Felicia A Rabito1, John C Carlson2, Hua He3, Derek Werthmann3, Coby Schal4. 1. Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, La. Electronic address: rabito@tulane.edu. 2. Department of Pediatrics, School of Medicine, Tulane University, New Orleans, La. 3. Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, La. 4. Department of Entomology, North Carolina State University, Raleigh, NC.
Abstract
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.
RCT Entities:
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.
Authors: William J Sheehan; Jonathan M Gaffin; David B Peden; Robert K Bush; Wanda Phipatanakul Journal: J Allergy Clin Immunol Date: 2017-12 Impact factor: 10.793
Authors: Wanda Phipatanakul; Petros Koutrakis; Brent A Coull; Choong-Min Kang; Jack M Wolfson; Stephen T Ferguson; Carter R Petty; Mihail Samnaliev; Amparito Cunningham; William J Sheehan; Jonathan M Gaffin; Sachin N Baxi; Peggy S Lai; Perdita Permaul; Liming Liang; Peter S Thorne; Gary Adamkiewicz; Kasey J Brennan; Andrea A Baccarelli; Diane R Gold Journal: Contemp Clin Trials Date: 2017-06-12 Impact factor: 2.226
Authors: Anna Pomés; Geoffrey A Mueller; Thomas A Randall; Martin D Chapman; L Karla Arruda Journal: Curr Allergy Asthma Rep Date: 2017-04 Impact factor: 4.806