Incidence and Mortality Trends of Upper Respiratory Infections in China and Other Asian Countries from 1990 to 2019

Respiratory infections remain a major public health problem, affecting people of all age groups, but there is still a lack of studies analyzing the burden of upper respiratory infections (URIs) in Asian countries. We used the data from the Global Burden of Diseases Study 2019 results to assess the current status and trends of URI burden from 1990 to 2019 in Asian countries. We found that Thailand had the highest age-standardized incidence rate (ASIR) of URI both in 1990 (354,857.14 per 100,000) and in 2019 (344,287.93 per 100,000); and the highest age-standardized mortality rate (ASMR) was in China in 1990 (2.377 per 100,000), and in Uzbekistan in 2019 (0.418 per 100,000). From 1990 to 2019, ASIRs of URI slightly increased in several countries, with the speediest in Pakistan (estimated annual percentage change [EAPC] = 0.404%, 95% CI, 0.322% to 0.486%); and Kuwait and Singapore had uptrends of ASMRs, at a speed of an average 3.332% (95% CI, 2.605% to 4.065%) and 3.160% (95% CI, 1.971% to 4.362%) per year, respectively. The age structure of URI was similar at national, Asian and Global levels. Children under the age of five had the highest incidence rate, and the elderly had the highest mortality rate of URI. Asian countries with a Socio-demographic Index between 0.5 and 0.7 had relatively lower ASIRs but higher ASMRs of URIs. The declined rate of URI ASMR in Asian countries was more pronounced in higher baseline (ASMR in 1990) countries. Our findings suggest that there was a huge burden of URI cases in Asia that affected vulnerable and impoverished people's livelihoods. Continuous and high-quality surveillance data across Asian countries are needed to improve the estimation of the disease burden attributable to URIs, and the best public health interventions are needed to curb this burden.