Asthma mortality in Serbia: a 30-year analysis.
BACKGROUND
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.


METHODS
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.


CONCLUSIONS
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.
School of Medicine University of Belgrade, Internal Medicine Department, Belgrade, Serbia. dragica.pesut@gmail.com
Dragica P
DP
Pesut
Milica V
MV
Bulajic
Ljudmila M
LM
Nagomi-Obradovic
Anita D
AD
Grgurevic
Zorana B
ZB
Gledovic
Dimitrije R
DR
Ponomarev
Ana Z
AZ
Blanka
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000191:economics / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends; D012042:Registries; D055771:Serbia / Q000453:epidemiology; D012959:Socioeconomic Factors; D055815:Young Adult