Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 23;24(1):169.
doi: 10.1186/s12931-023-02475-6.

Global, regional, and national burden of asthma and its attributable risk factors from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019

Zhufeng Wang #  1 , Yun Li #  1 , Yi Gao #  1 , Yu Fu  2 , Junfeng Lin  1 , Xuedong Lei  1 , Jinping Zheng  3 , Mei Jiang  4
Affiliations

Global, regional, and national burden of asthma and its attributable risk factors from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019

Zhufeng Wang et al. Respir Res. .

Abstract

Background: The burden of asthma in terms of premature death or reduced quality of life remains a huge issue. It is of great importance to evaluate asthma burden geographically and time trends from 1990 to 2019 and to assess the contributions of age, period, and cohort effects at global level.

Methods: Asthma prevalence, deaths, and disability adjusted life years (DALYs) as well as risk-attributable burden were collected from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 database and were compared by age and sex. The Smoothing Splines models were used to estimate the relationship between asthma DALYs and the sociodemographic index (SDI). The Age-Period-Cohort model was used to determine effects of ages, periods, and birth cohorts on disease rates.

Results: Between 1990 and 2019, the declines were 24.05% (95% uncertainty interval [UI] - 27.24 to - 20.82) in age-standardized asthma prevalence, 51.3% (- 59.08 to - 43.71) in mortality, and 42.55% (- 48.48 to - 36.61) in DALYs rate. However, the burden of asthma continued to rise, with an estimated 262.41 million prevalent cases globally (95% UI 224.05 to 309.45). Asthma caused greater DALYs in females than in males among people aged 20 years and older. The lowest age-standardized DALYs rate was observed at a SDI of approximately 0.70. The Longitudinal age curves showed an approximate W-shaped pattern for asthma prevalence and a likely J-shaped pattern for asthma mortality. The period effect on prevalence and mortality of asthma decreased from 1990 to 2019. Compared with the 1955-1959 birth cohort, the prevalence relative risk (RR) of asthma was highest in the 1905-1909 birth cohort, whereas the mortality RR continued to decline. At the global level, the percentages of high body-mass index, occupational asthmagens, and smoking contributing to DALYs due to asthma were 16.94%, 8.82%, and 9.87%, respectively.

Conclusions: Although the age-standardized rates of asthma burden declined in the past 30 years, the overall burden of asthma remains severe. High body mass index becomes the most important risk factor for DALYs due to asthma at the global level.

Keywords: Age-period-cohort analysis; Asthma; Burden; Risk factors.

PubMed Disclaimer

Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form. The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Age-standardized prevalence of asthma per 100,000 population in 2019
Fig. 2
Fig. 2
Age-standardized death rate of asthma per 100,000 population in 2019
Fig. 3
Fig. 3
Number of DALY cases globally and DALY rate of asthma per 100,000 population, by age and sex in 2019. Boxes indicate DALY cases with 95% uncertainty intervals for men and women. DALY: disability adjusted life year
Fig. 4
Fig. 4
Age-standardized disability adjusted life year (DALY) rates of asthma for the 21 Global Burden of Disease regions by sociodemographic index, 1990–2019. Thirty points are plotted for each region and show the observed age-standardized DALY rates from 1990 to 2019 for that region. Expected values, based on the sociodemographic index and disease rates in all locations, are shown as a solid line. Regions above the solid line represent a higher than expected burden and regions below the line show a lower than expected burden
Fig. 5
Fig. 5
Percentage of disability adjusted life years (DALYs) due to asthma attributable to each risk factor for the 21 Global Burden of Disease regions in 2019
See this image and copyright information in PMC

References

    1. Oh CK, Leigh R, McLaurin KK, et al. A randomized, controlled trial to evaluate the effect of an anti-interleukin-9 monoclonal antibody in adults with uncontrolled asthma. Respir Res. 2013;14(1):93. doi: 10.1186/1465-9921-14-93. - DOI - PMC - PubMed
    1. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2023. Available from: www.ginasthma.org.
    1. Sadatsafavi M, Rousseau R, Chen W, et al. The preventable burden of productivity loss due to suboptimal asthma control: a population-based study. Chest. 2014;145(4):787–793. doi: 10.1378/chest.13-1619. - DOI - PubMed
    1. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017;5(9):691–706. 10.1016/s2213-2600(17)30293-x. - PMC - PubMed
    1. Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir Med. 2020;8(6):585–96. 10.1016/s2213-2600(20)30105-3. - PMC - PubMed