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The PREVASC study: the clinical effect of a multifaceted educational intervention to prevent childhood asthma

Depts of ¹ General Practice, and ² Paediatric Pulmonology, Research Institute CAPHRI, University Hospital Maastricht, Maastricht, and ³ Dept of General Practice, University Medical Centre, Radboud University Nijmegen, Nijmegen, The Netherlands

CORRESPONDENCE: H. J. A. M. Schönberger, Dept of General Practice, Research Institute CAPHRI, University Maastricht, Cannerweg 289, 6213 BE Maastricht, The Netherlands. Fax: 31 433100663. E-mail: Huub.Schonberger@hag.unimaas.nl

Keywords: Childhood asthma, house dust mites, passive smoking, pets, prevention, primary care

Received: June 8, 2004
Accepted December 7, 2004

As asthma is the most common chronic disease in childhood, much attention is directed towards primary prevention. Here, the clinical effectiveness of a multifaceted educational prevention was studied.

A total of 476 high-risk children were recruited during the prenatal period by general practitioners and randomised to either: 1) a control group, receiving usual care; or 2) an intervention group in which families received instruction from nurses on how to reduce exposure of newborns to mite, pet and food allergens, and passive smoking.

A total of 443 infants were followed-up for 2 yrs. At 2 yrs of age, the intervention group (n = 222) had less asthma-like symptoms, including wheezing, shortness of breath and night-time cough, than the control group (n = 221). No significant differences in total and specific immunoglobulin E were found between the groups. During the first 2 yrs of life, the incidence of asthma-like symptoms was similar in both groups; however, subanalysis revealed a significant reduction in the female, but not in the male, intervention group.

In conclusion, the intervention used in this study was not effective in reducing asthma-like symptoms in high-risk children during the first 2 yrs of life, although it was modestly effective at 2 yrs. Follow-up is necessary to confirm whether the intervention can actually prevent the development of asthma.

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