BackgroundChronic disease among school-aged children is a public health concern, particularly for asthma and food allergy. In Chicago Public Schools (CPS), rates of asthma and food allergy among students are underreported. The aim of this study was to determine the barriers to chronic disease reporting as experienced by CPS parents and school nurses.MethodsA mixed-methods approach included focus groups and key informant interviews with parents and school nurses, and a cross-sectional survey was completed by parents. Qualitative data analysis was performed and survey data were analyzed to determine the significant demographic and knowledge variables associated with successfully completing the reporting process.ResultsThe three main barriers identified were 1) a lack of parental process knowledge; 2) limited communication from schools; and 3) insufficient availability of school nurses. Parents were significantly more likely to successfully complete the reporting process if they knew about special accommodations for chronic diseases, understood the need for physician verification, and/or knew the school nurse.ConclusionsThese findings suggest that increasing parental knowledge of the reporting process will allow schools to better identify and manage their students’ chronic conditions. A parent-focused intervention informed by these results has been completed.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-1250) contains supplementary material, which is available to authorized users.

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RATIONALE: To evaluate the safety of sublingual immunotherapy (SLIT) for peanut allergy using commercially prepared peanut cream. METHODS: We enrolled children aged <15 years who were diagnosed with peanut allergy by an open oral food challenge (OFC) and who agreed to undergo peanut SLIT. Doses of peanut protein from commercially prepared peanut cream were gradually increased from 13.8 mg/day to 4600 mg/day over the study period. We evaluated adverse events during SLIT and changes in maximum tolerated OFC doses from initiation to 12 months. RESULTS: Ten patients with a median age of 5.6 years (range: 5-13 years) were included in our study. One patient withdrew from the study; however, this was not due to an adverse event. Regarding adverse events, symptoms involving the oral cavity occurred in 7/10 cases (156/2045 dose times, 7.6%), and mild systemic symptoms occurred on an average at 0.1 times/case/year. The median maximum tolerated OFC dose increased significantly from 0.3 g (range: 0.1-0.5 g) to 0.4 g (range: 0.1-3.0) over 12 months (p50.034). In addition, the skin prick test wheal size decreased significantly from 1062.4 to 7.361.7 mm over 12 months (p50.006). Conversely, median peanut-specific IgE levels were not significantly different at 12 months (13.6 UA/ml) compared to baseline (13.5 UA/mL) (p50.43). CONCLUSIONS: SLIT using commercially prepared peanut cream resulted in only a few, mild adverse reactions and may increase tolerance to peanuts. Further studies are needed to evaluate the effectiveness of peanut SLIT.

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