Brazil
Improvements in basic public health have lessened severe asthma
Uruguaiana is a Brazilian municipality in the state of Rio Grande do Sul next to the river border with Argentina and Uruguay.
Asthma prevalence in the past 15 years
GAN Phase I was undertaken in Uruguaiana and found the prevalence of wheezing in 13-14 year old adolescents was lower (15.8%) than that reported in ISAAC Phase II, conducted at the same centre in 2004 - 12 years ago in 8-13 year olds (25.6%). Prevalence of severe asthma was lower in GAN compared to ISAAC (6.2% vs. 7.6%). In GAN the prevalence of asthma diagnosed by a doctor was 7% and 4.1% of participants had a written asthma plan.
National strategies to address this problem
Between the ISAAC Phase II and GAN Phase I studies, there were improvements in basic sanitation, from 16% to 81.2%, corroborated by the Human Development Index (HDI), which increased from 0.523 to the current 0.744. At the same time, there was a decrease in hospitalisations for severe asthma and in asthma mortality.
In 2012, the Children’s Asthma Prevention Program (PIPA) was created, enacted by municipal decree (2016), which aims to improve the medical care of children and adolescents in the municipality. Patients are referred to the programme by primary care physicians and paediatricians, and receive specific treatment to control asthma for free.
