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

TY - JOUR

T1 - Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019

T2 - A systematic analysis for the Global Burden of Disease Study 2019

AU - Shin, Youn Ho

AU - Hwang, Jimin

AU - Kwon, Rosie

AU - Lee, Seung Won

AU - Kim, Min Seo

AU - Shin, Jae Il

AU - Yon, Dong Keon

AU - GBD 2019 Allergic Disorders Collaborators

AU - Munblit, Daniel

N1 - © 2023 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd. Funding Information: This study was funded by the Bill and Melinda Gates Foundation, Australian National Health and Medical Research Council, and Queensland Department of Health, Australia and National Research Foundation of Korea (NRF) grant funded by the Korea government (NRF‐2021R1I1A2059735 and RS‐2023‐00248157). The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. All authors had full access to the study data and had final responsibility for the decision to submit for publication. Funding Information: We would like to express our deepest gratitude to Hyeon Jin Kim, Han Gyeol Lee, Ho Hyeok Chang, and Sungchul Choi for helping data acquisition and making tables and figures. R. Adha acknowledges support from the Department of Statistics, National Chengchi University, Taiwan. Ali Ahmed acknowledges support from Monash University, Malaysia. S. M. Alif acknowledges support from Monash University and the ASPREE Team. A. Badawi is supported by the Public Health Agency of Canada. A. Bikov acknowledges support from Manchester NIHR BRC. J. Car acknowledges support from the Centre for Population Health Sciences and NTU Singapore university's support. G. Damiani acknowledges support from the Italian Center of Precisione Medicine and Chronic Inflammation. A. Fatehizadeh acknowledges support from the Department of Environmental Health Engineering of Isfahan University of Medical Sciences, Isfahan, Iran. V. K. Gupta acknowledges funding support from National Health and Medical Research Council (NHMRC), Australia. S. Hussain Salman Hussain was supported from Operational Programme Research, Development and Education Project, Postdoc2MUNI (No. CZ.02.2.69/0.0/0.0/18_053/0016952). B.‐F. Hwang was partially supported by China Medical University, Taiwan (CMU111‐MF‐55). N. E. Ismail acknowledges AIMST University, Malaysia, for encouraging research affairs. N. Joseph acknowledges the Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India for their encouragement and support. K. Latief acknowledges funding from Taipei Medical University for Doctoral Education during the conduct of this review. M.‐C. Li was supported by the National Science and Technology Council, Taiwan (NSTC 111‐2410‐H‐003‐100‐SSS). G. Liu acknowledges support from the CREATE Hope Scientific Fellowship from Lung Foundation Australia. G. Lopes was supported by national funds through the Fundação para a Ciência e Tecnologia (FCT) under the Scientific Employment Stimulus–Individual Call (CEECIND/01768/2021). L. Monasta received support from the Italian Ministry of Health (Ricerca Corrente 34/2017), payments made to the Institute for Maternal and Child Health IRCCS Burlo Garofolo. T. P. Ng acknowledges support from the following: Geylang East Home for the Aged, Presbyterian Community Services, St Luke's Eldercare Services, Thye Hua Kwan Moral Society (Moral Neighbourhood Links), Yuhua Neighbourhood Link, Henderson Senior Citizens Home, NTUC Eldercare Co‐op Ltd, Thong Kheng Seniors Activity Centre (Queenstown Centre) and Redhill Moral Seniors Activity Centre. J. R. Padubidri acknowledges Manipal Academy of Higher Education, Manipal and Kasturba Medical College, Mangalore for their support to this collaborative research. E. M. M. Redwan acknowledges support from King Abdulaziz University (DSR), Jeddah, King Abdulaziz City for Science & Technology (KACSAT), Saudi Arabia, Science & Technology Development Fund (STDF), US‐Egypt Science & Technology Joint Fund, and The Academy of Scientific Research & Technology (ASRT), Egypt. U. Saeed acknowledges the International Center of Medical Sciences Research (ICMSR), Islamabad (44000) Pakistan. A. M. Samy acknowledges the support from Ain Shams University and the Egyptian Fulbright Mission Program. A. Sheikh acknowledges support from HDRUK. J. F. M. van Boven acknowledges his employer, the University Medical Center Groningen, University of Groningen, The Netherlands, for their support. C. Yu acknowledges support from the National Natural Science Foundation of China (Grant No. 82173626) H. J. Zar