Urticaria in China: Incidence, Prevalence, and Disability-adjusted Life Years Compared with G20 Countries: Findings from the Global Burden of Disease Study 2021

Overview

Journal Arch Dermatol Res

Specialty Dermatology

Date 2025 Mar 12

PMID 40072594

Authors

Weijia Zhao

Haihui Yang

Jiao Liu

Xixi Jin

Xiaoyuan Xie

Yunsheng Liang

Affiliations

Soon will be listed here.

Abstract

Urticaria has become a major public health challenge in China, yet comprehensive national data assessments are lacking. This study analyzes the burden of urticaria in China compared to G20 countries from 1990 to 2021. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we examined the incidence, prevalence, and disability-adjusted life years (DALYs) of urticaria by age and sex in China. Temporal trends were assessed using Average Annual Percent Change (AAPC) estimates. We also decomposed the changes in new cases, patient numbers, and urticaria burden in G20 countries and globally from 1990 to 2021. In 2021, China reported 17.30 million (95% uncertainty interval, 15.37-19.25) new cases of urticaria, 9.87 million (8.72-10.99) existing cases of urticaria, and 0.59 million (0.39-0.82) DALYs due to urticaria, ranking second among G20 countries. These metrics peaked in females under 5 years old. Age-standardized rates in China were lower than the global average and remained stable from 1990 to 2021. The under-5 age group showed the fastest growth in prevalence and DALY rates. The number of urticaria patients increased by 8.52%, with population growth contributing 19.86%, aging - 11.31%, and age-specific prevalence - 0.03%. Despite stable age-standardized rates, the absolute burden of urticaria in China has risen, particularly among females under 5 years old, highlighting the need for targeted public health interventions. Improving public emergency awareness and response is critical for urticaria patients, who may develop severe systemic diseases and fatal allergic symptoms.

References

Zuberbier T, Abdul Latiff A, Abuzakouk M, Aquilina S, Asero R, Baker D . The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2021; 77(3):734-766. DOI: 10.1111/all.15090. View

Kolkhir P, Gimenez-Arnau A, Kulthanan K, Peter J, Metz M, Maurer M . Urticaria. Nat Rev Dis Primers. 2022; 8(1):61. DOI: 10.1038/s41572-022-00389-z. View

Goncalo M, Gimenez-Arnau A, Al-Ahmad M, Ben-Shoshan M, Bernstein J, Ensina L . The global burden of chronic urticaria for the patient and society. Br J Dermatol. 2020; 184(2):226-236. DOI: 10.1111/bjd.19561. View

Maurer M, Abuzakouk M, Berard F, Canonica W, Oude Elberink H, Gimenez-Arnau A . The burden of chronic spontaneous urticaria is substantial: Real-world evidence from ASSURE-CSU. Allergy. 2017; 72(12):2005-2016. PMC: 5724512. DOI: 10.1111/all.13209. View

Zazzali J, Broder M, Chang E, Chiu M, Hogan D . Cost, utilization, and patterns of medication use associated with chronic idiopathic urticaria. Ann Allergy Asthma Immunol. 2012; 108(2):98-102. DOI: 10.1016/j.anai.2011.10.018. View

Hagstrom E, Patel S, Karimkhani C, Boyers L, Williams H, Hay R . Comparing cutaneous research funded by the US National Institutes of Health (NIH) with the US skin disease burden. J Am Acad Dermatol. 2015; 73(3):383-91.e1. DOI: 10.1016/j.jaad.2015.04.039. View

Chen L, Huang X, Xiao Y, Su J, Shen M, Chen X . Prevalence and risk factors of atopic dermatitis, psoriasis, acne, and urticaria in China. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020; 45(4):449-455. DOI: 10.11817/j.issn.1672-7347.2020.190115. View

Zhang X, Song X, Zhang M, Li C, Huang Z, Liu B . Prevalence and risk factors of chronic urticaria in China: A nationwide cross-sectional study. Allergy. 2022; 77(7):2233-2236. DOI: 10.1111/all.15287. View

Xiao Y, Huang X, Jing D, Huang Y, Chen L, Zhang X . The Prevalence of Atopic Dermatitis and Chronic Spontaneous Urticaria are Associated with Parental Socioeconomic Status in Adolescents in China. Acta Derm Venereol. 2018; 99(3):321-326. DOI: 10.2340/00015555-3104. View

10.

Dieleman J, Cowling K, Agyepong I, Alkenbrack S, Bollyky T, Bump J . The G20 and development assistance for health: historical trends and crucial questions to inform a new era. Lancet. 2019; 394(10193):173-183. DOI: 10.1016/S0140-6736(19)31333-9. View

11.

Clegg L, Hankey B, Tiwari R, Feuer E, Edwards B . Estimating average annual per cent change in trend analysis. Stat Med. 2009; 28(29):3670-82. PMC: 2843083. DOI: 10.1002/sim.3733. View

12.

Xu T, Wang B, Liu H, Wang H, Yin P, Dong W . Prevalence and causes of vision loss in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019. Lancet Public Health. 2020; 5(12):e682-e691. DOI: 10.1016/S2468-2667(20)30254-1. View

13.

Raciborski F, Klak A, Czarnecka-Operacz M, Jenerowicz D, Sybilski A, Kuna P . Epidemiology of urticaria in Poland - nationally representative survey results. Postepy Dermatol Alergol. 2018; 35(1):67-73. PMC: 5872247. DOI: 10.5114/ada.2018.73165. View

14.

Chen Y, Yu M, Huang X, Tu P, Shi P, Maurer M . Omalizumab treatment and outcomes in Chinese patients with chronic spontaneous urticaria, chronic inducible urticaria, or both. World Allergy Organ J. 2021; 14(1):100501. PMC: 7804987. DOI: 10.1016/j.waojou.2020.100501. View

15.

Wang Y, Du L, Zhu Y . Evidence-based therapies of Chinese medicine for chronic urticaria: Where do we stand and where are we going?. Chin J Integr Med. 2016; 23(8):566-569. DOI: 10.1007/s11655-016-2533-y. View

16.

Gold M, Pineda-Farias J, Close D, Patel S, Johnston P, Stocker S . Subcutaneous administration of a novel TRPM8 antagonist reverses cold hypersensitivity while attenuating the drop in core body temperature. Br J Pharmacol. 2024; 181(18):3527-3543. DOI: 10.1111/bph.16429. View

17.

Kulthanan K, Chusakul S, Recto M, Gabriel M, Aw D, Prepageran N . Economic Burden of the Inadequate Management of Allergic Rhinitis and Urticaria in Asian Countries Based on the GA²LEN Model. Allergy Asthma Immunol Res. 2018; 10(4):370-378. PMC: 6021592. DOI: 10.4168/aair.2018.10.4.370. View

18.

Andiappan A, Puan K, Lee B, Nardin A, Poidinger M, Connolly J . Allergic airway diseases in a tropical urban environment are driven by dominant mono-specific sensitization against house dust mites. Allergy. 2014; 69(4):501-9. PMC: 4240470. DOI: 10.1111/all.12364. View

19.

Mehta V, Ajmera P, Kalra S, Miraj M, Gallani R, Shaik R . Human resource shortage in India's health sector: a scoping review of the current landscape. BMC Public Health. 2024; 24(1):1368. PMC: 11110446. DOI: 10.1186/s12889-024-18850-x. View

20.

Dolgin E . Why autoimmune disease is more common in women: X chromosome holds clues. Nature. 2024; 626(7999):466. DOI: 10.1038/d41586-024-00267-6. View