Dirección de Administración y Desarrollo de Personal, Instituto de Seguridad Social del Estado de México y Municipios (ISSEMyM), Toluca de Lerdo, Mexico.
Pediatr Pulmonol. 2020 Apr;55(4):874-881. doi: 10.1002/ppul.24658. Epub 2020 Jan 21.
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.
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.
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.
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.
尽管有更多研究表明城市地区的哮喘患病率高于农村地区，但很少有研究评估按地区划分的儿童哮喘死亡率。本研究的目的是比较墨西哥儿童按居住地划分的哮喘死亡率（AMR）。
使用国家死亡证明和人口预测数据，按性别、年龄组和居住地区域比较了 1999 年至 2016 年期间 0 至 14 岁儿童的 AMR。使用 Joinpoint 回归计算 AMR 趋势。
在 680823 例死亡中，有 2464 例（0.36%）归因于哮喘。农村（0.65%）地区的哮喘死亡率高于城市（0.26%）地区，P<0.0001。整个研究期间，农村地区的 AMR 中位数也高于城市地区（分别为 0.6 和 0.3），P<0.05。整个研究期间 AMR 的平均年变化百分比（AAPC）在所有儿童中为-5.1%，农村地区的百分比下降高于城市地区（女孩 AAPC=-6.3%，男孩 AAPC=-4.1%）。0 至 4 岁儿童的 AMR 均呈下降趋势（农村地区 AAPC：女孩=-7.9，男孩=-5.2；城市地区 AAPC：女孩=-5.1，男孩=-5.4），P<0.05。5 至 14 岁儿童的 AMR 没有趋势。
墨西哥儿童的哮喘死亡率在农村地区高于城市地区。随着时间的推移，儿童早期死亡率的下降令人欣慰。需要进一步研究以确定墨西哥农村地区死亡率较高的原因，以及两个地区 5 至 14 岁儿童死亡率没有下降的原因。
