Global burden of asthma decreased from 1990 to 2019

A new study in Chest highlights a decrease in the global burden of asthma from 1990 to 2019, but prevalence of asthma continues to increase in regions with lower socioeconomic development.

Researchers analyzed data from the Global Burden of Disease study from 1990 to 2019 to determine the burden of asthma in 204 countries worldwide.

In 2019, the prevalence of asthma worldwide was 262.4 million and the age-standardized point prevalence was 3,415.5 per 100,000, which is a 24% decrease since 1990, the researchers reported.

In 2019, there were 461,100 deaths related to asthma and the age-standardized rate was 5.8, which is a 51.3% decrease since 1990, according to the results.

In 2019, the number of global disability-adjusted life-years attributable to asthma was 21.6 million and the age-standardized rate was 273.6 disability-adjusted life-years per 100,000, which is a 42.5% decrease since 1990, according to the researchers.

“Although the global burden of asthma decreased over the study period, this was primarily due to a reduction in deaths, rather than reduced prevalence,” Saeid Safiri, PhD, faculty of medicine in the department of community medicine at the Tuberculosis and Lung Disease Research Center and the Aging Research Institute at Tabriz University of Medical Sciences, Iran, and colleagues wrote.

North America had the highest age-standardized point prevalence of asthma in 2019 (10399.3 per 100,000) and East Asia had the lowest (2,025.5 per 100,000), the researchers reported. From 1990 to 2019, the number of prevalent cases of asthma increased from 226.9 million to 262.4 million, with the largest number of prevalent cases in South Asia and North America.

“At the regional level, there was a marked drop in [disability-adjusted life-years in all regions, while high-income North America showed stable [disability-adjusted life-year rates between 1990 and 2019. Similarly, high-income North America showed a rise in the prevalence between 1990 and 2019, whereas all other regions showed a moderate-marked fall. Better socioeconomic status and access to primary healthcare and diagnostic facilities, in addition to heightened awareness as a result of public health campaigns, may have led to an overdiagnosis of asthma in this region,” Safiri and colleagues wrote.

The researchers reported a negative association between sociodemographic index and age-standardized disability-adjusted life years of asthma. Asthma burden was higher in regions with lower socioeconomic development. Oceania, Southeast Asia, Southern Sub-Saharan Africa, the Caribbean and Australasia had disability-adjusted life-years that were higher than expected from 1990 to 2019, according to the results.

“Importantly, for some countries, such as Oman, Saudi Arabia and Vietnam, asthma prevalence is still increasing,” Safiri and colleagues wrote.

Higher BMI (16.9%), smoking (9.9%) and occupational asthmagen exposures (8.8%) were identified as global risk factors for the 2019 asthma disability-adjusted life-years, according to the results.