Zero tolerance for asthma deaths in children

Asthma mortality among children and adolescents in China, 2008-2018

BACKGROUND

Asthma mortality among children and adolescents at the national level in China was unreported. The aim of this study was to analyze the mortality of asthma among children and adolescents in China using a nationally representative database.

METHODS

This was a descriptive study using data from the Disease Surveillance Points (DSPs) system. All asthma-related deaths among children and adolescents aged 0-19 years occurring in DSPs across China from 2008 to 2018 were included. Multilevel Poisson regression models were used to compute the total, age-, gender-, region- and residence-specific asthma mortality rates and to investigate the significance of trends and factors associated with asthma mortality. Data from the National Bureau of Statistics were used to estimate the national asthma deaths.

RESULTS

Total asthma mortality rate among Chinese children and adolescents fluctuated between 0.020 (0.009, 0.045) and 0.059 (0.025, 0.137) per 100,000 and showed an overall downward trend (RR, 0.909; 95% CI 0.854-0.968) during the study period (2008-2018). Asthma mortality rate was higher in the western China (RR 2.356, 95% CI 1.513, 3.669) and varied over a ninefold range among DSPs in China. The estimated number of deaths decreased by 51.38% from 2008 (n = 148; 95% CI 58,379) to 2018 (n = 71; 95% CI 34, 109).

CONCLUSIONS

Asthma mortality rate among children and adolescents in China was at a low level compared to rates worldwide and decreased significantly from 2008 to 2018. Compared with most countries in the world, the number of asthma deaths was higher in China.

Long-Term Trends of Asthma Mortality in China from 2000 to 2019: A Joinpoint Regression and Age-Period-Cohort Analysis

Background: Trends of asthma mortality vary widely all over the world, while the trends in China over the past 15 years are unknown. The aim of this study was to assess the trends of asthma mortality in China. Methods: Asthma deaths and demographic characteristics were collected from National Death Cause Datasets of Disease Surveillance System between 2004 and 2019. The data were analyzed with joinpoint regression analysis and age-period-cohort (APC) analysis for the mortality rate due to asthma in China. Results: Asthma mortality declined from 2.4 (95% confidence interval (CI): 2.3–2.5) per 100,000 in 2004 to 1.6 (95% CI: 1.5–1.7) per 100,000 in 2019. Age-adjusted asthma mortality rates decreased for men and women in urban and rural areas from 2004 through 2019. The decreasing trend of the mortality rate has slowed down substantially during 2007 and 2009. After that, the decreasing trend has stabilized. The asthma mortality rates generally have a positive relationship with the age of the population when controlling for period and cohort. The period trend decreased and then increased when controlling for age and cohort. Conclusions: We should pay more attention to asthma management plans or treatment for aging people who are facing higher risk of asthma death.

Doxofylline for Pediatric Asthma Steps 1-4. Pediatric Asthma: New Role for an Old Drug

The panoply of anti-asthma drugs for children between 6 and 18 years is not limited to those reported in the guidelines. In this review, we will re-assess the role of doxofylline, a xanthine characterized by a much higher handling than that of theophylline, as add-on treatment in pediatric asthma grade 1-4. Ten studies evaluated doxofylline in the treatment of asthma of patients non-responsive to the first-line inhaled corticosteroids. Of these, two included children and one was exclusively pediatric. According to their results, doxofylline exerts a powerful bronchodilator and anti-inflammatory activity, which can be exploited when the inhaled oral corticosteroids are not sufficient to get the desired effect of reducing symptoms. Unlike theophylline, doxofylline does not require blood testing. It can be administered together with or as an alternative to a series of other drugs considered in additional therapy.