New programme by Ng Teng Fong General Hospital to tackle allergic rhinitis

SINGAPORE – While in Western, often temperate, regions allergic rhinitis tends to be triggered by different allergens based on the seasons – such as pollen in the summer and mould in the winter – in tropical climates, the main factor is typically dust mites.

The presence of these microscopic insects, which thrive in bedding and upholstery, is why those with the condition tend to have stuffy or runny noses in the morning after waking up, said Adjunct Associate Professor Ng Chew Lip, an ear, nose and throat specialist at Ng Teng Fong General Hospital (NTFGH).

Such differences are one of the reasons for a new initiative, led by the hospital, that aims to improve the diagnosis and long-term management of allergic rhinitis in Singapore.

Project ENTenna, which began in 2024, hopes to recruit up to 6,000 patients by 2026, with the aim of building a population allergy database for the condition.

Data from these patients will be analysed using artificial intelligence (AI) to develop personalised treatments and ensure they regularly take their medication, so as to prevent unnecessary hospital visits.

The programme is supported by the National University Hospital, Tan Tock Seng Hospital (TTSH), Changi General Hospital (CGH) and A*Star.

It is funded by the Ministry of Health’s Health Innovation Fund and the JurongHealth Fund, a registered charity that supports NTFGH and the Jurong Community Hospital.

Also known as hay fever, allergic rhinitis occurs when a person breathes in particles that they are allergic to, such as pollen, dust mites or mould.

Its symptoms are similar to those of the common cold, including uncontrollable sneezing as well as a runny nose with clear mucus.

As much as 39 per cent of the population here has allergic rhinitis, said Prof Ng, a senior consultant and the principal investigator for Project ENTenna.

How the condition affects Asian populations is also not well documented, he said.

For example, there may be genetic differences between Western and Asian populations that influence the impact of allergic rhinitis.

This means medication developed in the West may not be as effective in treating allergic rhinitis in Asians, said Prof Ng.

“What we hope for is that as Asia progresses, we develop our own specific patient treatments,” he said.

A research collaboration with A*Star’s Singapore Immunology Network will see molecular-level investigations undertaken to identify new therapeutic targets – referring to molecules or pathways in the body that can be affected by new treatments – as well as explore why patients experience different responses to the same treatment.

The programme uses AI-powered symptom trackers and reminders to improve patients’ management of their conditions.

Project ENTenna can also manage other conditions such as giddiness and tinnitus, with the data-driven care model being developed possessing the potential to be expanded to other chronic conditions in the future, said the programme’s co-principal investigator, Dr Tan Jian Li, a consultant with the otorhinolaryngology department at TTSH.

As part of the initiative, a WhatsApp chatbot is being developed that reminds patients to take their medication on time and provides travel advice based on real-time updated environmental data, such as the air pollution index.

“By better understanding the varying experiences of patients living with allergic rhinitis through the chatbot, and translating information into actionable insights using the Al model, Project ENTenna can enable clinicians to move towards proactive care strategies and early interventions to enhance patient outcomes,” said Dr Oh Hong Choon, deputy director of CGH’s health services research department.

Among the 2,000 patients recruited so far is Singapore Management University student Ryan Lim, who was diagnosed with the condition about four years ago.

The 21-year-old said he would often wake up feeling nasally congested and fatigued, with his nostrils blocked for days on end on particularly bad occasions.

The questionnaires and reminders he receives as part of the programme help remind him to take his medication, as well as track its effectiveness.

“I was able to better understand if the medicine wasn’t really working and say, hey, let’s switch to a different spray,” he said.