Temporal Trends of Asthma Mortality Rates in Brazil from 1980 to 2010

Abstract

Objective. Mortality from asthma has varied among countries during the last several decades. This study aimed to identify temporal trends of asthma mortality in Brazil from 1980 to 2010. Method. We analyzed 6840 deaths of patients aged 5–34 years that occurred in Brazil with the underlying cause of asthma. We applied a log-linear model using Poisson regression to verify peaks and trends. We also calculated the point estimation and 95% confidence interval (CI 95%) of the annual percent change (APC) of the mortality rates, and the average annual percent change (AAPC) for 2001–2010. Results. A decline was observed from 1980 to 1992 [APC = −3.4 (−5.0 to −1.8)], followed by a nonsignificant rise until 1996 [APC = 6.8 (−1.4 to 15.6)], and a new downward trend from 1997 to 2010 [APC = −2.7 (−3.9 to −1.6)]. The APCs varied according to age strata: 5–14 years from 1980 to 2010 [−0.3 (−1.1 to 0.5)]; 15–24 years from 1980 to 1991 [−2.1 (−5.0 to 0.9)], from 1992 to 1996 [6.8 (−6.7 to 22.2)], and from 1997 to 2010 [−3.9 (−5.7 to −2.0)]; 24–25 years from 1980 to 1992 [−2.5 (−4.6 to −0.3)], from 1993 to 1995 [12.0 (−21.1 to 59.1)], and from 1996–2010 [−1.7 (−3.0 to −0.4)]. AAPC from 2001 to 2010 was −1.7 (−3.0 to −0.4); the decline for this period was significant for patients over 15 years old, women, and those living in the Southeast region. Conclusion. Asthma mortality rates in Brazil have been declining since the late 1990s.

• bronchial diseases
• case fatality
• epidemiology
• joint point regression

Acknowledgments

Both authors are responsible for the work described in this article. Both were involved in the conception, design, acquisition, analysis, statistical analysis, interpretation of data, and drafting/revising the manuscript.

Declaration of Interest

This study was supported by an established research award from Conselho Nacional de Pesquisa, Brasília, DF. Dr. Lotufo received grants from Astra-Zeneca, Ely-Lilly, Takeda, and Glaxo-Smith-Kline for enrolling participants in acute coronary syndrome randomized trials. Dr. Bensenor reports no conflicts of interest.