Trends in international asthma mortality: analysis of data from the WHO Mortality Database from 46 countries (1993–2012)

Ebmeier, Stefan; Thayabaran, Darmiga; Braithwaite, Irene; Bénamara, Clément; Weatherall, Mark; Beasley, Richard

doi:10.1016/s0140-6736(17)31448-4

Cited by 230 publications

(162 citation statements)

References 29 publications

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“…The lack of mortality trend in age groups 5 to 9 or 10 to 14 years is consistent with the findings of a recent multi country study that found no significant changes in mortality from 2006 to 2012 34 in the group that included a combination of asthmatic children and adults (age 5‐34 years). The recent US study 14 from 1999 to 2015 did not show changes in asthma mortality either with low mortality rates in children aged 1 to 14.…”

Section: Discussionsupporting

confidence: 90%

Asthma mortality among Mexican children: Rural and urban comparison and trends, 1999‐2016

Hernández‐Garduño

2020

Pediatric Pulmonology

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Objective Although there are more studies showing higher asthma prevalence in urban rather than rural zones, few assessed asthma mortality by zone in children. The objective of this study is to compare asthma mortality rates (AMR) by zone of residence of Mexican children. Design Using national death certificate and population projections data, AMR were compared in children aged 0 to 14 years by gender, age group, and zone of residence from 1999 to 2016. AMR trends were calculated using Joinpoint regression. Results Of the 680 823 deaths, 2464 (0.36%) were due to asthma. Asthma mortality was higher in rural (0.65%) than urban (0.26%) zones, P < .0001. Whole period AMR median was also higher in rural vs urban zones (0.6 vs 0.3, respectively), P < .05. The average annual percent change (AAPC) of AMR for the whole period was −5.1 in all children with a higher percent decrease in rural vs urban zones (girls' AAPC = −6.3 vs −4.1, respectively and boys' AAPC = −4.8 vs −4.2, respectively). AMR decreased in children aged 0 to 4 from both zones (rural's AAPC: girls = −7.9, boys = −5.2; urban's AAPC: girls = −5.1, boys = −5.4), P < .05. No trend was found in children aged 5 to 14. Conclusions Asthma mortality in Mexican children is higher in rural than urban zones. The decrease of mortality over time in early childhood is reassuring. More research is needed to determine reasons for higher mortality in rural Mexico and for the lack of a favorable decreasing trend in children aged 5 to 14 from both zones.

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Section: Discussionsupporting

confidence: 90%

Asthma mortality among Mexican children: Rural and urban comparison and trends, 1999‐2016

Hernández‐Garduño

2020

Pediatric Pulmonology

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Section: Asthmamentioning

confidence: 99%

“…Improvements in estimated global asthma mortality in 5‐ to 34‐year‐olds have been observed since 1993, primarily due to the progressive increase in ICS therapy . However, there has been no appreciable change in asthma mortality rates from 2006 through 2012, and asthma remains a global problem. In 2017, severe asthma was the focus of a wide variety of papers in Respirology ranging from reviews of the current state of severe asthma management and targeted therapies to experimental trials of probiotics for asthma control in murine models …”

Section: Asthmamentioning

confidence: 99%

Year in review 2017: Chronic obstructive pulmonary disease and asthma

Benton

Lim

et al. 2018

Respirology

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“…Globally, asthma mortality is estimated at 0.19/100 000 population 4. According to a recent analysis of asthma mortality in 46 countries, asthma mortality rates were observed to be decreasing in the 1990s through the 2000s but have recently stagnated 4.…”

Section: Introductionmentioning

confidence: 99%

“…According to a recent analysis of asthma mortality in 46 countries, asthma mortality rates were observed to be decreasing in the 1990s through the 2000s but have recently stagnated 4. Asthma mortality rate was 0·44 deaths per 100 000 people in 1993 and reduced to 0·19 deaths per 100 000 people in 2006 but no significant change was observed between 2006 and 2012 4…”

Section: Introductionmentioning

confidence: 99%

Rates of asthma exacerbations and mortality and associated factors in Uganda: a 2-year prospective cohort study

Kirenga

Jong

Mugenyi

et al. 2018

Thorax

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Data on asthma treatment outcomes in Africa are limited. 449 patients with asthma (age 5-93 years) in Uganda were followed up for 2 years to determine rates of exacerbations and mortality and associated factors. During follow-up the median number of exacerbations per patient was 1 (IQR 0-5) and 17 patients died (3.7%, 27.3 deaths per 1000 person years). Considering only the first year of follow-up, 59.6% of the patients experienced at least one exacerbation, 32.4% experienced three or more exacerbations. A multivariable model showed that the likelihood of experiencing at least one exacerbation in the first year of follow-up was lower with better baseline asthma control (higher asthma control test (ACT) score), with OR 0.87 (95% CI: 0.82 to 0.93, P=0.000), and was higher with more exacerbations in the year prior to enrolment (OR for log number of exacerbations 1.28, 95% CI: 1.04 to 1.57, P=0.018). Better asthma control (OR 0.93, 95% CI: 0.88 to 0.99, P=0.021) and number of baseline exacerbations (OR 1.35,95% CI: 1.11 to 1.66, P=0.005) were also the only factors that were independently associated with experiencing three or more exacerbations during the first year of follow-up. The only factor found to be associated with all-cause mortality was FEV, with higher recent FEV associated with lower all-cause mortality (OR 0.30, 95% CI: 0.14 to 0.65; P=0.002). Rates of asthma exacerbations and mortality are high in Uganda and are associated with poor asthma control. Health systems should be strengthened to care for asthma patients.

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Trends in international asthma mortality: analysis of data from the WHO Mortality Database from 46 countries (1993–2012)

Cited by 230 publications

References 29 publications

Asthma mortality among Mexican children: Rural and urban comparison and trends, 1999‐2016

Asthma mortality among Mexican children: Rural and urban comparison and trends, 1999‐2016

Year in review 2017: Chronic obstructive pulmonary disease and asthma

Rates of asthma exacerbations and mortality and associated factors in Uganda: a 2-year prospective cohort study

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