Table 1.

Characteristics and prevalence of fruit allergy of eligible studies. (N = 31 studies).

Study (Year)	Country	Setting	Age (y, Mean ± SD)	Total Study Population	Data Source	Diagnostic Test	Prevalence of Fruit Allergy	Leading Types of Fruit (N, % of Total Study Population)
East Asia
Feng (2023) [6]	China (Jiangxi)	Community-based	44.72 ± 12.91	11,935	Self-reported	NA	NR	-Mango (89, 0.75%)
Feng (2022) [7]	China (Jiangxi)	Community-based	8.67 ± 1.26	8856	Parent-reported	NA	NR	-Mango (165, 1.86%) -Peach (5, 0.06%) -Pineapple (5, 0.06%)
Sha (2019) [8]	China (Beijing)	Community-based	0–14 *	13,073	Parent-reported	NA	1.5%	NR
Zeng (2015) [9]	China (Guangdong)	Community-based	4.6 ± 1.1	2540	Parent-reported	NA	NR	-Mango (58, 2.3%)
Kaneko (2015) [10]	Japan (Kawasaki)	Community-based	0–5 *	23,969	Physician-diagnosed	NR	0.24%	NR
Lee (2017) [11]	South Korea (Suwon)	Hospital-based	38.5 ± 14.1	95 †	Physician-diagnosed	SPT, sIgE	26 ¶	NR
Kim (2017) [12]	South Korea (Nationwide)	Community-based	6–16 *	29,842	Parent-reported	NA	1.41%	NR
Su (2023) [13]	Taiwan (Taipei)	Community-based	6–7 *, 13–14 *, and Adult [Median (IQR) 42 (39–46)]	16,200	Parent-reported and self-reported	NA	6–7 y: 0.96% 13–14 y: 1.16% Adult: 0.79% Overall: 0.89%	NR
Li (2022) [1]	Taiwan (Nationwide)	Community-based	Mean (range) 10.1 (6–13)	9982	Parent-reported and self-reported	NA	5.6%	-Mango (3.6%) -Kiwi (1.3%) -Strawberry, Orange, Pineapple, Watermelon (0.5% each)
Southeast Asia
Sompornrattanaphan (2023) [14]	Thailand (Bangkok)	Hospital-based	Median (IQR) 31.0 (24.0, 44.0)	711	Physician-diagnosed	SPT, sIgE, OFC	2.11%	-Banana (unpublished data)
South Asia
Mahesh (2016) [15]	India (Bangalore, Mysore)	Community-based	20–54 *	10,931	Self-reported and physician-diagnosed	sIgE	NR	-Apple (0.50%) ‡ -Banana (0.05%) ‡ -Tomato (0.02%) ‡
West Asia
Ahanchian (2016) [16]	Iran (Khorasan)	Hospital-based	Mean(range) 5.34 (0–18)	NR	Physician-diagnosed	SPT	371 ¶	-Tomato (7.8%) § -Orange (4.7%) § -Banana (4%) § -Grape (3.7%) §
Nachshon (2019) [17]	Israel (Recruitment center of the Israel Defense Forces)	Community-based	17	12,592	Self-reported and physician-diagnosed	SPT, OFC	NR	-Kiwi, Peach (3, 0.024% each) -Mango (2, 0.016%) -Apple, Banana, Fig, Plum, Strawberry (1, 0.008% each)
Irani (2015) [18]	Lebanon	Community-based	NR (infants, children, and adults)	506	Self-reported	NA	2.57%	-Strawberry (6, 1.19%) -Peach (5, 0.99%)
Alotiby (2022) [19]	Saudi Arabia (Makkah)	Community-based	18–80 *	531	Self-reported	NA	7%	NR
Akarsu (2021) [20]	Turkey (Ankara)	Hospital-based	Median (IQR) 6 (5–7.63)	534†	Physician-diagnosed	SPT, sIgE, OFC	NR	3–5 y (n = 440): -Kiwi (6) -Banana (2) 6–12 y (n = 217): -Kiwi (7) -Banana (2) 13–18 y (n = 35): -Banana (1)
Kaya (2013) [21]	Turkey (Ankara)	Community-based	12.9 ± 0.9	10,096	Parent-reported and physician-diagnosed	SPT, sIgE, OFC	0.029%	-Banana, Kiwi, Tomato (1, 0.001% each)
Europe
Tamazouzt (2022) [22]	France (Nationwide)	Community-based, birth cohort	0–5.5 *	16,400	Parent-reported	NA	NR	-Exotic fruit (i.e., banana, pineapple, and kiwi, 0.65%) ‡
