Purpose of the Study. Children living in the inner-city are at greater risk for asthma morbidity secondary to chronic exposure to indoor allergens, particularly including cockroach. This study evaluated the hypothesis that cockroach sensitization occurs early in life in inner-city children with recurrent wheezing.
Study Population. A total of 196 inner-city children from the ages of 6 months to 16 years who were seen between January 1995 and September 1997 at the Cook County Hospital Pediatric Allergy Clinic. Patients were assigned to 1 of 2 age groups, <4 years and 4 to 16 years. A total of 69.0% were African American, 26.5% were Hispanic, 1% were Caucasian, and 2.5% were of other ethnicity. Sixty-three of the 196 were <4 years old.
Methods. A retrospective review of charts was conducted. All patients had had prick skin tests to cockroach and dust mite and some were also tested to cat and dog. The children in the older age group had also been tested for other standard aeroallergens. Parents were asked to fill out a questionnaire to regarding the presence of cockroaches in the home environment.
Results. A total of 15 (24%) of the 63 children in the group <4 years old had a positive prick skin test to cockroach. The youngest patient with a positive test result was 6 months old. Eight (13%) of the 63 patients had a positive skin test to dust mite. Thirty-five of the 63 were tested for cat and dog and 11% were positive to each. In the older age group, 95 (71%) of the 133 children were sensitized to cockroach and 87 (65%) were sensitized to dust mite. Monosensitization was more prevalent in the younger group, with 21.4% of the younger group versus 7.5% of the older age group being monosensitized to cockroach.
Conclusion. Sensitization to cockroach in inner-city children with asthma can occur early in life and may contribute to wheezing.
Reviewers’ Comments. The weakness of this study is that it did not include any objective measure of cockroach exposure. Nevertheless, it does clearly demonstrate the ability of some children to become sensitized to environmental allergens very early in life. In addition to the obvious contribution that this may have on asthma morbidity, it also raises the possibility that efforts to reduce cockroach exposure in high-risk infants might have preventive effects on the development of asthma.
- Copyright © 2002 by the American Academy of Pediatrics