Prevention of sensitization to house dust mite by allergen avoidance in school age children: a randomized controlled study.
BACKGROUND
Sensitization to dust mites predisposes to asthma and allergic rhinitis, and prevention of this sensitization might reduce the rising prevalence of these disorders.


OBJECTIVE
To test the effectiveness of dust mite avoidance measures on the development of sensitization to dust mites in children.


METHODS
As part of a multicentre study (Study of Prevention of Allergy in Children of Europe), 242 children, aged 5-7 years, in three European countries (United Kingdom, Greece and Lithuania), were randomized to prophylactic group (n = 127) and control group (n = 115). At randomization these children were required to have a family history of atopy and positive skin test to an aeroallergen but not to house dust mite. Children in the prophylactic group were provided with dust mite impermeable mattress covers and advice on environmental measures to reduce exposure to dust-mite allergen. Control group children were given non-specific advice. After 12 months a standardized questionnaire was completed and skin prick tests were performed.


RESULTS
Ten children in the prophylactic group and 19 in the control group were lost to follow-up. Three of 117 (2.56%) children in the prophylactic group and nine of 96 (9.38%) in the control group developed sensitization to dust mites. Logistic regression analysis confirmed an independent effect of prophylactic measures (adjusted odds ratio (OR): 0.14, 95% confidence interval (CI): 0.03-0.79, P = 0.03). Fifteen children need to be treated to prevent sensitization in one child.


CONCLUSIONS
Dust mite sensitization can be reduced in school age children with simple mite avoidance measures.
Arshad
S H
SH
University Children's Hospital, Kaunas Medical University, Kaunas, Lithuania. sha@soton.ac.uk
Bojarskas
J
J
Tsitoura
S
S
Matthews
S
S
Mealy
B
B
Dean
T
T
Karmaus
W
W
Frischer
T
T
Kuehr
J
J
Forster
J
J
D016902:Air Pollution, Indoor; D000485:Allergens / Q000009:adverse effects* / Q000276:immunology*; D039741:Antigens, Dermatophagoides / Q000276:immunology; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000517:prevention & control*; D007114:Immunization; D016015:Logistic Models; D008297:Male; D010349:Patient Compliance; D011446:Prospective Studies; D039981:Pyroglyphidae / Q000276:immunology*; D012135:Respiratory Sounds / Q000276:immunology; D012307:Risk Factors; D012572:School Health Services; D016037:Single-Blind Method; D012882:Skin Tests
D000485:Allergens; D039741:Antigens, Dermatophagoides