ArticleThe Lancet regional health. Southeast Asia2026
The prevalence and risk factors of drug allergy in Sri Lanka-a multi-centre cross-sectional observational study (2024-2025).
Article in The Lancet regional health. Southeast Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: There is a huge burden of drug allergy (DA) in High-Income Countries and is a major impediment to clinical management, adversely affecting outcomes. Data regarding DA from low-and middle-income countries (LMICs) are sparse. Also, there is a vast unmet demand for DA services in LMICs. We aimed to determine the prevalence of self-reported and physician-documented DAs in Sri Lanka and to explore potential risk factors associated with DA labels. Methods: Cross-sectional, observational study was carried out among adults presenting to outpatient clinics in selected secondary and tertiary care centres during December 2024 to April 2025. A standardised e-proforma in a 1-1 interview captured details. Potential risk factors were explored using multivariable logistic regression. Findings: Total number of respondents was 12,491: Females: 8410 (67.4%) and males: 4081 (32.6%). Mean age (SD) was 55.1 (14.4) years and 727 reported allergies to 868 drugs; prevalence = 5.8% (95% CI: 5.42-6.24); allergy to ≥2 drugs = 0.74%. Most common reported were antibiotics (41.5%; penicillins most common), nonsteroidal-anti-inflammatory drugs (13%), and paracetamol (10.6%). In the mixed-effect logistic model, odds of DA were lower among males (AOR: 0.74, 95% CI: 0.61-0.88; p < 0.001), and Tamil ethnicity (AOR: 0.67; 95% CI: 0.51-0.89; p = 0.005). Higher odds were observed in 50-<60-year (AOR: 1.55; 95% CI: 1.20-1.99.; p < 0.001) and 60-93-year (AOR: 1.38; 95% CI: 1.08-1.77, p = 0.011) age groups and allergic, endocrine, cardiovascular, rheumatological, neurological, and haematological comorbidities. Interpretation: There is a high burden of reported DA in Sri Lanka. This is compounded by an unmet demand for DA services highlighting a need for capacity building. Funding: Institute of Global Innovation, University of Birmingham, UK.
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