Preschool children from lower household incomes experience inequality in asthma treatment: findings from a Danish nationwide cohort study.

BACKGROUND: The obligation to pay for asthma medication in a country with universal healthcare might lead to increased asthma exacerbations and inequitable healthcare access for children from low-income households. Thus, the aim of this study was to examine the association between household income and childhood/preschool asthma regarding hospitalization and medication receipt. METHODS: In this nationwide register-based cohort study, we encompassed all 3-year-old children residing in Denmark, born between 2000 and 2014, along with their linked parents and followed them until their sixth birthday. Household income was divided into quartiles. Asthma was categorized in two mutually exclusive groups as either the redemption of two prescriptions for asthma medication or receiving a hospital diagnosis. We utilized Poisson regression to estimate the risk ratio (RR). RESULTS: The analysis included 834 422 preschool children. The prevalence of asthma dependent on medication alone was 7.3%, while 1.8% of children necessitated asthma-related hospitalization. Income inequality was evident across all income quartiles. Notably, children from the lowest income quartile had a RR of 0.95 (95% CI: 0.92-0.98) of redeeming asthma medication and conversely a RR of 1.18 (95% CI: 1.14-1.23) of asthma-related hospitalization. CONCLUSIONS: Despite universal healthcare, income inequality has a dual impact on children from low-income households. They face a diminished risk of redeeming asthma medication and a higher susceptibility to asthma-related hospitalizations indicating an unequal access to healthcare. Prioritizing efforts to reduce childhood health inequalities is crucial. However, further research, particularly qualitative studies, is needed to better comprehend the underlying mechanisms to address the complexities of income inequality.

CD21 deficiency in 2 siblings and frequency of the associated mutation in the Danish population.

The clinical presentation of CD21 deficiency in 2 siblings caused by a novel mutation in the CD21 gene is reported, and the frequency of this mutation in the Danish population is explored. Successful treatment with IgG replacement in both patients with CD21 deficiency is also reported.

A genome-wide search for linkage to allergic rhinitis in Danish sib-pair families.

Allergic rhinitis (AR) is a complex disorder with a polygenic, multifactorial aetiology. Twin studies have found the genetic contribution to be substantial. We collected and clinically characterised a sample consisting of 127 Danish nuclear families with at least two siblings suffering from AR or allergic conjunctivitis including 540 individuals (286 children and 254 parents). A whole-genome linkage scan, using 424 microsatellite markers, was performed on both this sample and an earlier collected sample consisting of 130 families with atopic dermatitis and other atopic disorders. A third sib-pair family sample, which was previously collected and genotyped, was added to the analysis increasing the total sample size to 357 families consisting of 1508 individuals. In total, 190 families with AR was included. The linkage analysis software Genehunter NPL, Genehunter MOD, and Genehunter Imprinting were used to obtain nonparametric and parametric linkage results. Family-based association analysis of positional candidate SNPs was carried out using the FBAT program. We obtained genome-wide significant linkage to a novel AR locus at 1p13 and suggestive linkage to two novel regions at 1q31-q32 and 20p12, respectively. Family-based association analysis of SNPs in the candidate locus DNND1B/CRB1 at 1q31 showed no significant association and could not explain the linkage signal observed. Suggestive evidence of linkage was also obtained at three AR loci previously reported (2q14-q23, 2q23, and 12p13) and indication of linkage was observed at a number of additional loci. Likely maternal imprinting was observed at 2q23, and possible maternal imprinting at 3q28.

[Non-attendance at a pediatric outpatient clinic. SMS text messaging improves attendance]. / Udeblivelse fra aftale i børneambulatoriet. SMS-pamindelse hjaelper.

INTRODUCTION: To assess whether short message service (SMS) text message reminders would reduce non-attendance at a paediatric outpatient clinic. Furthermore, we wanted to clarify the families' attitude towards receiving an SMS reminder. METHOD AND MATERIALS: In a prospective cohort study we compared non-attendance among families who did/did not receive an SMS reminder. All patients with an appointment at the paediatric outpatient clinic in weeks 37 to 44, 2006 were included except those who were attending specific immunotherapy. By use of a computer program, the SMS reminders were sent to families with an appointment at the clinic in weeks 38, 40, 42 and 44. The families attending the clinic during these weeks were also asked to complete a questionnaire. RESULTS: Among families who did/did not receive an SMS reminder, the non-attendance was 10.0% and 5.9%, respectively. The relative risk was 1.7 (95% confidence interval (CI) 1.1-2.7). Sixty-eight (41.7%) of the parents stated, that the SMS reminder helped them remember their appointment. A total of 155 (95.1%) would like to receive an SMS reminder before future appointments in the clinic. Only seven (2.6%) were offended by the SMS reminder. CONCLUSION: SMS reminders reduced non-attendance at the paediatric outpatient clinic.