title: Environmental measures in domicilliary interventions of asthmatic children.
abstract: OBJECTIVE
  To evaluate the impact of environmental interventions and lifestyle management on respiratory symptoms, concurrent changes in asthma management and whether any observed health benefit could be attributed to these interventions.
  
  
  METHODS
  A longitudinal single cohort pre-post study was conducted on children between 5–14 y with moderate to severe asthma in an outpatient clinic at Jamshedpur over 2 y. History was noted using the pre-intervention questionnaire covering a period of 3 mo prior to enrolment. Participants were followed for 6 mo post- intervention. A childhood asthma severity (CHAS) scale was made and statistical analysis such as Wilcoxon rank sum tests and Mcnemar’s test performed to validate the outcomes. Principal component analysis was performed to classify the participants having no, mild and severe symptoms.
  
  
  RESULTS
  There was significant reduction in symptoms and need for medical care post-intervention. Mean of the respiratory symptom score decreased from 7.4 to 2.4 (p < 0.0001) and mean of the health care utilization score decreased from 4.1 to 1.7 (p < 0.0004) in the wilcoxon rank sum tests. Mcnemar’s test was used for the analysis of individual item of the asthma symptoms. A significant reduction in wheeze and cough (p < 0.001), slowing down physical activity (p < 0.001), diurnal symptoms (p < 0.000), school absence (p < 0.000), rescue therapy requirement (p < 0.1) and hospitalization (p < 0.000) was seen. PCA was used successfully to classify the participants on the basis of their severity of asthma.
  
  
  CONCLUSIONS
  Respiratory symptoms decreased significantly among asthmatic children following environmental interventions.
authors.affiliation: Department of Pediatrics, Tata Main Hospital, Jamshedpur, India. drasitmishra@gmail.com
authors.forename: Asit Kumar
authors.initials: AK
authors.lastname: Mishra
authors.forename: Aoyon
authors.initials: A
authors.lastname: Sengupta
authors.forename: Keshav
authors.initials: K
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires