Asthma mortality still dropping in Uruguay
1984-2008 period
Abstract
Introduction: asthma mortality has varied throughout time, there being two epidemic peaks in the 60s and 70s, and then gradually increase until the late eighties, followed by a period where figures were stable, and subsequently dropping in several countries.
Objectives: to conduct a report on the asthma mortality rates in Uruguay, its changes and trends, or a 25 year period between 1984 and 2008. To relate the trends followed by such rates with the sale of inhaled corticoids on its own and associated with long duration ß2 de larga duración (ß2LD).
Method: we conducted a retrospective epidemiological study with the purpose of assessing global and specific mortality rates (0-19, 5-34 and over 60 years old). The data to used to calculate the above mentioned rates were taken from the Statistics Department of the Ministry of Health and the National Statistics Institute, and the pharmaceutical products anti-asthma drug sales in the International Market Survey Report (IMS). Trends in mortality rates were analyzed by linear regression and the Spearman correlation was used to relate mortality rates with inhaled corticoids.
Results: 5-34 and over 60 years old showed a decreasing tendency in global mortality rates during the period studied (p=0,0001, p=0,0001 and p=0,02, respectively).
The highest global mortality rate was observed in 1987 (185 cases, 6.08 rate), and the lowest rate was observed in 2008 (78 deaths, 2.33 rate), decreasing 61.7% during the period studied. 5-35 years old mortality rates has a peak in 1986 and 1991 (0.62 rate) and its lowest value was observed in 2002 and 2005 (0.06). Average mortality was 0.17 in the last five years.
We proved a statistically meaningful inverse correlation (Rho –0,84, p=0,0001) between IC sales (administered on their own or associated to ß2LD) and the decrease of mortality.
Conclusions: asthma mortality rates have decreased in the last years, following a tendency that started in the eighties. The 5-34 years old group rates, considered to be the least reliable, are comparatively lower than average rates in those countries where recent publication on the topic are available. This decrease is correlated with the increase in the sale of IC, on its own or associated to ß2LD.
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