全球哮喘病预防指南附录.pdf

GINA Report 2014The Global Initiative for Asthma is supported by unrestricted educational grants from:Visit the GINA website at www.ginaasthma.org © 2014 Global Initiative for Asthma AlmirallBoehringer IngelheimBoston Scientific CIPLAChiesiClement Clarke GlaxoSmithKlineMerck Sharp symptom prevalence has been decreasing in Western Europe and increasing in regions where prevalence was previously low.4 Asthma symptom prevalence in Africa, Latin America, Eastern Europe and Asia continues to rise. The World Health Organization Global Burden of Disease Study estimates that 13.8 million disability-adjusted life years (DALYs) are lost annually due to asthma, representing 1.8% of the total global disease burden.5 It is estimated that asthma causes 346,000 deaths worldwide every year,6 with widely varying case fatality rates that may reflect differences in management.1 Box A1-1. World map of the prevalence of current asthma in children aged 13–14 years *Map provided by Richard Beasley. Data are based on ISAAC III.3 The prevalence of current asthma in the 13–14 year age group is estimated as 50% of the prevalence of self-reported wheezing in the previous 12 months. ≥ 10.0 5.0 – 9.9 0 – 4.9 No standardised data available GINA Appendix Chapter 1. Burden of asthma 7 COPYRIGHTED MATERIAL - DO NOT ALTER OR REPRODUCEBox A1-2. Prevalence of current asthma in 2000–2003 in children aged 13–14 years (%) Country % asthma Country % asthma Country % asthma Isle of Man 15.6 Austria 7.6 Ethiopia 4.6 El Salvador 15.4 Turkey* 7.4 Morocco 4.5 Australia 15.3 Malta 7.3 Malaysia 4.5 Vietnam 14.8 Ukraine 7.3 FYR Macedonia 4.4 Scotland 13.9 Tunisia 7.2 Algeria 4.4 Wales 13.8 Nicaragua 6.9 South Korea 4.4 Costa Rica 13.7 Canada 6.9 Mexico 4.4 New Zealand 13.4 France* 6.8 Hong Kong 4.3 Republic of Ireland 13.4 Norway* 6.8 Palestine 4.3 Channel Islands 13.3 Bolivia 6.8 Philippines 4.2 England 11.5 Trinidad and Tobago 6.6 Sultanate of Oman 4.2 Sri Lanka 11.5 Nigeria 6.5 Croatia 4.2 Panama 11.5 Niue 6.4 Belgium 4.2 Romania 11.4 Sudan 6.3 Bulgaria 4.1 United States of America 11.1 Argentina 6.3 New Caledonia 4.1 Honduras 11.0 United Arab Emirates* 6.2 Italy 4.1 Reunion Island 10.8 Jordan 6.2 Kyrgyzstan 3.9 Paraguay 10.5 Netherlands 6.1 Kuwait 3.8 Barbados 10.4 Colombia 5.9 Bangladesh* 3.8 Congo 9.9 Portugal 5.9 Democratic Republic of Congo 3.8 Tokelau 9.9 Singapore 5.7 Lithuania 3.7 Peru 9.8 French Polynesia 5.7 Occupied Territory of Palestine* 3.6 Ivory Coast 9.7 Russia 5.6 Egypt 3.5 South Africa 9.6 Iran 5.4 Taiwan 3.1 Finland 9.5 Pakistan 5.4 Denmark* 3.0 Brazil 9.4 Cook Islands 5.3 India 2.9 Guinéa 9.3 Spain 5.3 Hungary 2.9 Cuba 8.9 Latvia 5.3 Samoa 2.9 Germany 8.8 Fiji 5.2 Cameroon 2.9 Togo 8.4 Thailand 5.2 Syrian Arab Republic 2.6 Ecuador 8.3 Gabon 5.1 Indonesia 2.6 Uruguay 8.2 Poland 5.1 Georgia 2.6 Kingdom of Tonga 8.1 Japan 5.0 Switzerland* 2.3 Czech Republic* 8.0 Sweden 4.9 Greece* 1.9 Kenya 7.9 Serbia and Montenegro 4.8 China 1.8 Venezuela 7.7 Estonia 4.7 Albania 1.7 Chile 7.7 Uzbekistan* 4.6 Nepal* 1.5 Data are based on ISAAC III.3 The prevalence of current asthma in the 13-14 year age group is estimated as 50% of the prevalence of self- reported wheezing in the previous 12 months.*No data available from ISAAC III, figures taken from Global Burden of Asthma Report1 8 GINA Appendix Chapter 1. Burden of asthma COPYRIGHTED MATERIAL - DO NOT ALTER OR REPRODUCESOCIAL AND ECONOMIC BURDEN Social and economic factors are integral to understanding asthma and its care, from the perspective of both the individual person with asthma and the health care provider. In addition, quantifying the socioeconomic burden of diseases is important as it provides critical information to decision makers to efficiently allocate scarce health care resources. Attention needs to be paid to both direct medical costs (identifiable health care services and goods used for asthma such as hospital admissions, physician visits and medications) and indirect costs (productivity loss and premature death).7,8 Direct costs The monetary costs of asthma, as estimated in a variety of health care systems including those of the United States,9,10 Canada,11 Italy,12 and the United Kingdom13are substantial. Few economic studies are conducted in non-western countries, but there is strong evidence that asthma imposes a significant burden in the developing world.14 Exacerbations are major determinants of the direct cost of asthma, and preventing exacerbations should be an important consideration in asthma management.15 Indirect costs Since asthma is a chronic health condition that affects individuals across all ages, productivity loss due to asthma is substantial.16 Absence from school and days lost from work are reported as substantial social and economic consequences of asthma in studies from various regions of the world.8 Productivity loss itself can be in the form of missed work time (absenteeism), and present at work but with reduced performance (presen。