Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019
Background: Asthma and atopic dermatitis (AD) are chronic allergic conditions, along with allergic rhinitis and food allergy and cause high morbidity and mortality both in children and adults. This study aims to evaluate the global, regional, national, and temporal trends of the burden of asthma and...
- Autores:
-
Shin, Youn Ho
Hwang, Jimin
Kwon, Rosie
Lee, Seung Won
Kim, Min Seo
Shin, Jae Il
Yon, Dong Keon
Abate, Yohannes Habtegiorgis
Abbasi-Kangevari, Mohsen
Abbasi-Kangevari, Zeinab
Abdelmasseh, Michael
Abdulah, Deldar Morad
- Tipo de recurso:
- Article of investigation
- Fecha de publicación:
- 2023
- Institución:
- Corporación Universidad de la Costa
- Repositorio:
- REDICUC - Repositorio CUC
- Idioma:
- eng
- OAI Identifier:
- oai:repositorio.cuc.edu.co:11323/13934
- Acceso en línea:
- https://hdl.handle.net/11323/13934
https://repositorio.cuc.edu.co/
- Palabra clave:
- Asthma
Atopic dermatitis
Disability-adjusted life years
Eczema
Epidemiology
Global burden
Mortality
- Rights
- embargoedAccess
- License
- Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)
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|
dc.title.eng.fl_str_mv |
Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019 |
title |
Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019 |
spellingShingle |
Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019 Asthma Atopic dermatitis Disability-adjusted life years Eczema Epidemiology Global burden Mortality |
title_short |
Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019 |
title_full |
Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019 |
title_fullStr |
Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019 |
title_full_unstemmed |
Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019 |
title_sort |
Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019 |
dc.creator.fl_str_mv |
Shin, Youn Ho Hwang, Jimin Kwon, Rosie Lee, Seung Won Kim, Min Seo Shin, Jae Il Yon, Dong Keon Abate, Yohannes Habtegiorgis Abbasi-Kangevari, Mohsen Abbasi-Kangevari, Zeinab Abdelmasseh, Michael Abdulah, Deldar Morad |
dc.contributor.author.none.fl_str_mv |
Shin, Youn Ho Hwang, Jimin Kwon, Rosie Lee, Seung Won Kim, Min Seo Shin, Jae Il Yon, Dong Keon Abate, Yohannes Habtegiorgis Abbasi-Kangevari, Mohsen Abbasi-Kangevari, Zeinab Abdelmasseh, Michael Abdulah, Deldar Morad |
dc.subject.proposal.none.fl_str_mv |
Asthma |
topic |
Asthma Atopic dermatitis Disability-adjusted life years Eczema Epidemiology Global burden Mortality |
dc.subject.proposal.eng.fl_str_mv |
Atopic dermatitis Disability-adjusted life years Eczema Epidemiology Global burden Mortality |
description |
Background: Asthma and atopic dermatitis (AD) are chronic allergic conditions, along with allergic rhinitis and food allergy and cause high morbidity and mortality both in children and adults. This study aims to evaluate the global, regional, national, and temporal trends of the burden of asthma and AD from 1990 to 2019 and analyze their associations with geographic, demographic, social, and clinical factors. Methods: Using data from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2019, we assessed the age-standardized prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of both asthma and AD from 1990 to 2019, stratified by geographic region, age, sex, and socio-demographic index (SDI). DALYs were calculated as the sum of years lived with disability and years of life lost to premature mortality. Additionally, the disease burden of asthma attributable to high body mass index, occupational asthmagens, and smoking was described. Results: In 2019, there were a total of 262 million [95% uncertainty interval (UI): 224–309 million] cases of asthma and 171 million [95% UI: 165–178 million] total cases of AD globally; age-standardized prevalence rates were 3416 [95% UI: 2899–4066] and 2277 [95% UI: 2192–2369] per 100,000 population for asthma and AD, respectively, a 24.1% [95% UI: −27.2 to −20.8] decrease for asthma and a 4.3% [95% UI: 3.8–4.8] decrease for AD compared to baseline in 1990. Both asthma and AD had similar trends according to age, with