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Published on: August 7, 2017
[Characteristics of a target population for preventing house-dust mite allergy in toddlers]
Insights
This study successfully recruited high-risk toddlers for an allergy prevention program using routine check-ups and validated the recruitment strategy. Families readily accepted the prevention program, indicating its suitability for larger studies.
Area of Science:
- Pediatric Allergy and Immunology
- Preventive Medicine
- Clinical Trial Recruitment
Background:
- Identifying toddlers at high risk for developing allergies is crucial for early intervention.
- Routine pediatric check-ups offer a practical window for screening and recruitment.
- Parental acceptance of preventive measures is key to program success.
Purpose of the Study:
- To assess the effectiveness of a recruitment strategy for identifying high-risk toddlers for an allergy prevention program.
- To confirm parental readiness for implementing preventive allergy measures.
- To validate the recruitment approach for future large-scale studies.
Main Methods:
- Screening questionnaires and information forms were distributed during routine toddler check-ups (20-48 months).
- Inclusion criteria included age, positive atopic family history, and parental sensitization (skin prick test).
- Eligible toddlers were randomized into intervention and control groups for the prevention program.
Main Results:
- A 63.4% return rate for screening questionnaires was achieved, with 76.6% indicating a positive family history of atopy.
- Skin prick tests confirmed atopy in a significant percentage of parents, even with negative screening questionnaires.
- Detection of specific IgE to house dust mite in toddlers indicated allergy risk; families accepted the program with high compliance.
Conclusions:
- The recruitment strategy effectively identified high-risk toddlers for allergy prevention.
- The allergy prevention program demonstrated high acceptance rates among participating families.
- The validated recruitment strategy and program are suitable for implementation in larger research studies.
Aim:
To evaluate a recruitment strategy to identify high risk toddlers for a programme of prevention of allergy. For screening, parents were asked to participate in our study by information form and screening questionnaire on the occasion of routine check-up visits of toddlers scheduled between 20 and 48 months of age in four paediatric practices. As a next step, readiness of parents for implementation of preventive measures was confirmed.
Method:
Inclusion criteria were age between 20 and 48 months and a positive atopic family history (evaluated by 5 questions regarding asthma, allergic rhino-conjunctivitis and atopic dermatitis) of parents or siblings. This was confirmed by sensitization to an environmental allergen (skin prick test (SPT)) in at least one parent. If these inclusion criteria were fulfilled, the toddlers were randomly allocated to the intervention and control group of the prevention programme.
Results:
111 of 175 screening questionnaires (63.4 %) were returned. In 76.6 % (n = 85) of these 111 questionnaires a positive atopic family history (mother, father, sibling) was noted. All inclusion criteria were fulfilled by only 43 toddlers (age: median 33.6 months, 5-95 % quantile: 21.6-48 months). Based on the positive screening questionnaire, history of atopy was confirmed by positive SPT in 70.0 % of fathers and 77.8 % of mothers. Despite a negative screening questionnaire, history of atopy was detected by a positive SPT in 11.1 % of mothers and 47.4 % of fathers. Detection of specific IgE against house-dust mite in 9 of 18 serum samples revealed the risk for allergy of the toddlers. A re-evaluation after three months showed that all the elements of the prevention programme as well as the recommendations for the control group had been almost completely accepted by all the families concerned practically without any reservations.
Conclusion:
The recruitment of toddlers with high risk for developing allergy turned out well and could be validated. The prevention programme was readily accepted by the families and thus can be used for a larger study.
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