Asthma mortality in Serbia: a 30-year analysis

Introduction: The asthma mortality pattern differs among countries. No published evidence is currently available on asthma mortality in a European low-middle-income country in socioeconomic transition. We analyzed the trend of asthma mortality rate in Serbia during the period 1980-2009. Materials and Methodology: a descriptive study; source of data: Republic of Serbia Institute of Statistics Death Registry. We analyzed asthma mortality data in the total population, including gender specific analysis, and in the selected >= 5-34 year age group. The International Classification of Diseases codes for asthma 493 (1980-1996) and J45+J46 (1997-2009) were included. Population estimates were based on 1991 and 2002 census data, with extrapolation. Results: The over-all average mortality rate was 7.27 +/- 2.14/100,000 inhabitants. The mortality rate peaked in 1981 at 11.3/100,000 but was 4.45/100,000 in the last year of analysis. While both overall mortality rate, as well as gender specific rates, showed clear decreases over the observed 30-year period (average absolute annual decrease of 0.195/100,000 inhabitants, 0.241/100,000 men and 0.149/100,000 women; p < 0.001) with corresponding relative annual decreases of 2.9% for the whole population, 3.0% for men and 2.8% for women, a stable trend of the rate was found in the age group >= 5-34 years. Male-to-female ratio was 1.59 +/- 0.186, on average and it showed a stable trend over the observed period. Conclusion: Although the failure of the health care system during the socioeconomic crisis of the 1990s might have transiently affected asthma mortality rates, the overall mortality rate for the disease shows a favorable decreasing trend. (C) 2011 Elsevier Ltd. All rights reserved.