Abstract
BackgroundPrevention of childhood asthma is an important public health objective. This study evaluates the effectiveness of early detection of preschool children with asthma symptoms, followed by a counselling intervention at preventive child health centres. Early detection and counselling is expected to reduce the prevalence of asthma symptoms and improve health-related quality of life at age 6 years.Methods/designThis cluster randomised controlled trial was embedded within the Rotterdam population-based prospective cohort study Generation R in which 7893 children (born between April 2002 and January 2006) participated in the postnatal phase. Sixteen child health centres are involved, randomised into 8 intervention and 8 control centres. Since June 2005, an early detection tool has been applied at age 14, 24, 36 and 45 months at the intervention centres. Children who met the intervention criteria received counselling intervention (personal advice to parents to prevent smoke exposure of the child, and/or referral to the general practitioner or asthma nurse). The primary outcome was asthma diagnosis at age 6 years. Secondary outcomes included frequency and severity of asthma symptoms, health-related quality of life, fractional exhaled nitric oxide and airway resistance at age 6 years. Analysis was according to the intention-to-treat principle. Data collection will be completed end 2011.DiscussionThis study among preschool children provides insight into the effectiveness of early detection of asthma symptoms followed by a counselling intervention at preventive child health centres.Trial registrationCurrent Controlled Trials ISRCTN15790308.
Highlights
Prevention of childhood asthma is an important public health objective
This study among preschool children provides insight into the effectiveness of early detection of asthma symptoms followed by a counselling intervention at preventive child health centres
This study evaluates the effectiveness of early detection of asthma symptoms in preschool children in preventive child health centres
Summary
This study evaluates the effectiveness of early detection of preschool children with asthma symptoms, followed by a counselling intervention at preventive child health centres. Detection and counselling is expected to reduce the prevalence of asthma symptoms and improve health-related quality of life at age 6 years. Asthma (symptoms) Asthma is a highly prevalent chronic condition associated with considerable morbidity, reduced healthrelated quality of life (HrQoL) and significant costs for public health [1,2,3,4,5,6]. In the Netherlands, the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study reported a wheezing prevalence of 21% in the children’s first year, rapidly falling to 4% in the 4-5th years of age [11]
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