Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019


Youn Ho Shin, The Catholic University of Korea Yeouido St. Mary's Hospital
Jimin Hwang, Johns Hopkins University
Rosie Kwon, Kyung Hee Medical Center
Seung Won Lee, Sungkyunkwan University
Min Seo Kim, Sungkyunkwan University
Jae Il Shin, Yonsei University College of Medicine
Dong Keon Yon, Kyung Hee Medical Center
Yohannes Habtegiorgis Abate, Aleta Wondo Hospital
Mohsen Abbasi-Kangevari, Non-Communicable Diseases Research Center
Zeinab Abbasi-Kangevari, Non-Communicable Diseases Research Center
Michael Abdelmasseh, Joan C. Edwards School of Medicine
Deldar Morad Abdulah, University of Duhok
Richard Gyan Aboagye, University of Health and Allied Sciences, Ghana
Hassan Abolhassani, Research Center for Immunodeficiencies
Elissa M. Abrams, University of Manitoba
Yonas Derso Abtew, Arba Minch University
Eman Abu-Gharbieh, University of Sharjah
Denberu Eshetie Adane Adane, Debre Tabor University
Tigist Demssew Adane, Rijksuniversiteit Groningen
Isaac Yeboah Addo, UNSW Sydney
Rishan Adha, University of Mataram
Amin Adibi, The University of British Columbia
Qorinah Estiningtyas Sakilah Adnani, Universitas Padjadjaran
Anurag Agrawal, Ashoka University
Sohail Ahmad, MAHSA University
Ali Ahmadi, Shahrekord University of Medical Sciences
Ali Ahmed, Monash University Malaysia
Ayman Ahmed, Institute of Endemic Diseases Sudan
Sayer Al-Azzam, Jordan University of Science and Technology
Fadwa Alhalaiqa Naji Alhalaiqa, Philadelphia University
Sheikh Mohammad Alif, Faculty of Medicine, Nursing and Health Sciences
Vahid Alipour, IUMS Health Management and Economics Research Center
Zaid Altaany, Yarmouk University

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Allergy: European Journal of Allergy and Clinical Immunology


Background: Asthma and atopic dermatitis (AD) are chronic allergic conditions, along with allergic rhinitis and food allergy and cause high morbidity and mortality both in children and adults. This study aims to evaluate the global, regional, national, and temporal trends of the burden of asthma and AD from 1990 to 2019 and analyze their associations with geographic, demographic, social, and clinical factors. Methods: Using data from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2019, we assessed the age-standardized prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of both asthma and AD from 1990 to 2019, stratified by geographic region, age, sex, and socio-demographic index (SDI). DALYs were calculated as the sum of years lived with disability and years of life lost to premature mortality. Additionally, the disease burden of asthma attributable to high body mass index, occupational asthmagens, and smoking was described. Results: In 2019, there were a total of 262 million [95% uncertainty interval (UI): 224–309 million] cases of asthma and 171 million [95% UI: 165–178 million] total cases of AD globally; age-standardized prevalence rates were 3416 [95% UI: 2899–4066] and 2277 [95% UI: 2192–2369] per 100,000 population for asthma and AD, respectively, a 24.1% [95% UI: −27.2 to −20.8] decrease for asthma and a 4.3% [95% UI: 3.8–4.8] decrease for AD compared to baseline in 1990. Both asthma and AD had similar trends according to age, with age-specific prevalence rates peaking at age 5–9 years and rising again in adulthood. The prevalence and incidence of asthma and AD were both higher for individuals with higher SDI; however, mortality and DALYs rates of individuals with asthma had a reverse trend, with higher mortality and DALYs rates in those in the lower SDI quintiles. Of the three risk factors, high body mass index contributed to the highest DALYs and deaths due to asthma, accounting for a total of 3.65 million [95% UI: 2.14–5.60 million] asthma DALYs and 75,377 [95% UI: 40,615–122,841] asthma deaths. Conclusions: Asthma and AD continue to cause significant morbidity worldwide, having increased in total prevalence and incidence cases worldwide, but having decreased in age-standardized prevalence rates from 1990 to 2019. Although both are more frequent at younger ages and more prevalent in high-SDI countries, each condition has distinct temporal and regional characteristics. Understanding the temporospatial trends in the disease burden of asthma and AD could guide future policies and interventions to better manage these diseases worldwide and achieve equity in prevention, diagnosis, and treatment.

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