Temporal trend in burden of asthma in China, South Korea, and Japan, 1990-2019: results from the Global Burden of Disease Study 2019

J Thorac Dis. 2023 May 30;15(5):2559-2570. doi: 10.21037/jtd-23-22. Epub 2023 May 26.

Abstract

Background: Asthma is a public health problem worldwide. However, only a few studies have reported the epidemiology of asthma in various age groups in East Asia. The present study aimed to analyze and predict trends in the incidence of asthma in East Asia through the Global Burden of Disease 2019 (GBD 2019) study and provide information for prevention and control strategies.

Methods: The estimates of incidence, deaths, disability-adjusted life years (DALYs), and risk factors of asthma in China, South Korea, Japan, and the world from 1990-2019 were retrieved from the GBD 2019 study. The age-standardized rates (ASRs) and the average annual percentage changes (AAPCs) assessed the incidence, deaths, and DALYs of asthma, and the projection was assessed by applying the age-period-cohort model.

Results: The burden of asthma in South Korea and Japan was slightly higher than in China and slightly lower than that worldwide. The age-standardized incidence rate (ASIR) of asthma in China decreased slightly from 394.58/100,000 in 1990 to 355.33/100,000 in 2019 (with an AAPC of -0.59), while the age-standardized death rate (ASDR) and the age-standardized DALY rate (ASDALR) decreased significantly (with a AAPCs of -5.22 and -2.89, respectively), which were lower than those in South Korea and Japan. Moreover, males in China, South Korea, and Japan were significantly more affected by tobacco and environmental/occupational factors than females, while the proportion of metabolic factors in females was higher than that in males. The prediction for the burden of asthma in the three East Asian countries continued to decline or stabilize until 2030, especially in China and Japan.

Conclusions: Although the overall asthma burden has a downward trend according to GBD 2019, it is still heavy in East Asia, especially South Korea. In addition, increased concern and control measures are needed for the disease burden in elderly patients.

Keywords: Asthma; disease burden; east Asia; projection; risk factors.