Mouse Allergen and Asthma Intervention Trial


Importance Professionally-delivered integrated pest management (IPM) interventions can reduce home mouse allergen concentrations, but whether they reduce asthma morbidity among mouse-sensitized and exposed children and adolescents is unknown. Objective To determine the effect of an IPM intervention on asthma morbidity among mouse-sensitized and exposed asthmatic children and adolescents.

Design, Setting, Participants Randomized clinical trial in Baltimore and Boston. Participants were mouse-sensitized and exposed asthmatic children and adolescents, 5-17 years of age, randomized to receive professionally-delivered IPM plus pest management education or education alone. Enrollment occurred between May 2010 and August 2014, and the final follow-up visit occurred September 25, 2015.

Intervention IPM consisted of application of rodenticide, sealing holes that could serve as entry points for mice, trap placement, targeted cleaning, allergen-proof mattress and pillow encasements, and portable air purifiers. Infestation was assessed every three months, and if infestation persisted or recurred, additional treatments were delivered. All participants received education, which consisted of written material and demonstration of the materials needed to set traps and seal holes.

Main Outcomes and Measures The primary outcome was maximal symptoms days, defined as the highest number of days of symptoms in the previous two weeks among three types of symptoms (days of slowed activity due to asthma, number of nights of waking with asthma symptoms, and days of coughing, wheezing, or chest tightness) at 6, 9 and 12 months. Main secondary outcomes included other symptom outcomes, rescue medication use, asthma-related acute visits, and lung function. Secondary outcomes also included mouse allergen levels.

Results Among 361 children and adolescents who were randomized (mean: 9.8y [SD: 3.2] age; n=132 [38%] female), 181 to the IPM+Education Group and 180 to the Education Group, 334 were included in the primary analysis. For the primary outcome, there was no statistically significant difference between the IPM+Education Group and the Education Group for maximal symptoms days at 6, 9, and 12 months, with a median (Q1-Q3) of 2.0 (0.7-4.7) days and 2.7 (1.3-5.0) days, respectively, (p=0.16), ratio of symptom frequencies: 0.86 (95% CI: 0.69-1.06). Of the 18 secondary outcomes analyzed, none was statistically different between groups.

Conclusions and Relevance Among mouse-sensitized children and adolescents with asthma, an intensive year-long IPM intervention plus education, compared with pest management education alone, resulted in no significant difference in maximal symptoms days from 6 to 12 months.

Trial Registration identifier: NCT01251224

Summary of Findings

Summary of Findings

Demonstration Video

Demonstration Video

Data and Code

Dataset for primary analysis: CSV

Codebook: CSV Excel