Submitted to: International Archives of Allergy and Immunology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/2/1995
Publication Date: N/A
Interpretive Summary: Numerous studies have been published that confirm the relationship between cockroach allergens and atopic diseases. Cockroach allergens may exceed pollens in importance as etiological agents of chronic respiratory disease among asthmatics who are chronically exposed to the insect secondary to urban residency and/or socioeconomic constraints. The incidence of asthma directly related to cockroach allergens among atopic asthmatic adults has been reported to be as high as 58% and among atopic asthmatic children as high as 69%. More important, asthmatics sensitive to cockroach allergen have more severe disease than the general asthma population, exhibiting higher IgE levels and a higher degree of steroid dependency. This is probably due to the fact that both exposure and sensitivity to cockroach allergens are much greater among the inner-city po o-experience disproportionately higher asthma morbidity and mortality than their suburban, predominantly Caucasian, counterparts.
Technical Abstract: Fifty-one atopic asthmatic and/or allergic rhinitic children and 23 nonatopic control from Santo Domingo, the Dominican Republic, were skin tested with an extract mix of three cockroach species (Blatella germanica, Blatta orientalis, and Periplaneta americana). Sixteen percent of the atopics and none of the nonatopics demonstrated positive immediate skin reactions to the cockroach mix (x2=4.05, p=0.04). Hypersensitivity was correlated with the quality of the homes; 22% (8/36) of the atopics who lived in a concrete home were skin test positive to the cockroach mix, while none (0/15) of the atopics who lived in a wood home were skin test positive (x2=4.86, p=0.03). Although the incidence of cockroach allergy in this study is lower than that found elsewhere, these data support the notion that, in this tropical environment, sensitization to cockroaches is associated with housing quality.