Impact of house dust mite-driven asthma on children's school performance and activity

Abstract

Evidence regarding asthma's impact on children's daily lives is limited. This prospective and cross-sectional, observational, multicenter study assessed school/work and activity impairment in children and adolescents with allergic asthma and their caregivers and allergen immunotherapy (AIT) effects. Included patients were schooled children and adolescents (5 to 17 years) with allergic asthma due to house dust mites (HDM). Impairment of school/work (i.e., absenteeism and presenteeism) and activity was measured in patients and their caregivers using the Work Productivity Impairment Questionnaire plus Classroom Impairment Questions: Allergy Specific (WPAI + CIQ:AS). HDM allergic patients with school impairment received subcutaneous AIT with a MicroCrystalline Tyrosine-associated allergoid. WPAI + CIQ:AS and effectiveness variables were compared between baseline and 1-year post-AIT. Of the 113 patients included, 59 (52.2%) and 51 (45.1%) showed school and activity impairment, respectively, missing a mean (SD) of 37.6 (24.4) % and 42.6 (25.6) % of school and activity time, respectively. Twenty-six (23%) caregivers reported activity impairment and, of the 79 (69.9%) employed, 30 (38%) reported work impairment. Of the 65 patients with school/activities impairment, 41 (63.1%) received AIT, of which 21 (51.2%) completed 1 year of treatment. Effectiveness variables and WPAI + CIQ:AS significantly improved: Mean (SD) school impairment decreased from 39.7 (26.7) to 2.1 (7.1) % (p < 0.001) and activity impairment from 46.2 (34.6) to 1.4 (3.6) % (p < 0.001).

Conclusion: Allergic asthma due to HDMs results in school/work and activity impairment in children and adolescents and their caregivers. One year of AIT provided clinical benefits and reduced school and activity impairment.

What is known: • Allergic asthma impairs children's school performance and daily activities. • Allergen immunotherapy modifies allergic disease course and ameliorates its symptoms.

What is new: • Asthma symptoms due to allergy to house dust mites impair children's school attendance and productivity and daily activity and their caregivers' work performance and daily lives. • Allergen immunotherapy with a house dust mite MicroCrystalline Tyrosine (MCT)-associated allergoid seems to provide clinical benefits, associated with decreased school and activity impairment, supporting it as an effective treatment option.

Keywords: Absenteeism; Allergic asthma; Microcrystalline tyrosine; School impairment; Subcutaneous allergen immunotherapy; Work impairment.

Fig. 1

School time missed, classroom impairment, overall impairment, and activity impairment in patients who received allergen immunotherapy with a MicroCrystalline Tyrosine-associated house dust mite allergoid and attended the final visit at the indicated timepoints. Columns and error bars represent mean percentages and standard deviation, respectively. p-values were calculated using the Wilcoxon test

Fig. 2

Asthma severity (A) and control (B) at visit 1 and after 1 year (final visit) of treatment with allergen immunotherapy with a microcrystalline tyrosine-adsorbed house dust mite allergoid. McNemar test, p = 0.021 (A) and p = 0.001 (B)

Fig. 3

Use of medication to treat asthma before and after 1 year of treatment with allergen immunotherapy with a MicroCrystalline Tyrosine-associated house dust mite allergoid. LABAs, long-acting beta-2 agonists; LTRAs, leukotriene receptor antagonists; ns, not significant; SABAs, short-acting beta-2 agonists. p-values were calculated using the McNemar test