age-specific prevalence rates peaking at age 5–9 years and rising again in adulthood. The prevalence and incidence of asthma and AD were both higher for individuals with higher SDI; however, mortality and DALYs rates of individuals with asthma had a reverse trend, with higher mortality and DALYs rates in those in the lower SDI quintiles. Of the three risk factors, high body mass index contributed to the highest DALYs and deaths due to asthma, accounting for a total of 3.65 million [95% UI: 2.14–5.60 million] asthma DALYs and 75,377 [95% UI: 40,615–122,841] asthma deaths. Conclusions: Asthma and AD continue to cause significant morbidity worldwide, having increased in total prevalence and incidence cases worldwide, but having decreased in age-standardized prevalence rates from 1990 to 2019. Although both are more frequent at younger ages and more prevalent in high-SDI countries, each condition has distinct temporal and regional characteristics. Understanding the temporospatial trends in the disease burden of asthma and AD could guide future policies and interventions to better manage these diseases worldwide and achieve equity in prevention, diagnosis, and treatment. |
publishDate |
2023 |
dc.date.issued.none.fl_str_mv |
2023-08 |
dc.date.accessioned.none.fl_str_mv |
2025-01-21T14:20:13Z |
dc.date.available.none.fl_str_mv |
2025-08 2025-01-21T14:20:13Z |
dc.type.none.fl_str_mv |
Artículo de revista |
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http://purl.org/coar/resource_type/c_2df8fbb1 |
dc.type.content.none.fl_str_mv |
Text |
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info:eu-repo/semantics/article |
dc.type.redcol.none.fl_str_mv |
http://purl.org/redcol/resource_type/ART |
dc.type.version.none.fl_str_mv |
info:eu-repo/semantics/draft |
dc.type.coarversion.none.fl_str_mv |
http://purl.org/coar/version/c_b1a7d7d4d402bcce |
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Shin YH, Hwang J, Kwon R, et al. Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019. Allergy. 2023; 78: 2232-2254. doi:10.1111/all.15807 |
dc.identifier.issn.none.fl_str_mv |
0105-4538 |
dc.identifier.uri.none.fl_str_mv |
https://hdl.handle.net/11323/13934 |
dc.identifier.doi.none.fl_str_mv |
10.1111/all.15807 |
dc.identifier.eissn.none.fl_str_mv |
1398-9995 |
dc.identifier.instname.none.fl_str_mv |
Corporación Universidad de la Costa |
dc.identifier.reponame.none.fl_str_mv |
REDICUC - Repositorio CUC |
dc.identifier.repourl.none.fl_str_mv |
https://repositorio.cuc.edu.co/ |
identifier_str_mv |
Shin YH, Hwang J, Kwon R, et al. Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019. Allergy. 2023; 78: 2232-2254. doi:10.1111/all.15807 0105-4538 10.1111/all.15807 1398-9995 Corporación Universidad de la Costa REDICUC - Repositorio CUC |
url |
https://hdl.handle.net/11323/13934 https://repositorio.cuc.edu.co/ |
dc.language.iso.none.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartofjournal.none.fl_str_mv |
Allergy: European Journal of Allergy and Clinical Immunology |
dc.relation.references.none.fl_str_mv |
Yang JM, Koh HY, Moon SY, et al. Allergic disorders and susceptibility to and severity of COVID-19: a nationwide cohort study. J Allergy Clin Immunol. 2020; 146(4): 790-798. Lee SW, Shin YH, Shin JI, et al. Fracture incidence in children after developing atopic dermatitis: a Korean nationwide birth cohort study. Allergy. 2023; 78(3): 871-875. Pearce N, Sunyer J, Cheng S, et al. Comparison of asthma prevalence in the ISAAC and the ECRHS. ISAAC Steering Committee and the European Community Respiratory Health Survey. International Study of Asthma and Allergies in Childhood. Eur Respir J. 2000; 16(3): 420-426. Alavinezhad A, Boskabady MH. The prevalence of asthma and related symptoms in Middle East countries. Clin Respir J. 2018; 12(3): 865-877. Koo MJ, Kwon R, Lee SW, et al. National trends in the prevalence of allergic diseases among Korean adolescents before and during COVID-19, 2009-2021: a serial analysis of the national representative study. Allergy. 