Burden of chronic respiratory disease in Asia, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

Mohammad Fareed Giridhara Rathnaiah Babu Shankar M. Bakkannavar Anurag Agrawal Mahaveer Golechha Jesu Arockiaraj Devananda Devegowda Atif Amin Baig Rupesh K. Gautam Ferry Efendi Mahwish Arooj Vijay Kumar Chattu Ripon Kumar Adhikary Narayan Babu Dhital Anup Bhat Dinh Toi Chu Ashish D. Badiye Tahira Ashraf Ibrahim Elsohaby Saurav Basu Ayesha Fahim Syed Amir Ashraf Jaeyu Park Syed Shujait Ali Sheikh Mohammad Alif Jeetendra Bhandari Arun Ghuge Ahmad Naoras Bitar Mohammad Shahangir Biswas Linh Phuong Bui Bijit Biswas Syed Mahfuz Al Hasan Awais Altaf Zahid A. Butt Danish Ahmad Min Seo Kim Khurshid Alam Jeffrey Shi Kai Chan Muthia Cenderadewi Ginenus Fekadu Bibha Dhungel Narasimha M. Beeraka Muhammad Abdul Basit Ashraf Ildar Ravisovich Fakhradiyev Rafat Ali Qorinah Estiningtyas Sakilah Adnani Niroj Bhandari Balasubramanian Ganesh Tauseef Ahmad Syed Mohamed Aljunid Biswajit Banik Samath Dhamminda Dharmaratne Hitesh Chopra Siddhartha Dutta Sumbul Ansari Sajjad Ahmad An Tian Chen Anil Raj Assariparambil Sirshendu Chaudhuri Arushee Bhatnagar Mohammed Ahmed Akkaif Naveed Ahmed Syed Mohammed Basheeruddin Asdaq Mohammed Usman Ali Mainak Bardhan Ajay Nagesh Bhat Khabir Ahmad Sreedhar Dharmagadda Chiranjib Chakraborty Yuni Asri Sridevi G Artyom Urievich Gil Amol S. Dhane Priyadarshini Bhattacharjee Xueting Ding Jiyeon Oh Syed Yusuf Ali Thao Huynh Phuong Do Shehab Uddin Al Abid Tae Hyeon Kim Sandip Chakraborty Hyesu Jo Haiyan Chen Sunghyun Chung Ojas Prakashbhai Doshi Xiang Gao Kabilan Annadurai Nurila Aryntayeva Qorinah Estiningtyas Sakilah Adnani Samiun Nazrin Bente Kamal Tune Md Al-Mamun Aram Mahmood Ahmed Huyen Phuc Do Vinoth Gnana Chellaiyan Devanbu Syed Anees Ahmed Haroon Ahmed Guodong Ding MD Faisal Ahmed Syed Mohamed Aljunid Zareen Fatima Nadeem Shafique Butt Syed Masudur Rahman Dewan

Publication Name: Lancet Respiratory Medicine

Publication Date: 2026-03-01

Volume: 14

Issue: 3

Page Range: 233-255

Description:

Background: Chronic respiratory diseases are an important global issue, particularly in Asia, where burden patterns vary widely across countries. With more than half the world's population living in Asia, understanding the national and regional burden of chronic respiratory diseases is essential; however, research on this area remains inadequate. We aimed to investigate the burden of chronic respiratory diseases in Asia at national and regional levels, and to identify key risk factors. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study 2023 provides estimates for assessing the burden of chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease (ILD), and pulmonary sarcoidosis. We focused on 34 countries in Asia, encompassing the high-income Asia Pacific region and central, east, south, and southeast Asia. Estimates for age-standardised prevalence and disability-adjusted life-year (DALY) rates per 100 000 population, including 95% uncertainty intervals (UIs), were extracted by location, sex, year, and Socio-demographic Index (SDI). The average annual percentage change was calculated and presented as a percentage with 95% CIs. Estimates of modifiable attributable risk factors for DALYs and mortality were also included. Findings: In Asia, the age-standardised prevalence and DALY rates for chronic respiratory diseases generally declined from 1990 to 2023; however, the trend varied substantially by disease and country. In 2023, the age-standardised prevalence rate of COPD was highest in south Asia (3044·18 [95% UI 2748·67–3303·04] per 100 000 population), while the age-standardised asthma prevalence rate was highest in the high-income Asia Pacific region (4870·24 [4046·70–5962·78] per 100 000 population) and southeast Asia (4778·18 [3970·25–5735·61] per 100 000 population). Despite southeast Asia and the high-income Asia Pacific region having a similar age-standardised asthma prevalence rate, southeast Asia had a higher age-standardised DALY rate (508·67 [95% UI 394·89–669·92] per 100 000 population) compared with the high-income Asia Pacific region (204·40 [129·23–290·41] per 100 000 population). A decrease in the age-standardised DALY rate for chronic respiratory diseases was observed with increasing SDI, contrasting with its prevalence patterns. Age-standardised DALY rates of COPD decreased in all Asian countries except for Georgia (average annual percentage change 1·37 [95% CI 1·26–1·48]) and Kazakhstan (0·73 [0·55–0·93]), and age-standardised DALY rates of asthma decreased in all countries. Smoking and ambient particulate matter pollution were identified as leading attributable risk factors for chronic respiratory diseases across Asia. Household air pollution from solid fuels was a regionally pronounced risk factor for chronic respiratory diseases, particularly in south Asia (age-standardised DALY rate 657·58 [95% UI 485·04–880·45] per 100 000 population). Although smoking was a major risk factor in males, ambient particulate matter pollution and secondhand smoke emerged as important attributable risk factors for chronic respiratory diseases in females. Interpretation: Countries with lower SDI had markedly higher DALY rates, highlighting the need to address socioeconomic and health-care inequities. Household air pollution from solid fuels continues to impose a substantial but preventable burden in south Asia, calling for clean energy adoption and improved ventilation. Funding: Gates Foundation.

