Effect of mite‐impermeable mattress encasings and an educational package on the development of allergies in a multinational randomized, controlled birth‐cohort study – 24 months results of the Study of Prevention of Allergy in Children in Europe

Horák, F.; Matthews, S.; Ihorst, Gabriele; Arshad, Syed Hasan; Frischer, Thomas; Kuehr, Joachim; Schwieger, A.; Förster, Johannes

doi:10.1111/j.1365-2222.2004.02024.x

Cited by 85 publications

(60 citation statements)

References 27 publications

(52 reference statements)

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“…Children of families who had applied all three measures had less wheeze and asthma than children of families who executed only two measures. The studies might explain why avoidance of a single exposure has only marginal or no effects when other exposures are still existing, as might have been the case in other prevention studies [18,35]. In tertiary prevention of asthma intervention studies [46], focusing on a reduction of multiple environmental exposures has shown promising results, whereas the results of clinical trials targeting only one allergen were disappointing [47,48].…”

Section: Discussionmentioning

confidence: 99%

“…Several randomised intervention studies have reported results on various clinical symptoms at age 1 [17,20,34], 2 [18,35], 3 [36], 4 [37] and 8 yrs [19]. When the results of intervention studies are compared, it has to be kept in mind that comparison is hampered, as the studies differ in defining high-risk cases, the applied intervention(s) and the definition of outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the Canadian study [40], the PIAMA [18], the CAPS study [41] and the Study of Prevention of Allergy in Children in Europe (SPACE) [35] all found no effect of the intervention on mite sensitisation at age 2 yrs, while the nac MAAS study reported that the stringent mite avoidance regime was associated with an increased risk [36]. One explanation for this might be that the intervention was started too late, as sensitisation might already have occurred in utero [42,43].…”

Section: Discussionmentioning

confidence: 99%

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The PREVASC study: the clinical effect of a multifaceted educational intervention to prevent childhood asthma

Schönberger

Dompeling²,

Knottnerus³

et al. 2005

European Respiratory Journal

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As asthma is the most common chronic disease in childhood, much attention is directed towards primary prevention. Here, the clinical effectiveness of a multifaceted educational prevention was studied.A total of 476 high-risk children were recruited during the prenatal period by general practitioners and randomised to either: 1) a control group, receiving usual care; or 2) an intervention group in which families received instruction from nurses on how to reduce exposure of newborns to mite, pet and food allergens, and passive smoking.A total of 443 infants were followed-up for 2 yrs. At 2 yrs of age, the intervention group (n5222) had less asthma-like symptoms, including wheezing, shortness of breath and night-time cough, than the control group (n5221). No significant differences in total and specific immunoglobulin E were found between the groups. During the first 2 yrs of life, the incidence of asthma-like symptoms was similar in both groups; however, subanalysis revealed a significant reduction in the female, but not in the male, intervention group.In conclusion, the intervention used in this study was not effective in reducing asthma-like symptoms in high-risk children during the first 2 yrs of life, although it was modestly effective at 2 yrs. Follow-up is necessary to confirm whether the intervention can actually prevent the development of asthma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The PREVASC study: the clinical effect of a multifaceted educational intervention to prevent childhood asthma

Schönberger

Dompeling²,

Knottnerus³

et al. 2005

European Respiratory Journal

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“…Several ongoing studies are investigating the effects of environmental control on the primary prevention of asthma and allergies. Although the results of a pan-European study (1833) of 4 y old children and the Isle of Wight (1834) and Canadian studies (1835) at ages 8 and 7 y provide some encouragement, the preventive effect of the avoidance of HDM allergen alone during pregnancy or after birth is disappointing (1836)(1837)(1838)(1839)(1840)(1841). It will therefore be some time before a definitive public health message emerges.…”

Section: Primary Prevention Of Atopic Diseasesmentioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,812

1,761

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“…In total, 10 high-quality studies (enrolling 3473 patients) were included, of which 1124 had a multifaceted intervention design [23][24][25] and 2349 had a mono-intervention design. 21,[26][27][28][29][30][31] Several studies had repeated measurements on different ages of the children. The results suggested that a multifaceted approach might be effective in delaying or preventing asthma, whereas a mono-intervention does not seem to have such a protective effect.…”

Section: C) the Interaction Between Genotype And Environment -Childhomentioning

confidence: 99%

Global strategies for reducing the burden from asthma

Schayck

2013

Primary Care Respiratory Journal

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Asthma is one of the most important chronic diseases in childhood. For several decades, a steady increase in prevalence has been observed worldwide. In the structural collaboration between the Centre for Population Health Services in Edinburgh and the Research Institute CAPHRI of Maastricht we investigated the possibilities for primary prevention of asthma in childhood. We found that a multifaceted approach might be effective in delaying or preventing asthma, whereas a mono-intervention does not seem to have such a protective effect. The most likely explanation is that the development of a multifactorial disease, such as asthma, is extremely difficult, if not impossible, to prevent by eliminating only one risk factor.Underdiagnosis of asthma is still a big problem in primary care. Most patients do not present bronchial symptoms to the general practitioner, even though they have decreased lung function, so they remain unknown and undiagnosed. However, patients who do present with respiratory problems and who have reduced lung function are not always recognised as such. We found that the perception of dyspnoea seems to determine, at least in part, the presentation to the general practitioner with symptoms.These observations show that both the prevention of the development of asthma in early childhood, as well as case finding of asthma in adulthood, do not seem to be very effective in primary care. More research is needed to clarify what steps can be taken to reduce the global burden from asthma.

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Effect of mite‐impermeable mattress encasings and an educational package on the development of allergies in a multinational randomized, controlled birth‐cohort study – 24 months results of the Study of Prevention of Allergy in Children in Europe

Abstract: In this study, HDM avoidance did not show a protective effect on the development of sensitization to HDM or symptomatic allergy in children at age 24 months.

Cited by 85 publications

References 27 publications

The PREVASC study: the clinical effect of a multifaceted educational intervention to prevent childhood asthma

The PREVASC study: the clinical effect of a multifaceted educational intervention to prevent childhood asthma

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Global strategies for reducing the burden from asthma

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