S. Janson

Pet‐keeping in early childhood and airway, nose and skin symptoms later in life

Background: It is discussed whether exposure to pets during childhood is a risk or a protective factor for sensitization and allergic symptoms. The aim of this study was to investigate the association between pet‐keeping at time of birth and allergic symptoms in airways, nose and skin among young children in Sweden.

Chest X-ray investigation in newly discovered asthma.

Chest X‐ray in 60 children (0–6 yr old) with newly diagnosed asthma at the primary care level showed normal findings in 85% at paediatric follow‐up. The pathological findings were transient. The only X‐ray that led to a change in treatment was performed on clinical grounds due to concurrent disease. In conclusion, routine X‐ray need not be part of the initial routine work up of asthma in preschool children.

The burden of asthma as reflected by the prevalence defined by doctor's diagnosis and the use of healthcare services by preschool children in a Swedish region.

Aim: Epidemiological data and reports on the prevalence and burden of preschool asthma are mainly based on questionnaires and generally give a prevalence of above 6% in Sweden. In this study we used other ways of studying the prevalence, risk factors and the use of healthcare services in a defined region. Methods: The catchment area included 9410 children aged 0‐6 y. All outpatient clinics had computerized records of patients and visits to the outpatient clinic could be studied as well as admissions to hospital for asthma between 1988 and 1998. Results: According to patients’record data, the prevalence of doctor‐diagnosed asthma was 4.5% in 1998. Seventy‐nine percent of recorded patients are seen outside the hospital, thus the burden of asthma for the health system is mainly on the outpatient clinics. Admissions and especially readmissions to the hospital have decreased during the past decade. One‐third of the children with newly diagnosed asthma had recurring exacerbations and risk for persistent asthma.

Group discussions with parents have long-term positive effects on the management of asthma with good cost-benefit: Group discussions and the management of asthma

Aim: To investigate if an intervention with extra information and support in a group setting to parents of preschool children could improve adherence and clinical outcome. Methods: This is a controlled, prospective study where the parents of 60 newly diagnosed preschool asthmatic children aged 3 mo–6 y were randomized to either a control group or to an intervention that consisted of four group sessions in close connection with the diagnosis. The basic education on asthma and the written treatment plan were the same in both groups. The outcome measures were questionnaires to the parents and classification of the children according to symptoms and medication. The adherence rate and the burden of asthma were calculated with the help of diaries and weighing of the MDIs used between 12 and 18 mo after inclusion. Results: The follow‐up rate was 85% after 18 mo. The parents’ presence in the sessions was around 70%, with no gender difference. The parents’ view on adherence issues improved significantly in the intervention group. In the control group, 30% had poor adherence compared to 8% in the intervention group (p=0.015). Both the parents and the paediatricians underestimated the number of children with poor adherence. The children in the intervention group had significantly fewer exacerbation days during the last 6 mo—2.1 compared to 3.9 d/child—although they had lower inhaled steroid doses after 18 mo. An economic calculation showed that the intervention was profitable.