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Randomized Trial to Prevent Sensitization to Mite Allergens in Toddlers and Preschoolers by Allergen Reduction and Education
One-Year Results
Stella Tsitoura, MD;
Katerina Nestoridou, MD;
Panayotis Botis, MD;
Wilfried Karmaus, MD;
Calin Botezan, MD;
Jurgis Bojarskas, MD;
Hassan Arshad;
Joachim Kuehr, MD;
Johannes Forster, MD;
for the SPACE Group
Arch Pediatr Adolesc Med. 2002;156:1021-1027.
Objective To evaluate the effectiveness of prevention measures against dust mite
sensitization.
Design European (England, Germany, Greece, Lithuania) multicenter prospective
single-blind randomized control trial with a follow-up of 12 months.
Participants Toddlers and preschoolers, with at least 1 parent with atopic symptoms
and sensitization, who initially were not sensitized to mite allergens.
Interventions A combination of education and a simple preventive measure (mattress
encasement) to reduce mite allergen exposure.
Setting Community-based study.
Main Outcome Measures Sensitization to mite allergens (skin-prick test or specific immunoglobulin
E).
Results Of 636 children (mean age, 3.1 years) included in the study, 566 (89%)
participated in the first-year follow-up. The incidence of sensitization to
mite allergens was 10 (3%) of 330 in the intervention vs 20 (6.5%) of 306
in the control arm, including loss of follow-up (intention-to-treat principle).
Allergic symptoms were more common in sensitized than in nonsensitized children
and so was the prevalence of physician-diagnosed asthma, eczema, and food
allergy.
Conclusions This simple, harmless, and inexpensive measure can be used in toddlers
and preschoolers of parents with atopic disorders to reduce sensitization
to mite allergens. With regard to clinical manifestations of atopy, follow-up
studies are needed to determine the effectiveness of the intervention.
From the Department of Social Medicine, P & A Kyriakou Children's
Hospital, Athens, Greece (Drs Tsitoura, Nestoridou, and Botis); Department
of Epidemiology, Michigan State University, East Lansing (Drs Karmaus and
Botezan); Kaunas Children's Hospital, Kaunas, Lithuania (Dr Bojarskas); the
David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of
Wight, England (Mr Arshad); University Children's Hospital, Freiburg, (Dr
Kuehr); and St Josefkrankenhaus, Freiburg, Germany (Dr Forster).
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