Mexico
Increasing prevalence of asthma, yet underdiagnosis and poor control still major issues.
Mexico is a middle-income country with 80% of its 127.5 million people living in urban areas. The prevalence of asthma continues to increase in Mexico, yet underdiagnosis and poor control of the disease are still major issues.
In the International Study of Asthma and Allergies in Childhood Phase Three, conducted in eight centres, in 6-7 year olds, the prevalence of “wheeze ever” (WE) ranged from 5.5% to 27% and “wheezing in the last 12 months” (W12) from 3.6% to 12.7%. In 13-14 year olds, the figures were 4.1 to 23.7%, and 3.9 to 14.4%, respectively.
Global Asthma Network study
The Global Asthma Network (GAN) Phase I study already has data from four centres. In 6-7 year olds, there is an increase in prevalence of WE in North Mexico City, Toluca and Victoria City, as well as W12 in North Mexico City, Victoria City and Mexicali. In 13-14 year olds, there is increased prevalence of WE in North Mexico City and Mexicali and in W12 only in Mexicali. Within North Mexico City, 26% of possible asthma patients among 6 year olds have diagnosed asthma, of whom 70% have a written plan for treatment.
Access to medicines
The Ministry of Health under Seguro Popular, a public health insurance scheme, provides secondary care for asthma and access to salbutamol, beclometasone, budesonide and montelukast 5 and 10 mg tablets. The other public institutions have broader access to the same medicines, and also fluticasone, salbutamol with ipratropium, tiotropium, and fixed dose combinations of salmeterol/fluticasone, budesonide/ formoterol and anti-IgE therapy (omalizumab).
Mexico has a clinical practice guideline for the diagnosis and treatment of asthma developed by a group of specialists and primary care physicians, adapted from international guidelines to the Mexican context.
Political advocacy
On December 2017 Mexican experts in asthma presented in the Senators’ Chamber of the Mexican Republic. The discussion included asthma being an important public health problem with increasing prevalence, and mortality; the necessity of a wider basic catalogue of asthma medicines and more well-trained physicians able to care for first and second level allergy patients; patients’ and parents’ experiences; the project of the Mexican Official Standard for the practice of Allergology.