Fighting respiratory diseases: divided efforts lead to weakness

death in 2010.Recently, a successful detection program in high-risk subjects based on chest CT scanning has been described. (18)hese "big five" respiratory diseases (ARI, tuberculosis, asthma, COPD, and lung cancer), due to their extremely high combined burden, should receive more attention by health and economy authorities in developing countries, in accordance with the recommendations of a recent report by the Forum of the International Respiratory Societies. (4) In fact, if we group the codes of all respiratory diseases in the International Classification of Diseases, 10th revision (ICD-10) together, their burden and mortality are quite similar to those of cardiovascular diseases and cancer, and much higher than those of diabetes, which usually receives abundant funds for health care, research, and health promotion activities.Except for some priority regarding tuberculosis, respiratory diseases are often neglected in developing countries.In 2005 and 2008, respectively, 14.7% and 13.4% of all deaths had acute or chronic respiratory origin in Mexico, (19) which was close to the proportion of all cancer and cardiovascular-related deaths.This happens frequently in other countries. (19)he results of various studies have markedly increased the knowledge of the natural history of asthma and showed the relationship between persistent asthma during childhood and the development of chronic lung disease.It is relevant that prematurity is associated with significant decreases in lung function early in life, which influences the development of chronic lung disease later.It is relevant to analyze why this is happening.One factor that contributes to the problem is the underestimation of the burden of respiratory diseases, and this is related to the imperfections of the ICD-10, which is based on different perspectives: by organs or systems (respiratory diseases for example, the J codes), by mechanisms of disease (infections, in which ARIs and tuberculosis are inserted), but also by the period of life of the patients (neonatal diseases, infectious or respiratory, are in a separate

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