acknowledges support from the SA‐Medical Research Council. Funding Information: E. M. Abrams reports leadership or fiduciary role in other board, society, committee or advocacy group, unpaid, as President of the Allergy Section, Canadian Pediatric Society, and as Chair of the Food Allergy/Anaphylaxis Section, Canadian Society of Allergy and Clinical Immunology; other financial or non‐financial interests in the Public Health Agency of Canada (PHAC) as their employee. The views expressed in this manuscript are not necessarily representative of PHAC; all outside the submitted work. A. Agrawal reports leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, with the International Clinical Epidemiology Network as a board member, outside the submitted work. N. Bayileyegn reports a planned patent for surgical instruments to be used in low resources settings (Jan 2024); participation on a Data Safety Monitoring Board or Advisory Board as hospital lead for HIPPO and supervision of surgical data quality; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as surgical unit head at the hospital department of surgery Jimma University; all outside the submitted work. A. Bikov reports grants or contracts form the Northwest Lung Charity and Manchester NIHR Biomedical Research Centre outside the submitted work. A. Carungo reports consulting fees from AbbVie as personal payments; payment or honoraria for educational events from Janssen‐Cilag, Almirall, Novartis, Eli Lilly, Leo Pharma, and Amgen, all as personal payments; all outside the submitted work. J. S. K. Chan reports grants or contracts from the Observational and Pragmatic Research Institute as their employee, outside the submitted work. X. Dai reports support for the present work from UW and IHME as salary payments. T. Fukumoto reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AbbVie, Eli Lilly, Sanofi, Pfizer, and Maruho, all outside the submitted work. R. F. Gillum reports other financial or non‐financial interest in as the Associate Editor, and in the as a member of the editorial board, all outside the submitted work. V. K. Gupta reports grants or contracts from National Health and Medical Research Council (NHMRC), Australia outside the submitted work. N. E. Ismail reports leadership or fiduciary role in other board, society, committee or advocacy group, unpaid, as Bursar for the Malaysian Academy of Pharmacy, outside the submitted work. B. Kaambwa reports leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, with , , and as a member of their editorial boards, all outside the submitted work. I. M. Karaye reports support for attending meetings and/or travel from Hofstra University, Hempstead, New York, for the American Public Health Association Meeting 2022, and the American College of Epidemiology Meeting 2022, all outside the submitted work. P. Kolkhir reports consulting fees from ValenzaBio; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Novartis and Roche; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, with EAACI Dermatology Section as a board member; all outside the submitted work. K. Krishan reports non‐financial support from UGC Centre of Advanced Study, CAS II, Department of Anthropology, Panjab University, Chandigarh, India, outside the submitted work. M.‐C. Li reports support for the present manuscript from National Science and Technology Council, Taiwan through research funding (NSTC 111‐2410‐H‐003‐100‐SSS). G. L. L. Lopes reports grants or contracts from Fundação para a Ciência e Tecnologia (FCT), under the Scientific Employment Stimulus–Individual Call (CEECIND/01768/2021), outside the submitted work. J. R. Medina reports support for attending meetings and/or travel from SPARK Consortium to attend the Introduction to Mathematical Modeling for Infectious Diseases in Bali, Indonesia, March 6–12, 2023, outside the submitted work. A.