Recent figures from the National Child Mortality Database show that there were 54 child deaths due to asthma, and a further 19 from anaphylaxis in the four years to March 2023.
The majority of these deaths were considered preventable, according to the report.
Contributory factors included excessive use of short acting beta agonist (SABA) – 87% had three or more SABA inhalers dispensed, and 65% of children had fewer than 9 inhaled corticosteroid (ICS) in the year before their death.
Exposure to levels of air pollution above WHO guidelines, smoking by family members, poor communication between and within services, no asthma plan in place, poor indoor air quality, pets in the house and allergies were also commonly reported.
Asthma deaths occurred across all age groups (2 to 17 years), but were highest in 15 – 17-year-olds. The death rate was higher in urban than rural areas, and four times higher for children in the most deprived areas compared with the least deprived.
Almost two-thirds of children (63%) had attended an emergency department at least once in the year before their death, and seven children had attended more than five times. Half the children had at least one emergency admission. In five deaths, no formal diagnosis of asthma was recorded, and diagnoses of suspected asthma were not discussed with parents, leaving them unaware of the seriousness of their child’s illness.
Modifiable factors included failure of primary care to refer the child to a paediatric respiratory specialist when the threshold was reached; failure of hospitals to communicate to the child’s GP, and no planned review on discharge; lack of asthma care plans, which should be shared between GPs, nurses, families and school, but were not.
Among the children who died due to anaphylaxis, the most commonly recorded factors were unclear labelling of food, and the lack of standardised allergy plans in schools and hospitals.
One Child Death Overview Panel commented: ‘Preventing another child dying is the responsibility of us all.’
HQIP. Child deaths due to asthma or anaphylaxis (NCMD). https://www.hqip.org.uk/resource/ncmd-dec24/
