Asthma and Atopic Dermatitis in Asia, 1990–2021: The Global Burden of Disease Study 2021

BACKGROUND: Given the diverse population and regional differences across Asia, a comprehensive analysis of allergic diseases is crucial for guiding healthcare planning, resource allocation, and prevention strategies. Therefore, utilising the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we aimed to thoroughly investigate the burden of allergic conditions and their attributable risk factors in Asia. METHODS: Asthma and atopic dermatitis (AD) prevalence and burden estimates were calculated across various regions within Asia (Central, South, Southeast, East Asia and high-income Asia Pacific) from 1990 to 2021, covering age groups segmented into five-year intervals and analysing data separately and combined for males and females. The Bayesian meta-regression tool was employed to estimate the prevalence, incidence, and cause-specific mortality of allergic disorders. Asthma-related deaths and disability-adjusted life years (DALYs) attributable to each risk factor were estimated using relative risks, risk exposure and the theoretical minimum risk exposure level input. RESULTS: From 1990 to 2021, asthma in Asia showed significant declines in age-standardised prevalence, mortality, and DALYs, exceeding global trends. In 2021, an estimated 106 million (95% UI, 92-121) individuals in Asia had asthma, with age-standardised rates decreasing significantly. However, asthma-related deaths still accounted for 346,755 (278,046-464,848) cases in 2021. In contrast, the AD burden remained stable, with 68.1 million (65.4-71.0) cases in 2021, reflecting a 16.1% increase since 1990, though the age-standardised prevalence remained unchanged. AD exhibited the highest DALYs rates in high-income Asia Pacific and Central Asia, with significant gender disparities in prevalence. CONCLUSION: This study showed a declining age-standardised asthma burden, mortality, and impact, along with a stable burden of AD in Asia from 1990 to 2021. This comprehensive data analysis would provide invaluable insights for making targeted health interventions and policies aimed at mitigating the burden of allergic diseases in Asia.