Improvement in asthma related health status among children in two housing projects in Puerto Rico after clinical and home based interventions

Background: Children in Puerto Rico have a disproportionate burden of asthma with the highest prevalence and among the highest rates of poverty in the U.S, with forty to fifty percent of Island children affected. La Red de Asthma Infantil de Puerto Rico is an evidenced based intervention project aimed to improve asthma-related health status among children of two low-income communities in San Juan. Objective: To evaluate the relationship between the presence of home-based triggers, allergen sensitivity, asthma symptoms (LASS), and quality of life (QOL) with data from low income pediatric participants who received a clinic based intervention and a home-based environmental intervention performed by community health workers. Methods: Asthma symptom and morbidity data were collected from 245 children with moderate or severe persistent asthma at baseline and at 12-months of a home and clinic based interventions aimed to improve asthma symptom control in these children. Outcomes included asthma symptoms, preventive medications use, emergency department visits, hospitalizations, quality of life, sensitivity to home allergens and asthma trigger burden. Results: Sixty (60) % of children had positive skin tests to two or more allergen groups. At baseline, sensitivity to cockroaches was significantly associated with an higher number of symptoms of participants. Other allergens such as dust mites, molds, and pets showed no association with any of the outcomes included. Conclusion: Data suggest that after one year of the clinical and home based intervention, there is significant reduction in asthma symptoms independently of its sensitivity to cockroaches.