ArticleJournal of translational autoimmunity2025
Divergent trajectories of inflammatory bowel disease in East, South, South-East and Central Asia: A comprehensive GBD 2021 analysis.
Article in Journal of translational autoimmunity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Corrections and comments
- Erratum issued
Authors and funding
4 authors.
Funding
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Abstract
Background: Inflammatory bowel disease (IBD) is no longer confined to Western populations; its burden is rising across Asia, a region with marked demographic, economic, and health-system heterogeneity. Quantifying contemporary trends and their drivers is essential for region-tailored policy. We aimed to provide the first continent-wide, methodologically harmonized assessment of temporal trends, demographic-epidemiologic determinants, and projections of IBD burden in Asia. Methods: We extracted country-specific incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) for 1990-2021 from the Global Burden of Disease 2021 for 43 Asian countries/territories. Age-standardized rates (ASRs) were summarized using estimated annual percentage change (EAPC). An additive Das-Gupta decomposition apportioned absolute changes in cases and DALYs to population growth, population ageing, and epidemiologic change. Bayesian age-period-cohort models projected burden to 2040. Results: From 1990 to 2021, prevalent IBD cases more than doubled (0.54 million→1.34 million) and incident cases nearly tripled. Age-standardized prevalence (ASPR) and incidence (ASIR) rose by 25 % (EAPC 0.98 %) and 34 % (EAPC 1.17 %), respectively. In contrast, the age-standardized death rate declined from 0.50 to 0.30 per 100 000 (EAPC -1.97 %), and the DALY rate fell by 32 % (16.1 → 11.0 per 100 000; EAPC -1.30 %). Decomposition attributed 56 % of additional prevalent cases to population growth, 20 % to ageing, and 24 % to rising age-specific rates. East Asia showed the fastest proportional rise in ASIR yet the steepest DALY decline; Central Asia maintained the highest per-capita disability load; and Southeast Asia remained a low-burden plateau. Projections indicate continued prevalence growth in South and Central Asia, epidemiologic stabilization in East Asia, and sustained low burden in Southeast Asia by 2040. Conclusions: Asia is experiencing a dual dynamic of expanding IBD caseload alongside improving survival and disability outcomes, with pronounced sub-regional heterogeneity. Demography remains the principal driver of case growth, but genuine increases in age-specific incidence signal ongoing propagation of risk. Strengthening surveillance, expanding equitable access to advanced therapies, and implementing region-specific, longitudinal care pathways are imperative to avert disproportionate future disability and economic loss.
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