Patterns and trends in burden of asthma and its attributable risk factors from 1990 to 2021 among south Asian countries: a systematic analysis for the Global Burden of Disease Study 2021

Akashanand A 1 , Khatib MN 2 , Balaraman AK 3 , R R 4 , Kaur M 5 , Srivastava M 6 Show all authors , Barwal A 7 , Prasad GVS 8 , Rajput P 9 , Vishwakarma T 10 , Puri S 11 , Tyagi P 12 , Bushi G 13 , Chilakam N 14 , Pandey S 15 , Jagga M 16 , Mehta R 17 , Sah S 18 , Shabil M 19 , M Gaidhane A 20 , Jena D 1

Affiliations 

  • 1 Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
  • 2 Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
  • 3 Research and Enterprise, University of Cyberjaya, Persiaran Bestari, Cyber 11, 63000 Cyberjaya, Selangor, Malaysia
  • 4 Department of Chemistry and Biochemistry, School of Sciences, JAIN (Deemed to be University), Bangalore, Karnataka, India
  • 5 Department of Allied Healthcare and Sciences, Vivekananda Global University, Jaipur, Rajasthan-303012, India
  • 6 Department of Endocrinology, NIMS University, Jaipur, India
  • 7 Chandigarh Pharmacy College, Chandigarh Group of College, Jhanjeri, Mohali - 140307, Punjab, India
  • 8 Department of Chemistry, Raghu Engineering College, Visakhapatnam, Andhra Pradesh-531162, India
  • 9 School of Applied and Life Sciences, Division of Research and Innovation, Uttaranchal University, Dehradun, India
  • 10 IES Institute of Pharmacy, IES University, Bhopal, Madhya Pradesh 462044, India
  • 11 New Delhi Institute of Management, Tughlakabad Institutional Area, New Delhi. India
  • 12 Department of Pulmonary Medicine, Graphic Era (Deemed to be University) Clement Town Dehradun-248002, India
  • 13 School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
  • 14 Noida Institute of Engineering and Technology (Pharmacy Institute), Greater Noida, India
  • 15 Centre of Research Impact and Outcome, Chitkara University, Rajpura- 140417, Punjab, India
  • 16 Chitkara Centre for Research and Development, Chitkara University, Himachal Pradesh-174103 India
  • 17 Clinical Microbiology, RDC, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana 121004, India
  • 18 Department of Paediatrics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune 411018, Maharashtra, India
  • 19 University Center for Research and Development, Chandigarh University, Mohali, Punjab, India
  • 20 Jawaharlal Nehru Medical College, and Global Health Academy, School of Epidemiology and Public Health. Datta Meghe Institute of Higher Education, Wardha, India
J Asthma, 2025 Jan 16.
PMID: 39817407 DOI: 10.1080/02770903.2025.2453810

Abstract

OBJECTIVE: Asthma poses a significant health burden in South Asia, with increasing incidence and mortality despite a global decline in age-standardized prevalence rates. This study aims to analyze asthma trends from 1990 to 2021, focusing on prevalence, incidence, mortality, and disability-adjusted life years (DALYs) across South Asia. The study also assesses the impact of risk factors like high body mass index (BMI), smoking, and occupational exposures on asthma outcomes.

METHOD: We extracted asthma data from the Global Burden of Disease (GBD) database for South Asia (1990-2021). Joinpoint regression analysis was used to assess temporal trends in asthma burden. Annual percentage changes in age-standardized rates (ASR) of incidence, mortality, and DALYs were calculated. Data were stratified by gender, and the contribution of risk factors was evaluated.

RESULTS: Asthma-related mortality in South Asia decreased by 37%, from 27.78 per 100,000 (1990) to 17.54 per 100,000 (2021). The Maldives showed the most significant reduction in mortality (78.31%), while Bangladesh recorded a 47.44% reduction in prevalence and a 62.64% decrease in DALYs. High BMI, smoking, and environmental risks contributed significantly to DALYs, with environmental factors playing a major role in countries like Afghanistan (20.73%) and Bhutan (18.58%). Females, particularly those over 20, experienced higher asthma-related DALYs than males.

CONCLUSION: Asthma burden in South Asia has reduced over the past three decades, yet the absolute number of cases continues to rise, driven by population growth and environmental risk factors. Targeted interventions addressing risk factors and healthcare disparities are essential for further reducing asthma burden.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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