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Meta-Analysis
. 2020 Jun;10(1):010801.
doi: 10.7189/jogh.10.01081.

The disease burden of childhood asthma in China: a systematic review and meta-analysis

Xue Li  1   2 , Peige Song  1   3   2 , Yongjian Zhu  4 , Haohao Lei  5 , Kit Yee Chan  1 , Harry Campbell  1 , Evropi Theodoratou  1   6 , Igor Rudan  1 ; Global Health Epidemiology Research Group (GHERG)
Affiliations
Meta-Analysis

The disease burden of childhood asthma in China: a systematic review and meta-analysis

Xue Li et al. J Glob Health. 2020 Jun.

Abstract

Background: In China, childhood asthma prevalence showed a remarkable increase in the past decades. An updated epidemiological assessment of childhood asthma in China with a focus on prevalence and time trends is required.

Methods: We systematically searched three main Chinese databases and one English database to identify epidemiological studies of the prevalence of childhood asthma in China. Asthma cases were defined according to one of the five sets of Chinese diagnostic criteria which were established by the Children Respiratory Disease Group. We estimated age- and sex-specific prevalence of asthma using a multilevel mixed-effects logistic regression. We presented the time trends of asthma prevalence between 1990 and 2020 by age, sex and setting (urban vs rural), and also estimated the number of children affected by asthma in 2010.

Results: In 1990, the prevalence of asthma ranged from 0.13% (95% confidence interval (CI) = 0.10-0.20) in rural girls aged 14 years to 1.34% (95% CI = 1.11-1.67) in urban boys aged five years. In 2010, the overall prevalence of asthma in Chinese children aged 0-14 years was 2.12% (95% CI = 1.83-2.51), corresponding to 5.16 million children living with asthma. Children aged 5-9 years were with the highest prevalence estimate of 2.65% (95% CI = 2.31-3.12) and those aged 10-14 years were with the lowest (1.48%, 95% CI = 1.26-1.78). In 2020, it is expected that this disparity will continue, with the prevalence of asthma being at the lowest level among rural girls aged 14 years (1.11%, 95% CI = 0.82-1.54) and at the highest level among urban boys aged four years (10.27%, 95% CI = 8.61-12.18). Over the 30 years (1990-2020), the prevalence of asthma in children aged 0-14 years has increased in both sexes and settings, which was consistently the lowest in rural girls and the highest in urban boys.

Conclusions: This study shows that childhood asthma has been increasingly prevalent in China. Asthma is more frequent in boys and in rural areas. The detailed and systematic estimates of asthma prevalence in this study constitute the best currently available basis for policymaking, planning, and allocation of health and welfare resources related to the burden of childhood asthma in China.

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Conflict of interest statement

Competing interests: Igor Rudan and Harry Campbell are Co-Editors in Chief of the Journal of Global Health. To ensure that any possible conflict of interest relevant to the journal has been addressed, this article was reviewed according to best practice guidelines of international editorial organisations. The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no further conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of systematic review process.
Figure 2
Figure 2
Age-specific prevalence of asthma in Chinese children based on the data points from the included studies. The spot sizes were scaled according to the study sample sizes.
Figure 3
Figure 3
Age-, sex- and setting-specific prevalence of asthma in Chinese children in the years 1990, 2000, 2010 and 2020, with 95% confidence intervals.
See this image and copyright information in PMC

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