The proposed concerted action facilitates the evalutation of simple preventive measures against the development of atopic diseases from birth to the age of nine years, both in terms of efficiency and cost-effectiveness under the different health plans of five European countries.
The prospective randomised study includes newborns, children at 3 and 6 years, each cohort to be followed for 3 years to cover the whole timespan quickly. To cover a wide spectrum of the European lifestyles, children from Austria, Germany, Greece, Lithuania, and the UK are included. For each country the following issues are checked prospectively: the number of children at risk, the means by which they can be identified, the local living conditions and customs interfering with the scheduled preventive measures.
The recruitment procedure has to identify children at risk for atopic disease (family history and sensitization in the parents, sensitization already present in the child). The standardization of study instruments (questionnaires, allergy tests, counselling, allergen avoidance procedures, diary cards, outcome protocols) allows a valid comparison of the population despite the different nationality.
The prevention/intervention measures will consist of health counselling, house dust mite (HDM) allergen avoidance measures, namely encasing mattress and bedding, and simple reinforcment visits. The controls will have health counselling alone. The prevention/intervention measures are so simple, that they could be implemented in the general population immediately, if successful. The outcome variables are sensitization against HDM and manifestation of atopic disease. Eventually the efficency and costs-effectiveness of the prevention programme can be evalutated on a national as well as on the European level.