Allergic rhinitis in South Africa: 2012 guidelines

  • R J Green University of Pretoria
  • M Hockman Linksfield Clinic and Sandton Clinic
  • R Friedman University of Stellenbosch
  • E Vardas Lancet Laboratories
  • P Cole Netcare Krugersdorp Hospital
  • A Halkas Charlotte Maxeke Johannesburg Academic Hospital and University of the Witwatersrand
  • C Feldman
Keywords: allergic rhinitis, South African guidelines 2012


Allergic rhinitis (AR) is an important disease in South Africa. The South African Allergic Rhinitis Working Group (SAARWG) has published previous guidelines on AR diagnosis and management. Areas of concern have arisen that require additional information, including the management of AR in infancy, appropriate and inappropriate allergy testing, the cost of AR management, diagnosis and distinguishing the condition from sinusitis, use of over-the-counter (OTC) medications and the concept of the “united airway”. Clinicians should consider the possibility of AR in infants with recurrent nasal symptoms. Allergy testing must be used wisely and be based on local allergens. Total immunoglobulin E testing is not routinely required to prove allergy. Acute and chronic sinusitis should be considered in conjunction with AR. Treatment of rhinitis will improve these conditions. OTC medications should be used sparingly and with caution. Concern for long-term use of topical decongestants must be noted. Asthma should always be considered in AR diagnosis. Immunotherapy is available in South Africa and may be extremely useful in selected AR patients. The SAARWG has proposed an algorithm for the diagnosis and management of rhinitis in South Africa. AR is common, important and troubling to patients, so every effort should be made to target therapy correctly. Patient education is important in the management of AR.

Author Biographies

R J Green, University of Pretoria
MBBCh, FCPaed (SA), MMed(Paed), PhD, FRCP Department of Paediatrics and Child Health University of Pretoria; Private Practice Linksfield Clinic Johannesburg
M Hockman, Linksfield Clinic and Sandton Clinic
BSc, MBBCh, FCS(SA)(ORL) Private Practice Linksfield Clinic and Sandton Clinic Johannesburg
R Friedman, University of Stellenbosch
MBBCh, FCS(SA)(ORL) Lancet Laboratories and Division of Medical Virology Faculty of Health Sciences Tygerberg Campus Stellenbosch University
E Vardas, Lancet Laboratories
BSc(Hons), MBBCh, DTM&H, DPH, MMedVirology, FCPathClinicalVirology(SA) Lancet Laboratories Johannesburg
P Cole, Netcare Krugersdorp Hospital
MBBCh, MMed(Chem Path) Private Practice Netcare Krugersdorp Hospital
A Halkas, Charlotte Maxeke Johannesburg Academic Hospital and University of the Witwatersrand
MBBCh, FCPaed(SA), MMed(Paed) Charlotte Maxeke Johannesburg Academic Hospital and University of the Witwatersrand Johannesburg
C Feldman