Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 0 0 2025 12 31 1 7 Seyed Hesamodin Nabavizadeh Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Aida Askarisarvestani Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Elham Amini Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Fardin Karbakhsh Ravari Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Golnoosh Karimi Department of Pediatric, Shiraz University of Medical Sciences, Shiraz, Iran 2025 08 18 2025 11 14 Alternaria alternata is one of the most potent fungal allergens associated with allergic respiratory diseases, particularly asthma. Sensitization to A alternata has been linked to poor asthma control and increased morbidity, yet its prevalence varies widely across populations due to environmental and methodological differences. This study aimed to determine the prevalence and demographic predictors of A alternata sensitization among patients with moderate to severe asthma. A cross-sectional study was conducted from March to September 2024 among 80 patients with physician-diagnosed moderate or severe asthma in Shiraz, Iran. Participants underwent skin prick testing (SPT) for A. alternata. Demographic and clinical data were collected and analyzed using descriptive statistics, χ2 tests, and logistic regression. Among the 80 patients (mean age 29.03 ± 20.45 years; 53.8% male), 28.8% tested positive for Alternaria sensitization. Sensitization was significantly more prevalent in patients younger than 18 years (44.1%) compared to adults (17.4%). No significant difference was observed based on sex. Although sensitization was more frequent in patients with severe asthma (40.6%) than moderate asthma (20.8%), this trend was not statistically significant. Logistic regression identified younger age as the only independent predictor of sensitization. Alternaria alternata sensitization is common among individuals with moderate to severe asthma, particularly in younger patients. These findings underscore the importance of routine fungal allergen screening in asthmatics, especially children, to inform targeted management strategies and potentially reduce asthma-related morbidity. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/4554 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/4554/2278