2022; 78: 1665-1670. Yaghoubi M, Adibi A, Safari A, FitzGerald JM, Sadatsafavi M. The projected economic and health burden of uncontrolled asthma in the United States. Am J Respir Crit Care Med. 2019; 200(9): 1102-1112. Strachan DP. Family size, infection and atopy: the first decade of the “hygiene hypothesis”. Thorax. 2000; 55(Suppl 1): S2-S10. Schaub B, Lauener R, von Mutius E. The many faces of the hygiene hypothesis. J Allergy Clin Immunol. 2006; 117(5): 969-977. quiz 978. Carroll K. Socioeconomic status, race/ethnicity, and asthma in youth. Am J Respir Crit Care Med. 2013; 188(10): 1180-1181. Martinez A, de la Rosa R, Mujahid M, Thakur N. Structural racism and its pathways to asthma and atopic dermatitis. J Allergy Clin Immunol. 2021; 148(5): 1112-1120. Inselman JW, Jeffery MM, Maddux JT, Shah ND, Rank MA. Trends and disparities in asthma biologic use in the United States. J Allergy Clin Immunol Pract. 2020; 8(2): 549-554.e1. Laughter MR, Maymone MBC, Mashayekhi S, et al. The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990-2017. Br J Dermatol. 2021; 184(2): 304-309. GBD Chronic Respiratory Disease Collaborators. Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir Med. 2020; 8(6): 585-596. Lee HH, Patel KR, Singam V, Rastogi S, Silverberg JI. A systematic review and meta-analysis of the prevalence and phenotype of adult-onset atopic dermatitis. J Am Acad Dermatol. 2019; 80(6): 1526-1532.e7. GBD 2019 Demographics Collaborators. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258): 1160-1203. Smith L, Shin JI, Hwang SY, et al. Global Burden of Disease study at the World Health Organization: research methods for the most comprehensive global study of disease and underlying health policies. Life Cycle. 2022; 2:e8. Woo A, Lee SW, Koh HY, Kim MA, Han MY, Yon DK. Incidence of cancer after asthma development: 2 independent population-based cohort studies. J Allergy Clin Immunol. 2021; 147(1): 135-143. Lee SW, Yon DK, James CC, et al. Short-term effects of multiple outdoor environmental factors on risk of asthma exacerbations: age-stratified time-series analysis. J Allergy Clin Immunol. 2019; 144(6): 1542-1550.e1. Vos T, Lim SS, Abbafati C, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258): 1204-1222. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018; 392(10159): 1789-1858. Murray CJL, Aravkin AY, Zheng P, et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258): 1223-1249. GBD 2020 Alcohol Collaborators. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020. Lancet. 2022; 400(10347): 185-235. Barbarot S, Auziere S, Gadkari A, et al. Epidemiology of atopic dermatitis in adults: results from an international survey. Allergy. 2018; 73(6): 1284-1293. Enilari O, Sinha S. The global impact of asthma in adult populations. Ann Glob Health. 2019; 85(1):2. Smirnova J, Montgomery S, Lindberg M, Svensson Å, von Kobyletzki L. Associations of self-reported atopic dermatitis with comorbid conditions in adults: a population-based cross-sectional study. BMC Dermatol. 2020; 20(1): 23. Asher MI, Montefort S, Björkstén B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet. 2006; 368(9537): 733-743. Asher MI, García-Marcos L, Pearce NE, Strachan DP. Trends in worldwide asthma prevalence. Eur Respir J. 2020; 56(6):2002094. Asher MI, Rutter CE, Bissell K, et al. Worldwide trends in the burden of asthma symptoms in school-aged children: global asthma network phase I cross-sectional study. Lancet. 2021; 398(10311): 1569-1580. To T, Stanojevic S, Moores G, et al. Global asthma prevalence in adults: findings from the cross-sectional world health survey. BMC Public Health. 2012; 12: 204. Aaron SD, Boulet LP, Reddel HK, Gershon AS. Underdiagnosis and overdiagnosis of asthma. Am J Respir Crit Care Med. 2018; 198(8): 1012-1020. Shin YH, Lee SW, Yon DK. Single inhaler as maintenance and reliever therapy (SMART) in childhood asthma in 2021: the paradigm shift in the inhaled corticosteroids reliever therapy era. J Allergy Clin Immunol Pract. 2021; 9(10): 3819-3820. Cloutier MM, Baptist AP, Blake KV, et al. 2020 focused updates to the asthma management guidelines: a report from the National Asthma Education and prevention program coordinating committee expert panel working group. J Allergy Clin Immunol. 