The Burden of Childhood Asthma by Age Group, 1990-2019: A Systematic Analysis for Global Burden of Disease Study 2019 Data

Abstract Background: Asthma is a common respiratory disease in children. We aimed to update information about incidence of and mortality and disability adjusted life years (DALYs) due to childhood asthma and provide evidence-based recommendations for childhood asthma prevention.Methods Data were obtained from the Global Burden of Disease (GBD) Study, which was conducted from 1990 to 2019 in 204 countries. First, we estimated the incidence, mortality and DALY rates of childhood asthma with a Bayesian meta-regression model. Second, we analyzed the relationship between the sociodemographic index (SDI) and DALYs in different age groups. Third, we studied changes in the trends of the age-standardized DALY rate between 1990 and 2019 by age group, SDI, and risk factors.Results Globally, the numbers of deaths due to and the incidence and DALY rates of childhood asthma were 12.9 thousand (95% UI 10.6 to 15.7), 22 million (95% UI 15 to 31), and 5.1 million (95% UI 3.4 to 7.5) in 2019, representing 65.1% (95% UI 47.6 to 72.4), 5.3% (95% UI 2.6 to 8.8) and 30% (95% UI 18 to 41) decreases from those in 1990, respectively. With the exception of high-SDI regions, the age-standardized DALY rate in all age groups in all SDI regions decreased. In 2019, the age-standardized DALY rate in 1- to 4-year-olds was highest in low-SDI regions, and that of 5- to 19-year-olds was highest in high-SDI regions. In contrast to those in low-SDI regions, children, except those aged 1 to 4 years, in high-SDI regions had a higher risk of DALYs due to asthma. A high body mass index was a stronger risk factor than occupational asthmagens for childhood asthma.Conclusion Our findings provide insights into asthma prevention and treatment through the identification of key factors related to childhood asthma. Children, especially those aged 5 to 14 years, in high-SDI regions should change their eating and lifestyle habits and exercise regularly. Data on additional chronic diseases in children need to be collected to develop better health prevention recommendations.