‐F. Mentis reports grants or contracts from “MilkSafe: A novel pipeline to enrich formula milk using omics technologies,” a research co financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call RESEARCH – CREATE – INNOVATE (project code: T2EDK‐02222), as well as from ELIDEK (Hellenic Foundation for Research and Innovation, MIMS‐860); payment for expert testimony as a peer‐reviewer for Fondazione Cariplo, Italy; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, by serving as Editorial Board Member for “” journal, for “” journal, and as Associate Editor for “”; stocks in a family winery; and other financial or non‐financial interests as a scientific officer with the BGI Group; all outside the submitted work. S. Mohammed reports support for the present manuscript from the Bill and Melinda Gates Foundation. L. Monasta reports support for the present manuscript from Italian Ministry of Health through a contribution given to the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy (RC 34/2017). D. Munblit reports grants or contracts from the European Cooperation in Science and Technology (COST) as payments made to their institution for the Core Outcome Measures for Food Allergy (COMFA) consortium; support for attending meetings and/or travel from European Cooperation in Science and Technology (COST) as personal payments; all outside the submitted work. T. P. Ng reports support from the present manuscript from Agency for Science, Technology and Research and National Medical Research Council as grant funding; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Singapore Institute of Technology, Singapore Nanyang Technological University, Singapore; all outside the submitted work. A. Sheikh reports grants or contracts from HDRUK through a research infrastructure grant, outside the submitted work. C. Simpson reports research grants to their institution from MBIE (NZ), HRC (NZ), Ministry of Health (NZ), MRC (UK), HDRUK, and CSO (UK), all outside the submitted work. J. A. Singh reports consulting fees from Crealta/Horizon, Medisys, Fidia, PK Med, Two Labs Inc., Adept Field Solutions, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, Jupiter Life Science, UBM, Trio Health, Medscape, WebMD, and Practice Point Communications, the National Institutes of Health, and the American College of Rheumatology; payment or honoraria for speakers' bureaus from Simply Speaking; support for attending meetings or travel from the steering committee of OMERACT; participation on a Data Safety Monitoring Board or Advisory Board with the US Food and Drug Administration Arthritis Advisory Committee; leadership or fiduciary role in board, society, committee or advocacy group, paid or unpaid, with OMERACT as a steering committee member, with the Veterans Affairs Rheumatology Field Advisory Committee as Chair (unpaid), and with the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta‐analysis and editor and director (unpaid); stock or stock options in TPT Global Tech, Vaxart Pharmaceuticals, Aytu BioPharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics, Seres Therapeutics, Tonix Pharmaceuticals and Charlotte's Web Holdings, and previously owned stock options in Amarin, Viking, and Moderna Pharmaceuticals; all outside the submitted work. E. Upadhyay reports patents planned, issued or pending for a system and method of reusable filters for anti‐pollution mask (published), a system and method for electricity generation through crop stubble by using microbial fuel cells (published), a system for disposed personal protection equipment (PPE) into biofuel through pyrolysis and method (published), and a novel herbal pharmaceutical aid for formulation of gel and method thereof (filed); leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, Indian Meteorological Society, Jaipur Chapter, as joint secretary; all outside the submitted work. J. F. M. van Boven reports grants or contracts from Aardex, AstraZeneca, Chiesi, European Commission COST Action 19,132 “ENABLE”, Novartis, Pill Connect, Pfizer, and Trudell Medical, all as payments made to their institution; consulting fees from AstraZeneca, Chiesi, GSK, Novartis, Teva, and Vertex as payments made to their institution; all outside the submitted work. Annals of Epidemiology Journal of the National Medical Association PloS One PharmacoEconomics Open International Journal of Environmental Research and Public Health Systematic Reviews Annals of Epidemiology Translational Psychiatry Publisher Copyright: © 2023 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

PY - 2023/8

Y1 - 2023/8

N2 - 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.

AB - 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.

KW - Adult

KW - Child

KW - Humans

KW - Child, Preschool

KW - Global Burden of Disease

KW - Quality-Adjusted Life Years

KW - Risk Factors

KW - Morbidity

KW - Asthma/epidemiology

KW - Prevalence

KW - Incidence

KW - Global Health

UR - http://www.scopus.com/inward/record.url?scp=85165169066&partnerID=8YFLogxK

U2 - 10.1111/all.15807

DO - 10.1111/all.15807

M3 - Article

C2 - 37431853

SN - 0105-4538

VL - 78

SP - 2232

EP - 2254

JO - Allergy

JF - Allergy

IS - 8

ER -