2020; 146(6): 1217-1270. Cho YM, Kim CB, Yeon KN, Lee ES, Kim K. Trends in the prevalence of childhood asthma in Seoul Metropolitan City, Korea: the Seoul atopy asthma-friendly school project. J Prev Med Public Health. 2018; 51(6): 275-280. Williams H, Stewart A, von Mutius E, Cookson W, Anderson HR. Is eczema really on the increase worldwide? J Allergy Clin Immunol. 2008; 121(4): 947-954.e15. Gibson PG, McDonald VM, Marks GB. Asthma in older adults. Lancet. 2010; 376(9743): 803-813. Deckers IA, McLean S, Linssen S, Mommers M, van Schayck CP, Sheikh A. Investigating international time trends in the incidence and prevalence of atopic eczema 1990–2010: a systematic review of epidemiological studies. PLoS ONE. 2012; 7(7):e39803. Cruz ÁA, Stelmach R, Ponte EV. Asthma prevalence and severity in low-resource communities. Curr Opin Allergy Clin Immunol. 2017; 17(3): 188-193. Cooper PJ, Rodrigues LC, Cruz AA, Barreto ML. Asthma in Latin America: a public heath challenge and research opportunity. Allergy. 2009; 64(1): 5-17. Lenney W, Bush A, Fitzgerald DA, et al. Improving the global diagnosis and management of asthma in children. Thorax. 2018; 73(7): 662-669. Østergaard MS, Nantanda R, Tumwine JK, Aabenhus R. Childhood asthma in low income countries: an invisible killer? Prim Care Respir J. 2012; 21(2): 214-219. Woods ER, Bhaumik U, Sommer SJ, et al. Community asthma initiative to improve health outcomes and reduce disparities among children with asthma. MMWR Suppl. 2016; 65(1): 11-20. |
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2232 |
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8 |
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© 2024 Elsevier B.V. |
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Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0) |
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https://creativecommons.org/licenses/by-nc-nd/4.0/ |
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Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0) © 2024 Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/ http://purl.org/coar/access_right/c_f1cf |
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23 páginas |
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Wiley-Blackwell Publishing Ltd |
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United Kingdom |
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Wiley-Blackwell Publishing Ltd |
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https://onlinelibrary.wiley.com/doi/abs/10.1111/all.15807?getft_integrator=scopus&utm_source=scopus |
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Corporación Universidad de la Costa |
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Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)© 2024 Elsevier B.V.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/embargoedAccesshttp://purl.org/coar/access_right/c_f1cfShin, Youn HoHwang, JiminKwon, RosieLee, Seung WonKim, Min SeoShin, Jae IlYon, Dong KeonAbate, Yohannes HabtegiorgisAbbasi-Kangevari, MohsenAbbasi-Kangevari, ZeinabAbdelmasseh, MichaelAbdulah, Deldar Morad2025-01-21T14:20:13Z2025-082025-01-21T14:20:13Z2023-08Shin YH, Hwang J, Kwon R, et al. Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019. Allergy. 2023; 78: 2232-2254. doi:10.1111/all.158070105-4538https://hdl.handle.net/11323/1393410.1111/all.158071398-9995Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/Background: Asthma and atopic dermatitis (AD) are chronic allergic conditions, along with allergic rhinitis and food allergy and cause high morbidity and mortality both in children and adults. This study aims to evaluate the global, regional, national, and temporal trends of the burden of asthma and AD from 1990 to 2019 and analyze their associations with geographic, demographic, social, and clinical factors. Methods: Using data from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2019, we assessed the age-standardized prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of both asthma and AD from 1990 to 2019, stratified by geographic region, age, sex, and socio-demographic index (SDI). DALYs were calculated as the sum of years lived with disability