COCKROACH allergy is less frequent in European than in American children (1), but also less well characterized. This study was undertaken to determine whether clinical features differ among French children hospitalized for acute asthma attack according to their sensitivity to cockroach. During the last 3 years, 324 children were hospitalized for acute asthma attacks in our unit. Among children who had had skin prick tests (n=122), 34 had a positive response to Blattella germanica (monosensitive, n=13; multiple sensitive, i.e., cockroach and dust mites and/or grass pollens, n=21), and 18 others, treated as controls, were positive only for dust mites. All children were treated by the same protocol, including discontinuous salbutamol nebulizations (150 mg/kg; daily number in accordance with severity), prednisolone (1 mg/kg/day), and nasal oxygen when the value of pulsed oximetry was less than 92%. Demographic data and data on ethnic origin, and place and mode of residence were collected. The number of hospitalized episodes and days, mean hospital stay per episode, delay between the onset of the episode and the emergency room admission, the consumption of salbutamol nebulizations on the ®rst day, and the need of oxygen, intravenous salbutamol, or intensive care unit hospitalization were noted. Data, expressed as meanuSD, were compared with the Kruskal-Wallis test. The cockroach-monosensitive children were mainly black children from central Africa and the Comoro Islands (61.5% vs 14.3% for multiple sensitive children and 16.7% for dust-mite sensitive children; P=0.002). Socioeconomic status was similar between groups: parents with unquali®ed jobs in 82.3% of subjects, lowcost public housing in poor city neighborhoods in 61.7%. The 52 children were hospitalized for 73 acute asthma attacks within the 3 studied years (Table 1).Cockroach-monosensitive children had a shorter delay in hospital admission, a higher consumption of salbutamol, a higher total of hospitalized days, and a longer hospital stay per episode than children allergic to cockroach and other allergens or children with only allergy to dust mites. Follow-up and compliance were poor for all children, as only six of them, two per group, had regular scheduled medical visits and antiasthma treatments.
