The burden of asthma, hay fever and eczema in children in 25 countries: GAN Phase I study

There have been no worldwide standardised surveys of prevalence and severity of asthma, rhinoconjunctivitis and eczema in school children for 15 years. The present study aims to provide this information.Following the exact International Study of Asthma and Allergies in Childhood (ISAAC) methodology (cross-sectional questionnaire-based survey) the Global Asthma Network (GAN) Phase I was carried out between 2015 and 2020 in many centres worldwide.The study included 157 784 adolescents (13-14 years of age) in 63 centres, in 25 countries; and 101 777 children (6-7 years of age) in 44 centres, in 16 countries. The current prevalence of symptoms, respectively, was: 11.0% and 9.1% for asthma; 13.3% and 7.7% for rhinoconjunctivitis; and 6.4% and 5.9% for eczema. For asthma ever, hay fever ever and eczema ever prevalence was 10.5% and 7.6%; 15.2% and 11.1%; and 10.6% and 13.4%. Centres in countries with low- or lower-middle- gross national income (LICs or L-MICs) had significantly lower prevalence of the three disease symptoms and diagnoses (except for hay fever). In children, the prevalence of asthma and rhinoconjunctivitis symptoms were higher in males, while the reverse occurred among adolescents. For eczema, while the prevalence among female adolescents was double that of males, there was no sex difference among children. Centre accounted for a non-negligible variability of all disease symptoms (10% to 20%).The burden of asthma, rhinoconjunctivitis and eczema vary widely among the limited number of countries studied. Although symptom prevalence is lower in LICs and L-MICs, it represents a considerable burden everywhere studied.