Background: The incidence and prevalence of allergy in childhood are increasing with a significant impact on quality of life healthcare costs. Families and schools are responsible for learning first aid skills to ensure the safety of children with allergies since they are at the front line for dealing with life-threatening emergencies including anaphylaxis. Knowing how to promptly administer self-injectable epinephrine (EpiPen^®) remains a key component in effective out-of-hospital management of anaphylaxis. Caregivers have identified insufficient knowledge of allergy and anaphylaxis as an important challenge to coping with these vulnerable cohorts. Effective communication among caregivers is critical for developing an appropriate care plan and addressing the challenges faced by school personnel dealing with children’s’ allergies.

Aims: This study aimed to assess and compare the knowledge and perception of families and school personnel caring for children with a history of anaphylaxis who were prescribed the epinephrine auto-injector (EpiPen ^®) and the underlying reasons for any observed knowledge gaps. The study also aimed to identify the challenges facing school personnel managing children with allergies, and the role of instruction received by school personnel in their knowledge outcomes.

Methods: A cross-sectional study of 128 families and 50 corresponding school personnel caring for children 1-14 years old who had anaphylaxis and were prescribed the EpiPen^® was conducted. A telephone-administered questionnaire for families and school personnel was developed and employed. The primary outcomes were the knowledge of family and school personnel, the reasons behind the knowledge gaps and the challenges facing school personnel in managing children with allergies and history of anaphylaxis.

Results: Of the 128 potential schools, 30 (23%) were not informed by parents about their pupils’ risk of anaphylaxis. Importantly, 88% of families and 84% of schools were unable to recognize the symptoms of anaphylaxis. Also, 52% of families and 44% of schools were not aware that a child should ideally have 2 EpiPen^® in case of a severe allergic reaction. The EpiPen^® had been used by 14% of families and 6% schools. Challenges faced school personnel were as follows: 60% had no emergency action plans in place, 40% had no epinephrine stock, 24% had not received instructions on how to manage anaphylaxis, 15% were banned by school administrators to give injections at schools; 10% were not informed by parents about their school children, and 10% had an expired EpiPen ^®.

Conclusion: Communication amongst families and school personnel regarding anaphylaxis was suboptimal. Both parents and school personnel lacked key information in allergy management Managing a child at risk of anaphylaxis requires effective communication amongst healthcare professionals, families and schools. There is an urgent need to improve knowledge of anaphylaxis and its management amongst families and school caregivers.