Global decline in asthma deaths may have stalled
medwireNews: Death rates from asthma among younger people appear to have plateaued in the past decade despite substantial improvements before this, a study in The Lancet suggests.
Estimated global asthma death rates appeared to have fallen by more than half in people aged 5 to 34 years between 1993 and 2006 according to the data from 46 countries collected by the World Health Organization (WHO).
But there was no appreciable change following this in the period up to 2012, report Stefan Ebmeier (Medical Research Institute of New Zealand, Wellington) and colleagues. They believe their study is the most comprehensive analysis of international asthma mortality trends to date.
In a comment accompanying the study, Christine Jenkins (University of New South Wales, Sydney, Australia) says the findings are a “call to action”.
She maintains: “The job of eliminating deaths in patients with asthma is half done, and the next half will be tougher.”
The researchers collected age-standardized, country-specific asthma mortality rates in peopled aged 5 to 34 years from 36 high-income countries and 10 middle-income countries that had 10 years of complete data in the online WHO Mortality Database between 1993 and 2012.
The estimated mean global asthma mortality rate fell by 57% from 0.44 deaths per 100,000 people in 1993 to 0.19 deaths per 100,000 in 2006, they report. However, despite further reductions in some countries and regions, there was no appreciable change from 2006 to 2012, with the global estimate remaining at 0.19 deaths per 100,000 people.
Ebmeier and colleagues suggest it is likely that the reduction in asthma mortality since the late 1980s, extending through to 2006, is primarily due to the widespread and progressive increase in inhaled corticosteroid therapy.
They note: “Recognition that about half of asthma deaths might be preventable if recommended guidelines are followed, suggests that better implementation of established management strategies is needed.
“However, to achieve a further substantive reduction in asthma mortality, novel strategies will also be required.”
Jenkins adds in her comment: “Epidemiological, clinical, and sociological research focused on the challenging issues that characterize the more resistant burden of mortality is needed, to help define new approaches beyond the solutions that proved so effective up to a decade ago.”
By Anita Chakraverty
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