D3.474 - Non-IgE-mediated rhinitis in sub-Saharan Africa: an underdiagnosed condition?

Chronic rhinitis is a common reason for ENT consultations in sub-Saharan Africa. In routine practice, it is often mistaken for allergic rhinitis due to the lack of systematic allergy testing. The prevalence of non-IgE-mediated rhinitis remains poorly understood and is likely underestimated.

Objective : To evaluate the prevalence of non-IgE-mediated rhinitis in patients presenting with symptoms of chronic rhinitis and initially diagnosed with allergic rhinitis based on clinical criteria.

This was a prospective cross-sectional study conducted in ENT clinics. Patients with chronic rhinitis underwent a standardized clinical evaluation (ARIA criteria) and targeted allergy skin tests for local aeroallergens. Non-IgE-mediated rhinitis was defined as negative skin tests in the absence of immuno-allergic evidence.

Of the 180 patients included, 124 (68.9%) had an initial clinical diagnosis of allergic rhinitis. Skin tests were negative in 52 patients (41.9%), suggesting non-IgE-mediated rhinitis. These patients more frequently presented with persistent symptoms (73%), exposure to environmental irritants (household smoke, urban pollution) in 65% of cases, and fewer personal atopic predispositions (18% vs. 46%, p < 0.05).

Non-IgE-mediated rhinitis represents a significant proportion of chronic rhinitis in sub-Saharan Africa and remains largely underdiagnosed. The integration of simple diagnostic tools would improve phenotyping and optimize management in a resource-limited setting.