A single intervention for cockroach control reduces cockroach exposure and asthma morbidity in children

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:140

Article

Rabito, Felicia A.¹  Carlson, John C.²  He, Hua¹  Werthmann, Derek¹  Schal, Coby³ 

[1] Tulane Univ, Sch Publ Hlth & Trop Med, Dept Epidemiol, 1440 Canal St,Ste 2016, New Orleans, LA 70112 USA

[2] Tulane Univ, Sch Med, Dept Pediat, New Orleans, LA 70112 USA

[3] North Carolina State Univ, Dept Entomol, Raleigh, NC USA

关键词: Asthma;    cockroach;    integrated pest management;    indoor allergens;    intervention studies;    FEV1;    FENO;   

DOI  :  10.1016/j.jaci.2016.10.019

来源: Elsevier

【 摘 要 】

Background: Exposure to cockroaches is an important asthma trigger, particularly for children with asthma living in inner cities. Integrated pest management is the recommended approach to cockroach abatement; however, it is costly and difficult to implement. The impact of reducing cockroach exposure on asthma outcomes is not known. Objective: We sought to test the use of a single intervention, insecticidal bait, to reduce cockroach exposure in the home of children with asthma in New Orleans and to examine the impact of cockroach reduction on asthma outcomes. Methods: One hundred two children aged 5 to 17 years with moderate to severe asthma were enrolled in a 12-month randomized controlled trial testing the use of insecticidal bait on cockroach counts and asthma morbidity. Homes were visited 6 times and asthma symptoms were assessed every 2 months. Results: After adjustment, intervention homes had significantly fewer cockroaches than did control homes (mean change in cockroaches trapped, 13.14; 95% CI, 6.88-19.39; P < .01). Children in control homes had more asthma symptoms and unscheduled health care utilization in the previous 2 weeks (1.82, 95% CI, 0.14-3.50, P = .03; 1.17, 95% CI, 0.11-2.24, P = .03, respectively) and a higher proportion of children with FEV1 of less than 80% predicted (odds ratio, 5.74; 95% CI, 1.60-20.57; P = .01) compared with children living in intervention homes. Conclusions: Previous research has demonstrated improvement in asthma health outcomes using multifaceted interventions. The strategic placement of insecticidal bait, which is inexpensive, has low toxicity, and is widely available, resulted in sustained cockroach elimination over 12 months and was associated with improved asthma outcomes. This single intervention may be an alternative to multifaceted interventions currently recommended to improve asthma morbidity.

【 授权许可】

Free