The growing burden of asthma in China from 1990 to 2021: An analysis for the global burden of disease study 2021

Abstract Background: Asthma, one of the most widespread chronic respiratory diseases, has placed a considerable economic and social stress on China. This study examines the burden of asthma in China from 1990 to 2021 and forecasts future trends, providing guidance for establishing focused preventive and regulatory strategies. Methods: Utilizing data from the Global Burden of Disease Database 2021, the analysis of trends in asthma burden was conducted for China from 1990 to 2021. Key indicators such as incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were analysed. The investigation applied the estimated annual percentage change (EAPC), average annual percentage change (AAPC), and age-period-cohort model (APCM) to evaluate these trends. Furthermore, predictions for incidence and mortality in 2035 were generated using the Bayesian APCM and the Nordpred model. Results: In 2021, there were 25,015,668 prevalent asthma cases in China, alongside 3,934,875 new cases and 26,233 deaths. The age-standardized incidence rate and age-standardized death rate for 2021 were 364.17 (95% uncertainty interval [95% UI]: 283.22–494.1) and 1.47 (95% UI: 1.15–1.79) per 100,000, respectively. The age-standardized rates (ASR) for incidence were detected to be elevated in the 0–4 years age group, and the prevalence was significantly higher in the 5–9 years age group compared to other cohorts. ASR for incidence and prevalence of asthma in China were lower than that in the global average. Between 1990 and 2021, the ASR of incidence, prevalence, mortality, and DALYs demonstrated a downward trajectory, with EAPC values of −1.17, −1.57, −4.69, and −2.98, respectively. People aged 0–9 and over 60 years experienced a disproportionately higher disease burden. Projections indicate that the ASR for incidence will continue to rise, whereas the death will continue to decline by 2035. Conclusions: Between 1990 and 2021, a general reduction in the asthma burden in China was observed. However, the burden remains particularly high among people aged 0–9 and over 60 years, underscoring the need for targeted interventions and policies to address the ongoing challenges of asthma.