Röhrl (2022) [23]	Germany	Community-based	0–2 *	KUNO Kids cohort 1139	Parent-reported	NA	NR	-Citrus fruit 0.97%
				SPATZ cohort 1006	Physician-diagnosed	NR	NR	NR
Lozoya-Ibáñez (2020) [24]	Portugal (Central region)	Community-based	14.3 ± 1.1	1702	Self-reported and physician-diagnosed	SPT, sIgE, OFC	0.47%	NR
Lozoya-Ibáñez (2016) [25]	Portugal (Central region)	Community-based	Mean(range) 48 (18–80)	965	Self-reported and physician-diagnosed	SPT, sIgE, OFC	0.1%	NR
Oceania
Sasaki (2017) [26]	Australia	Community-based	10–14 *	9816	Parent-reported and Physician-diagnosed	SPT, sIgE, OFC	NR	Clinic group ※ -Kiwi (7, 0.1%) -Avocado (3, 0.05%) Self-reported FA ※ -Kiwi (23, 0.5%) -Banana (7, 0.2%) -Avocado (1, 0.02%)
North America
Singer (2021) [27]	Canada	Hospital-based (Primary care)	≤19	288,490	Physician-diagnosed	NR	0.2%	NR
Bedolla-Pulido (2019) [28]	Mexico (Guadalajara)	Community-based	15–18 *	1992	Self-reported	NA	NR	-Avocado (1.0%) -Banana (0.8%) -Peach, Apple (0.7% each)
Ontiveros (2016) [29]	Mexico (Culiacan)	Community-based	8.6 (5–13)	1049	Parent-reported	NA	NR	-Strawberry (8, 0.76%) -Citric fruits (2, 0.19%)
Puente-Fernández (2016) [30]	Mexico (Toluca)	Community-based	18–25	1200	Self-reported	NA	8%	-Avocado, Kiwi (17, 1.4% each) -Pineapple (16, 1.3%) -Guava (12, 1.0%)
Verril (2015) [31]	United States	Community-based	≥18	4568	Self-reported	NA	2.7% ‡	NR
South America
da S. Correia (2022) [32]	Brazil (Limoeiro town, Pernambuco state)	Community-based	3.6 ± 1.1	412	Parent-reported	NA	1.9%	-Coconut (2, 0.48%) -Acai, Apple, Avocado, Banana, Guava, Tomato (1, 0.24% each)
Silva (2016) [33]	Brazil (Uberlandia)	Community-based	18–65 *	1583	Self-reported	NA	1.6%	-Watermelon -Pineapple -Avocado -Tomato
Hoyos-Bachiloglu (2014) [34]	Chile (Santiago)	Community-based	~5, 10, 15	455	Parent-reported	NA	NR	-Banana (0.9%) -Citrus fruits (0.4%)
Beltrán-Cárdenas (2021) [35]	Colombia (Medellín)	Community-based	5–12 *	969	Self-reported	NA	1.13%	-Strawberry (7, 0.72%) -Other fruits were not mentioned.

Note: Studies were stratified by continents and arranged according to alphabetical order of country’s name, and year of publication. Prevalence was either reported directly from each study or calculated as a percentage using the reported data on food or fruit allergy/hypersensitivity divided by the total study population, unless otherwise specified. Abbreviations: FA, food allergy; IQR, interquartile range; NA, not available; NR, not reported; OFC, oral food challenge; SD, standard deviation; sIgE, serum specific immunoglobulin E; SPT, skin prick test; y, year. * Range; ¶ Number of fruit-allergic patients; † Number of food-allergic patients; § Percentage per food-allergic patients; ‡ Weighted prevalence; ※ Clinic group (n = 5016) consisted of students who had a parent-reported questionnaire, with successful phone contact and completion of clinic evaluation. Self-reported group (n = 4800) consisted of the remaining students, who had a student questionnaire only or parent-reported questionnaire but without nurse contact or completion of clinic evaluation.