and years of life lost to premature mortality. Additionally, the disease burden of asthma attributable to high body mass index, occupational asthmagens, and smoking was described. Results: In 2019, there were a total of 262 million [95% uncertainty interval (UI): 224–309 million] cases of asthma and 171 million [95% UI: 165–178 million] total cases of AD globally; age-standardized prevalence rates were 3416 [95% UI: 2899–4066] and 2277 [95% UI: 2192–2369] per 100,000 population for asthma and AD, respectively, a 24.1% [95% UI: −27.2 to −20.8] decrease for asthma and a 4.3% [95% UI: 3.8–4.8] decrease for AD compared to baseline in 1990. Both asthma and AD had similar trends according to age, with age-specific prevalence rates peaking at age 5–9 years and rising again in adulthood. The prevalence and incidence of asthma and AD were both higher for individuals with higher SDI; however, mortality and DALYs rates of individuals with asthma had a reverse trend, with higher mortality and DALYs rates in those in the lower SDI quintiles. Of the three risk factors, high body mass index contributed to the highest DALYs and deaths due to asthma, accounting for a total of 3.65 million [95% UI: 2.14–5.60 million] asthma DALYs and 75,377 [95% UI: 40,615–122,841] asthma deaths. Conclusions: Asthma and AD continue to cause significant morbidity worldwide, having increased in total prevalence and incidence cases worldwide, but having decreased in age-standardized prevalence rates from 1990 to 2019. Although both are more frequent at younger ages and more prevalent in high-SDI countries, each condition has distinct temporal and regional characteristics. Understanding the temporospatial trends in the disease burden of asthma and AD could guide future policies and interventions to better manage these diseases worldwide and achieve equity in prevention, diagnosis, and treatment.23 páginasapplication/pdfengWiley-Blackwell Publishing LtdUnited Kingdomhttps://onlinelibrary.wiley.com/doi/abs/10.1111/all.15807?getft_integrator=scopus&utm_source=scopusGlobal, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019Artículo de revistahttp://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/drafthttp://purl.org/coar/version/c_b1a7d7d4d402bcceAllergy: European Journal of Allergy and Clinical ImmunologyYang JM, Koh HY, Moon SY, et al. Allergic disorders and susceptibility to and severity of COVID-19: a nationwide cohort study. J Allergy Clin Immunol. 2020; 146(4): 790-798.Lee SW, Shin YH, Shin JI, et al. Fracture incidence in children after developing atopic dermatitis: a Korean nationwide birth cohort study. Allergy. 2023; 78(3): 871-875.Pearce N, Sunyer J, Cheng S, et al. Comparison of asthma prevalence in the ISAAC and the ECRHS. ISAAC Steering Committee and the European Community Respiratory Health Survey. International Study of Asthma and Allergies in Childhood. Eur Respir J. 2000; 16(3): 420-426.Alavinezhad A, Boskabady MH. The prevalence of asthma and related symptoms in Middle East countries. Clin Respir J. 2018; 12(3): 865-877.Koo MJ, Kwon R, Lee SW, et al. National trends in the prevalence of allergic diseases among Korean adolescents before and during COVID-19, 2009-2021: a serial analysis of the national representative study. Allergy. 2022; 78: 1665-1670.Yaghoubi M, Adibi A, Safari A, FitzGerald JM, Sadatsafavi M. The projected economic and health burden of uncontrolled asthma in the United States. Am J Respir Crit Care Med. 2019; 200(9): 1102-1112.Strachan DP. Family size, infection and atopy: the first decade of the “hygiene hypothesis”. Thorax. 2000; 55(Suppl 1): S2-S10.Schaub B, Lauener R, von Mutius E. The many faces of the hygiene hypothesis. J Allergy Clin Immunol. 2006; 117(5): 969-977. quiz 978.Carroll K. Socioeconomic status, race/ethnicity, and asthma in youth. Am J Respir Crit Care Med. 2013; 188(10): 1180-1181.Martinez A, de la Rosa R, Mujahid M, Thakur N. Structural racism and its pathways to asthma and atopic dermatitis. J Allergy Clin Immunol. 2021; 148(5): 1112-1120.Inselman JW, Jeffery MM, Maddux JT, Shah ND, Rank MA. Trends and disparities in asthma biologic use in the United States. J Allergy Clin Immunol Pract. 