Trends in asthma mortality in Uruguay 1984-2001
Antiasthmatic drugs association
Keywords:
ASTHMA, MORTALITY
Abstract
Background: mortality rates had varied in many countries during last years, a few studies have been done in Latin America.
Objectives: to assess mortality trends in Uruguay over a 18-year period (1984-2001) and determine the association with antiasthmatic drug consumption.
Method: a retrospective epidemiological study was performed for the total population, data was provided by the Statistic Department of Health Public Ministry (Departamento de Estadística del Ministerio de Salud Pública) and analyzed by lineal regression. Spearman correlation was used to relate mortality trends with antiasthma-tic drugs sold.
Results: it was seen a decreasing trend for global mortality rates (mean 4.96 per 100.000 inhabitants through the study period) and for the 5-34 years old group (mean 0.40 per 100.000), especially during 1995-2001 (mean 4.19 and 0.22 respectively). A significant mortality decrease was seen for both rates during the study period (p = 0.000 and p = 0.001 respectively).
There was significant correlation between mortality rates and drug sales: inhaled corticoids (global rate rho = 0.83, p = 0.000 and 5-34 years rate rho = 0.83, p = 0.000); oral beta2 agonist (global rate rho = 0.86, p = 0.000 and 5-34 years rate rho = 0.77, p = 0.000).
Conclusion: although there is a decrease in global mortality rates, it is still high. Higher decrease in 5-34 years group and current figures place Uruguay among countries with lower mortality rates in Latin America, fact likely associated with the new therapeutic approaches of the disease.
References
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37) Garret J, Kolbe J, Richard G, Whitlock T, Rea H. Major reduction in asthma morbidity and continued reduction in asthma mortality in New Zeland: what lesson have been learned? Thorax 1995; 50: 303-11.
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39) Suissa S, Ernst P, Benayoun S, Baltzan M, Cai B. Low-dose inhaled corticoisteroids and the prevention of death from asthma. N Engl J Med 2000; 343(5): 332-6.
40) Sin DD, Tu JV. Underuse of inhaled steroid in elderly patients with asthma. Chest 2001; 119: 720-5.
41) Busaniche H, Neffen H, Sánchez Guerra ME. Tasa de muerte por asma en la provincia de Santa Fe. (1980-1987). Arch Arg Alerg Inmunol Clin 1991; 11: 13-20.
42) Baena Cagnani CE, Salvucci KD, Jalil ME, Patiño CM, Gurne SE, Mareca O. Estudio de la mortalidad por asma en la provincia de Córdoba entre 1980 y 1991. Arch Argent Alerg Inmunol Clin 1991; 26(2): 91-9.
43) Weiss K, Wagener D. Changing patterns of asthma mortality. Identifying target populations of high risk. JAMA 1990; 264: 1683-7.
2) Beasley R, Pearce N, Crane J. Wordwide trends in asthma mortality during the twentieth centuri. In: Lenfant C, Sheffer A, ed. Fatal Asthma, Lung Biology in Health Disease Series. New York: Marcel Decker, 1998: 13-30.
3) Beasley R, Pearce N, Crane J. Worldwide trends in asthma mortality during the twentieth century. In: Scheffer AL, editor. Fatal asthma. New York: Marcel Decker, 1998: 13-29.
4) Jackson R, Sears M, Beaglehole R, Rea H. International trends in asthma mortality: 1970 to 1985. Chest 1988; 94(5): 914-8.
5) Jenkins C. Asthma mortality in Australia. Clin Asthma Rev 1998; 2: 7-13.
6) Crane J, Pearce N, Beasley R, Burgess M. Asthma mortality -The New Zealand experience. Clin Asthma Rev 1998; 2: 15-20.
7) Stolley PD, Schinnar R. Association between asthma mortality and isoproterenol aerosols: a review. Prev Med 1978; 7: 519-38.
8) Crane J, Pearce N, Flatt A, Burgess C, Jackson R, Kwong T, et al. Prescribed fenoterol and death from asthma in New Zealand, 1981-83: case-control study. Lancet 1981; 1: 917-22.
9) Beasley R, Burgess C, Crane J, Pearce N. The New Zealand asthma mortality epidemic. Clin Sci 1995; 88: 14-7.
10) Burney PG. Asthma mortality in England and Wales: evidence for a further increase. 1974-84. Lancet 1986; 2(8502): 323-6.
11) Esdaile J. Asthma mortality. How high is up? And is it up? Chest 1987; 91: 640-1.
12) Beasley R, Pearce NÑ, Crane J, Burgess C. ?-Agonists: what is the evidence that their use increases the risk of asthma morbidity and mortality? J Allergy Clin Immunol 1999; 104: S18-30.
13) Mannino DM, Homa DM, Pertowski CA, Ashizawa A, Nixon LL, Johnson CA, et al. Surveillance for Asthma-United States, 1960-1995. MMWR 1998; 47(Nº SS-1): 1-28.
14) National Institute of Health. National Heart, Lung, Blood Institute. Global strategy for asthma management and prevention. NHLBI/ WHO Workshop report (Publication number 95-3659, January) 1995: 13-6.
15) Sly RM, O'Donnell R. Stabilization of asthma mortality. Ann Allergy Asthma Immunol 1997; 78: 347-54.
16) Campbell MJ, Cogman GR, Holgate ST, Johnstone SL. Age specific trends in asthma mortality in England and Wales, 1983-95: Results of an observational study. Br Med J 1997; 314: 1439-41.
