Demonstration project - Minas Gerais (Brazil)

Reduction in hospitalizations and emergency room visits in asthmatic children and adolescents after enrolment in a public asthma programme for low-income families, Belo Horizonte City

Belo Horizonte, located in the state of Minas Gerais, in the southeastern region of Brazil, has 2.4 million inhabitants, a third of whom are under 18 years old. Prevalence surveys demonstrated that 40% of infants less than 15 months old and 20% of adolescents aged 13–14 years had suffered from at least one episode of wheezing over the past 12 months. After a first hospitalization for acute asthma, 50% of the patients were readmitted within the next three months. High prevalence rates combined with lack of affordability of inhaled steroids led to higher asthma morbidity. Acute episodes were one of the leading causes of hospital admissions and readmissions in children and adolescents.

A partnership between the Belo Horizonte Municipal Health Authority and the Federal University of Minas Gerais was established to address this major public health problem. The collaboration led to the Wheezy Child Programme, targeting children and adolescents from low-income families.

Overall 20 000 children and adolescents have been assisted by the Programme in the past 10 years. The overall coverage with inhaled steroids increased from less than 3% of children with persistent asthma in 1996, to 17% by the end of 2000, and to 30% by the end of 2006.

Three thousand patients are currently on follow-up. The different programme components, i.e. training, implementation of a specific network, and the accessibility to beclomethasone dipropionate, also led to a significant decrease in the frequency of hospital admissions and emergency department visits and an increase in the quality of life of the assisted patients.

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