2020; 8(2): 549-554.e1.Laughter MR, Maymone MBC, Mashayekhi S, et al. The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990-2017. Br J Dermatol. 2021; 184(2): 304-309.GBD Chronic Respiratory Disease Collaborators. Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir Med. 2020; 8(6): 585-596.Lee HH, Patel KR, Singam V, Rastogi S, Silverberg JI. A systematic review and meta-analysis of the prevalence and phenotype of adult-onset atopic dermatitis. J Am Acad Dermatol. 2019; 80(6): 1526-1532.e7.GBD 2019 Demographics Collaborators. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258): 1160-1203.Smith L, Shin JI, Hwang SY, et al. Global Burden of Disease study at the World Health Organization: research methods for the most comprehensive global study of disease and underlying health policies. Life Cycle. 2022; 2:e8.Woo A, Lee SW, Koh HY, Kim MA, Han MY, Yon DK. Incidence of cancer after asthma development: 2 independent population-based cohort studies. J Allergy Clin Immunol. 2021; 147(1): 135-143.Lee SW, Yon DK, James CC, et al. Short-term effects of multiple outdoor environmental factors on risk of asthma exacerbations: age-stratified time-series analysis. J Allergy Clin Immunol. 2019; 144(6): 1542-1550.e1.Vos T, Lim SS, Abbafati C, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258): 1204-1222.GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. 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MMWR Suppl. 2016; 65(1): 11-20.22542232878AsthmaAtopic dermatitisDisability-adjusted life yearsEczemaEpidemiologyGlobal burdenMortalityPublicationORIGINALGlobal, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019.pdfGlobal, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019.pdfapplication/pdf228086https://repositorio.cuc.edu.co/bitstreams/28f2d5f8-b7ca-40c4-bec7-a4a54878e0d5/download3fd9813826bbdad75d45037947bc3116MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-815543https://repositorio.cuc.edu.co/bitstreams/6fec566d-4310-441f-8953-783251a62304/download73a5432e0b76442b22b026844140d683MD52TEXTGlobal, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019.pdf.txtGlobal, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019.pdf.txtExtracted texttext/plain18211https://repositorio.cuc.edu.co/bitstreams/23ab1930-76f7-4b4a-9cae-b5233017178b/download3de2715d15bec00f31f815240095b9e8MD53THUMBNAILGlobal, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019.pdf.jpgGlobal, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019.pdf.jpgGenerated Thumbnailimage/jpeg19218https://repositorio.cuc.edu.co/bitstreams/e6efb04f-5faf-485a-9b42-fdd06349b5e8/downloada7f44d5ce64ef0b151bc3429dfcbb3b2MD5411323/13934oai:repositorio.cuc.edu.co:11323/139342025-01-22 04:00:52.027https://creativecommons.org/licenses/by-nc-nd/4.0/© 2024 Elsevier B.V.open.accesshttps://repositorio.cuc.edu.coRepositorio de la Universidad de la Costa 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ara ejercer estos derechos sobre la Obra tal y como se indica a continuación:</p>
    <ol type="a">
      <li>Reproducir la Obra, incorporar la Obra en una o más Obras Colectivas, y reproducir la Obra incorporada en las Obras Colectivas.</li>
      <li>Distribuir copias o fonogramas de las Obras, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública, incluyéndolas como incorporadas en Obras Colectivas, según corresponda.</li>
      <li>Distribuir copias de las Obras Derivadas que se generen, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública.</li>
    </ol>
    <p>Los derechos mencionados anteriormente pueden ser ejercidos en todos los medios y formatos, actualmente conocidos o que se inventen en el futuro. Los derechos antes mencionados incluyen el derecho a realizar dichas modificaciones en la medida que sean técnicamente necesarias para ejercer los derechos en otro medio o formatos, pero de otra manera usted no está autorizado para realizar obras derivadas. Todos los derechos no otorgados expresamente por el Licenciante quedan por este medio reservados, incluyendo pero sin limitarse a aquellos que se mencionan en las secciones 4(d) y 4(e).</p>
  </li>
  <br/>
  <li>
    Restricciones.