17) Pearce N, Beasley R, Crane J, Burgess C, Jackson R. End of the New Zealand asthma mortality epidemic. Lancet 1995; 345: 41-4.
18) Baluga JC, Sueta A, Ceni M. Asthma mortality in Uruguay, 1984-1998. Ann Allergy Asthma Immunol 2001; 87: 124-8.
19) Sly RM. Decreases in asthma mortality in the United States. Ann Allergy Asthma Immunol 2000; 85:121-7.
20) Goldman M, Rachmiel M, Gendler L, Katz Y. Decrease in asthma mortality rate in Israel from 1991-1995: is it related to increased use of inhaled corticosteroids? J Allergy Clin Immunol 2000; 105: 71-4.
21) Haahtela T, Klaukka T. Societal and health care benefits of early use of inhaled steroids. Thorax 1998; 53: 1005-56.
22) Neffen H, Baena Cagnani CE. Asthma mortality in Latin America. Allergy Clin Immunol Int (ACII) 1999; 11(5): 171-5.
23) Center for diseases control and prevention. Asthma mortality and hospitalization among children and young adults - United States, 1980-93. JAMA 1996; 275: 1535-7.
24) Salto Júnior JJ, Wanhdalsen G, Naspitz CK, Solé D. Asthma and respiratory disease mortality rates in the state of Sao Paolo, Brazil: 1970-1996. Allergol et Immunopathol 2002; 30: 30-5.
25) Vergara C, Caraballo L. Asthma mortality in Colombia. Ann Allergy Asthma Immunol 1998; 80(1): 55-60.
26) Canseco González C, González Díaz S, Alvarado Valdes C. Asthma mortality in the State of Nuevo León, México. Rev Alerg Mex 1993; 40(5): 119-23.
27) Baluga JC, Spagna F, Ceni M. Mortalidad por Asma en Uruguay: Período 1984-94 Rev Med Uruguay 1997; 13: 12-22.
28) Chatkin JM, Menna Barreto SM, Fonseca NA, Gutiérrez CA, Sears MR. Trends in asthma mortality in young people in Southern Brazil. Ann Allergy Asthma Immunol 1999; 82: 287-92.
29) Neffen H, Baena Cagnani CE, Malka, Sole D, Sepúlveda R, Caraballo L, et al. Asthma mortality in Latin America. J Invest Allergol Clin Immunol, 1997: 7(4): 249-53.
30) Beasley R, Pearce N, Crane J. International trends in asthma mortality. Ciba Found Symp 1997; 206: 140-50; Discussion 150-6, 157-9.
31) Vondra V, Reisova M. The prevalence of bronchial asthma is increasing and mortality varies. Cas Lek Cesc 1996; 135: 471-6.
32) Hills E. Eccuracy of death certificates in bronchial asthma. Accuracy of certification procedures during the confidential inquiry by the British Thoracic Association, a subcommitte of the BTA Research Committe. Thorax 1984; 39: 505-59.
33) Sears MR. Accuracy of certification of death due to asthma. A national study. Am J Epidemiol 1986; 194: 1004-11.
34) Sears MR. Worldwide trends in asthma mortality. Bull Int Union Tuberc Lung Dis 1991; 66: 79-83.
35) Grainger G, Woodman K, Pearce N, Crane J, Burgess C, Keane A, Beasley R. Prescribed fenoterol and death from asthma in New Zealand. 1981-7: a further case-control study. Thorax 1991; 46: 105-11.
36) Spitzer WO, Suissa S, Ernst P, Horwitz RI, Habbick B, Cockcroft D, et al. The use of B-agonists and the risk of death and near death from asthma. N Engl J Med 1992; 326: 501-6.
37) Garret J, Kolbe J, Richard G, Whitlock T, Rea H. Major reduction in asthma morbidity and continued reduction in asthma mortality in New Zeland: what lesson have been learned? Thorax 1995; 50: 303-11.
38) Suissa S, Ernst P. Inhaled corticosteroids: Impact on asthma morbidity and mortality. J Allergy Clin Immunol 2001; 107: 937-44.
39) Suissa S, Ernst P, Benayoun S, Baltzan M, Cai B. Low-dose inhaled corticoisteroids and the prevention of death from asthma. N Engl J Med 2000; 343(5): 332-6.
40) Sin DD, Tu JV. Underuse of inhaled steroid in elderly patients with asthma. Chest 2001; 119: 720-5.
41) Busaniche H, Neffen H, Sánchez Guerra ME. Tasa de muerte por asma en la provincia de Santa Fe. (1980-1987). Arch Arg Alerg Inmunol Clin 1991; 11: 13-20.
42) Baena Cagnani CE, Salvucci KD, Jalil ME, Patiño CM, Gurne SE, Mareca O. Estudio de la mortalidad por asma en la provincia de Córdoba entre 1980 y 1991. Arch Argent Alerg Inmunol Clin 1991; 26(2): 91-9.
43) Weiss K, Wagener D. Changing patterns of asthma mortality. Identifying target populations of high risk. JAMA 1990; 264: 1683-7.
Published
2003-08-31
How to Cite
1.
Baluga JC, Sueta A, Ceni M. Trends in asthma mortality in Uruguay 1984-2001. Rev. Méd. Urug. [Internet]. 2003Aug.31 [cited 2024Nov.17];19(2):117-25. Available from: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/940
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