Abstract
Background
The prevalence and demographic correlates of cockroach (CR) and mouse sensitization among children hospitalized for wheezing and asthma are not known. Objectives: (1) To describe the prevalence of CR and mouse sensitization in a population-based sample; (2) To examine factors potentially associated with allergic sensitization including sociodemographic factors and asthma history.
Methods
We examined baseline data of the first 416 children enrolled in a prospective study cohort between August 2010 and February 2011. Eligible children were aged 1 to 16 years, were admitted for bronchodilator-responsive wheezing or acute asthma to a single children's hospital that captures >90% of all asthma admissions in the county. Allergic sensitization was determined using specific Ig-E to CR and mouse. Caregivers were surveyed regarding sociodemographic characteristics and asthma history. Associations were assessed using chi-square statistics.
Results
The sample is 65% African-American, 76% publically insured. 78% report household income less than $60,000. 81% have a previous physician-diagnosis of asthma. 26% of children are sensitized to CR, 16% to mouse, and 34% are sensitized to either CR or mouse. 8% are sensitized to both. Patients younger than 4 years are less likely to be sensitized to CR (10 vs 34%, P < 0.0001) and mouse (8 vs 20%, P = 0.002) than older patients. Patients with a previous physician-diagnosis of asthma are more likely to be sensitized to CR (29 vs 13%, P = 0.007) and mouse (13 vs 9%, P = 0.06) than patients without a previous diagnosis. Compared to children in families with annual income >$90,000, those in families earning less than $15,000 were more likely to be CR sensitized (33 vs 18%, P = 0.01). The opposite trend exists for mouse sensitization: 13% of low income children are sensitized compared to 25% of high income children (P = 0.02).
Conclusions
In a population based sample, one-third of children admitted for bronchodilator-responsive wheezing or asthma are sensitized to either CR or mouse. Sensitization is associated with older age, a previous physician-diagnosis of asthma, and household income. Assessment of allergic sensitization during an inpatient admission may be an opportunity to target interventions for children at highest risk of allergy-related asthma morbidity.