Open Access: Yes

DOI: 10.1016/S2213-2600(25)00404-7

Authors - 102

Mohammad Fareed

24491815600

Giridhara Rathnaiah Babu

25923306400

Shankar M. Bakkannavar

34970692400

Anurag Agrawal

35214460700

Mahaveer Golechha

36006347600

Jesu Arockiaraj

36150120800

Devananda Devegowda

36815720100

Atif Amin Baig

49460999600

Rupesh K. Gautam

55216656700

Ferry Efendi

55301269100

Mahwish Arooj

55599732000

Vijay Kumar Chattu

55743746500

Ripon Kumar Adhikary

55847469100

Narayan Babu Dhital

56147244400

Anup Bhat

56204883400

Dinh Toi Chu

56239816300

Ashish D. Badiye

56340201200

Tahira Ashraf

56366752600

Ibrahim Elsohaby

56401825200

Saurav Basu

56925914600

Ayesha Fahim

56996903600

Syed Amir Ashraf

56999974100

Jaeyu Park

57092892800

Syed Shujait Ali

57188688612

Sheikh Mohammad Alif

57190228064

Jeetendra Bhandari

57190685987

Arun Ghuge

57193322557

Ahmad Naoras Bitar

57193844216

Mohammad Shahangir Biswas

57194219452

Linh Phuong Bui

57195126817

Bijit Biswas

57200084942

Syed Mahfuz Al Hasan

57201069050

Awais Altaf

57201900507

Zahid A. Butt

57202522739

Danish Ahmad

57202805842

Min Seo Kim

57203591936

Khurshid Alam

57203681299

Jeffrey Shi Kai Chan

57203968284

Muthia Cenderadewi

57206668799

Ginenus Fekadu

57207252461

Bibha Dhungel

57209098892

Narasimha M. Beeraka

57209468586

Muhammad Abdul Basit Ashraf

57209568307

Ildar Ravisovich Fakhradiyev

57210120213

Rafat Ali

57211501723

Qorinah Estiningtyas Sakilah Adnani

57211604149

Niroj Bhandari

57212808140

Balasubramanian Ganesh

57213155679

Tauseef Ahmad

57214283386

Syed Mohamed Aljunid

57215378130

Biswajit Banik

57216204052

Samath Dhamminda Dharmaratne

57216324802

Hitesh Chopra

57217071283

Siddhartha Dutta

57217989206

Sumbul Ansari

57218630101

Sajjad Ahmad

57218961022

An Tian Chen

57219562045

Anil Raj Assariparambil

57220063090

Sirshendu Chaudhuri

57222398739

Arushee Bhatnagar

57222548401

Mohammed Ahmed Akkaif

57222709271

Naveed Ahmed

57650122100

Syed Mohammed Basheeruddin Asdaq

57721016100

Mohammed Usman Ali

57726370200

Mainak Bardhan

57819452400

Ajay Nagesh Bhat

57819974900

Khabir Ahmad

57927912600

Sreedhar Dharmagadda

57948125000

Chiranjib Chakraborty

57983357900

Yuni Asri

58139309900

Sridevi G

58158331500

Artyom Urievich Gil

58284852000

Amol S. Dhane

58542222900

Priyadarshini Bhattacharjee

58581938400

Xueting Ding

58616117500

Jiyeon Oh

58640500100

Syed Yusuf Ali

58640508800

Thao Huynh Phuong Do

58955491100

Shehab Uddin Al Abid

58984765000

Tae Hyeon Kim

59007672300

Sandip Chakraborty

59126608900

Hyesu Jo

59145815900

Haiyan Chen

59407736200

Sunghyun Chung

59667270000

Ojas Prakashbhai Doshi

59748102300

Xiang Gao

59849889300

Kabilan Annadurai

59942051700

Nurila Aryntayeva

59998436200

Qorinah Estiningtyas Sakilah Adnani

60038796000

Samiun Nazrin Bente Kamal Tune

60174938000

Md Al-Mamun

60175570700

Aram Mahmood Ahmed

60175690400

Huyen Phuc Do

60211218200

Vinoth Gnana Chellaiyan Devanbu

60262699600

Syed Anees Ahmed

60262936500

Haroon Ahmed

60271518200

Guodong Ding

60410580300

MD Faisal Ahmed

60435872600

Syed Mohamed Aljunid

6504304159

Zareen Fatima

6507874697

Nadeem Shafique Butt

7003613681

Syed Masudur Rahman Dewan

7102176358