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.

CONCLUSION

Dust mite sensitization can be reduced in school age children with simple mite avoidance measures.

Association of allergy-related symptoms with sensitisation to common allergens in an adult European population

BACKGROUND

Atopy is an important risk factor for asthma and allergic diseases. However, the relationship between atopy and allergic symptoms is not fully understood, and may not be the same for different allergy related symptoms and in differing environmental conditions.

OBJECTIVE

To study the differences in the association of allergy-related symptoms and atopy, in an adult population from five European countries.

METHODS

A prospective, multi-national study was conducted. Centres included Isle of Wight (UK), Vienna (Austria), Freiburg (Germany), Athens (Greece), and Kaunas (Lithuania). We used five questions derived from the ISAAC (International Study of Asthma and Allergy in Children) and other validated questionnaire, to evaluate the presence of allergic symptoms in a selected adult population. Atopy was assessed by SPT or IgE measurement to 3 core allergens (dust mite, cat and grass pollen) in all centres and 1-2 additional allergens relevant to each area (parietaria, olive, birch pollen, tree pollen mix, dog).

RESULTS

Of 3985 subjects, 2478 (62%) responded positively to one or more core ISAAC questions. Sensitisation rate was high in Austria and UK and relatively low in Greece. Dust mite and cat were important allergens for asthma, odds ratio (OR): 2.24, 95% confidence interval (CI): 1.63-3.08 and OR: 2.31, CI: 1.69-3.14, respectively. Grass pollen was strongly associated with hay fever in all centres (OR: 3.62 CI: 2.81-4.66) and with birch pollen in Austria (OR: 3.57, CI: 2.09-6.09) and with parietaria in Greece (4.61 (2.99-7.12). In the comparative analysis, using UK as a reference, Lithuanians had a 10-20-fold reduced risk of asthma and hay fever, but were twice more likely to report chronic itching. The risk of dust mite allergy was 3- and 10-fold lower in Lithuania and Greece, respectively, whereas the risk of cat and grass pollen allergy was one and half times higher in Austria.

CONCLUSION

The risk of allergic symptoms and sensitisation and their association vary widely in different European countries.

Cross-cultural validation of the Child Abuse Potential Inventory in Greece: a preliminary study

OBJECTIVE

The aim of this study was first, to provide preliminary findings on the reliability and validity of a Greek translation of the CAP Inventory (Milner, 1986), and second, to examine whether there were any differences between Greek and American scores in the CAP Inventory.

METHOD

A convenience sample of 320 Greek parents was recruited from the outpatient unit of a large Children's Hospital in Athens, Greece. Greek scores were compared with American scores taken from the test manual.

RESULTS

Internal consistency reliability was high for the Abuse scale (.91), two factor scales (Distress = .93 and Rigidity = .86) and one Validity scale (Inconsistency = .80). The Greek version of the Abuse scale had a similar factorial structure with the American version. Also, 78.1% of Greek parents were classified correctly as nonabusive by the Abuse scale. This rate was increased to 88.6% when invalid questionnaires were excluded from the sample. Comparisons between Greek and American mean scale scores indicated that Greek scores were significantly higher than American scores in all but one scale. Greeks had significantly lower scores than Americans in the Problems with Child and Self scale.

CONCLUSIONS

Current findings including the high reliability, relatively high correct classification rates and factorial structure of the Greek Abuse scale are promising and support the idea of continuation of research for the development and validation of the Greek CAP Inventory. The difference between Greek and American scores in particular indicates the need for adjustment of cut off scores in the Greek scale.

Serum 25-hydroxyvitamin D levels in thalassaemia

Serum 25-hydroxyvitamin D levels were measured in 36 thalassaemic children and 27 controls aged 5-15 years. Blood specimens were collected from the beginning of April until the end of October 1976. We considered as the winter period the first 3 months and the summer period the last 4 months. We found that (a) thalassaemic children had lower levels of serum 25-hydroxyvitamin D than controls: (b) there was a seasonal variation of serum 25-hydroxyvitamin D in both groups; and (c) the thalassaemic children had malabsorption of vitamin D. We suggest that the bone lesions in thalassaemic children are related to vitamin D deficiency.