Prevalence of asthma and the premature mortality in Eastern sub-Saharan Africa, from 1990 to 2023

Abstract

Background: There is a paucity of information that characterized the burden of asthma in the Eastern Sub-Saharan African (ESSA) region. Therefore, this study estimated the prevalence of asthma and its premature mortality in the region from 1990 to 2023. Methods: Data on the prevalence of asthma and the years of life lost (YLL) were extracted from the Global Burden of Diseases 2023 database for the ESSA region. Asthma prevalence was estimated using disease modelling with a Bayesian meta-regression tool (DisMod-MR 2.1), whereas YLLs were derived using the Cause of Death Ensemble model (CODEm). The Comparative Risk Assessment Framework was applied to identify the risk factors for years of life lost. The spatiotemporal Gaussian process regression technique (ST-GPR) was used to smooth the trend. Age-standardized rates as well as the percentage change between 1990 and 2023 were estimated. Results: There were an estimated 20,716,738 prevalent cases (95% UI: 16,523,031-26,057,565) of asthma in the ESSA region in 2023, with an age-standardized rate of 4,324 cases per 100,000 population (95% UI: 3,555-5,261). There were an estimated 918,517 years of life lost (95% UI: 582,476-1,379,986) in the region and 297 age-standardized years of life lost per 100,000 population (95% UI: 221-487). No inter-country variations were estimated throughout the region. However, the YLLs rate increased with age. Occupational asthmagens, high body-mass index, sexual violence against children, and tobacco use were the leading risk factors for asthma-related premature mortalities in the region, with variable impacts by countries. Conclusion: There were high and persistent rates of morbidity and premature mortality from asthma in the ESSA region from 1990 and 2023. Targeted strategies are urgently needed to mitigate asthma risk factors and improve disease management.