%; p &lt; 0.001) and polysensitization rates (29.8% vs. 20.5%; p &lt; 0.001) than preschool children, while sensitization to food allergens did not differ between age groups. Food allergen sensitization rates differed by region, with higher prevalence in Zagreb compared with Dalmatia and Slavonia (p = 0.0055), whereas total sensitization rates did not differ regionally. The agreement between sensitization and self-reported FA among school-aged children was low (\u03ba = 0.22; p &lt; 0.001), as was the agreement between sensitization and physician-diagnosed FA in preschool children (\u03ba = 0.13; p &lt; 0.001), despite high specificity in both analyses (95% and 99%%, respectively). Conclusions: Allergic sensitization is common among Croatian children, but it poorly predicts clinically relevant food allergy. These findings highlight the multifactorial nature of allergen sensitization in children and emphasize the need for improvements in diagnostic pathways, targeted prevention strategies, and continued surveillance to optimize allergy prevention and management in children.<\/jats:p>","DOI":"10.3390\/children13020234","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T16:32:59Z","timestamp":1770395579000},"page":"234","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Age-, Sex- and Region-Specific Patterns in Sensitization Rates to Food Allergens and Food Allergy Prevalence in Croatian Children: The H2020 IMPTOX and ERDF P4 Study Findings"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2902-6228","authenticated-orcid":false,"given":"Jan","family":"Pantlik","sequence":"first","affiliation":[{"name":"Department of Medical Research, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6284-053X","authenticated-orcid":false,"given":"Marcel","family":"Lipej","sequence":"additional","affiliation":[{"name":"IT Department, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0017-142X","authenticated-orcid":false,"given":"Ivana","family":"Bani\u0107","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"},{"name":"Department of Innovative Diagnostics, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"\u0160uti\u0107","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Mija\u010d","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"Ani\u0107","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana-Marija","family":"Genc","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Vuki\u0107","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5365-1243","authenticated-orcid":false,"given":"Antonija","family":"Pi\u0161kor","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0894-640X","authenticated-orcid":false,"given":"Adrijana Mileti\u0107","family":"Gospi\u0107","sequence":"additional","affiliation":[{"name":"Department of Allergy and Clinical Immunology, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u017deljka Vla\u0161i\u0107","family":"Lon\u010dari\u0107","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milan","family":"Juri\u0107","sequence":"additional","affiliation":[{"name":"Department of Allergy and Clinical Immunology, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vlatka","family":"Drinkovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Allergy and Clinical Immunology, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivana","family":"Mari\u0107","sequence":"additional","affiliation":[{"name":"Department of Allergy and Clinical Immunology, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tin","family":"Ku\u0161an","sequence":"additional","affiliation":[{"name":"Department of Allergy and Clinical Immunology, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5339-861X","authenticated-orcid":false,"given":"Mirjana","family":"Turkalj","sequence":"additional","affiliation":[{"name":"Department of Allergy and Clinical Immunology, Srebrnjak Children\u2019s Hospital, HR-10000 Zagreb, Croatia"},{"name":"Faculty of Medicine, J.J. Strossmayer University of Osijek, HR-31000 Osijek, Croatia"},{"name":"Faculty of Medicine, Catholic University of Croatia, HR-10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1080\/14737167.2020.1819793","article-title":"Burden and Socioeconomics of Asthma, Allergic Rhinitis, Atopic Dermatitis and Food Allergy","volume":"20","author":"Dierick","year":"2020","journal-title":"Expert Rev. Pharmacoecon. Outcomes Res."},{"key":"ref_2","unstructured":"EAACI (2024). European Academy of Allergy and Clinical Immunology EAACI Advocacy Manifesto 2024: Tackling the Allergy Crisis in Europe, EAACI."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Gargano, D., Appanna, R., Santonicola, A., De Bartolomeis, F., Stellato, C., Cianferoni, A., Casolaro, V., and Iovino, P. (2021). 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