    <p>La licencia otorgada en la anterior Sección 3 está expresamente sujeta y limitada por las siguientes restricciones:</p>
    <ol type="a">
      <li>Usted puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra sólo bajo las condiciones de esta Licencia, y Usted debe incluir una copia de esta licencia o del Identificador Universal de Recursos de la misma con cada copia de la Obra que distribuya, exhiba públicamente, ejecute públicamente o ponga a disposición pública. No es posible ofrecer o imponer ninguna condición sobre la Obra que altere o limite las condiciones de esta Licencia o el ejercicio de los derechos de los destinatarios otorgados en este documento. No es posible sublicenciar la Obra. Usted debe mantener intactos todos los avisos que hagan referencia a esta Licencia y a la cláusula de limitación de garantías. Usted no puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra con alguna medida tecnológica que controle el acceso o la utilización de ella de una forma que sea inconsistente con las condiciones de esta Licencia. Lo anterior se aplica a la Obra incorporada a una Obra Colectiva, pero esto no exige que la Obra Colectiva aparte de la obra misma quede sujeta a las condiciones de esta Licencia. Si Usted crea una Obra Colectiva, previo aviso de cualquier Licenciante debe, en la medida de lo posible, eliminar de la Obra Colectiva cualquier referencia a dicho Licenciante o al Autor Original, según lo solicitado por el Licenciante y conforme lo exige la cláusula 4(c).</li>
      <li>Usted no puede ejercer ninguno de los derechos que le han sido otorgados en la Sección 3 precedente de modo que estén principalmente destinados o directamente dirigidos a conseguir un provecho comercial o una compensación monetaria privada. El intercambio de la Obra por otras obras protegidas por derechos de autor, ya sea a través de un sistema para compartir archivos digitales (digital file-sharing) o de cualquier otra manera no será considerado como estar destinado principalmente o dirigido directamente a conseguir un provecho comercial o una compensación monetaria privada, siempre que no se realice un pago mediante una compensación monetaria en relación con el intercambio de obras protegidas por el derecho de autor.</li>
      <li>Si usted distribuye, exhibe públicamente, ejecuta públicamente o ejecuta públicamente en forma digital la Obra o cualquier Obra Derivada u Obra Colectiva, Usted debe mantener intacta toda la información de derecho de autor de la Obra y proporcionar, de forma razonable según el medio o manera que Usted esté utilizando: (i) el nombre del Autor Original si está provisto (o seudónimo, si fuere aplicable), y/o (ii) el nombre de la parte o las partes que el Autor Original y/o el Licenciante hubieren designado para la atribución (v.g., un instituto patrocinador, editorial, publicación) en la información de los derechos de autor del Licenciante, términos de servicios o de otras formas razonables; el título de la Obra si está provisto; en la medida de lo razonablemente factible y, si está provisto, el Identificador Uniforme de Recursos (Uniform Resource Identifier) que el Licenciante especifica para ser asociado con la Obra, salvo que tal URI no se refiera a la nota sobre los derechos de autor o a la información sobre el licenciamiento de la Obra; y en el caso de una Obra Derivada, atribuir el crédito identificando el uso de la Obra en la Obra Derivada (v.g., "Traducción Francesa de la Obra del Autor Original," o "Guión Cinematográfico basado en la Obra original del Autor Original"). Tal crédito puede ser implementado de cualquier forma razonable; en el caso, sin embargo, de Obras Derivadas u Obras Colectivas, tal crédito aparecerá, como mínimo, donde aparece el crédito de cualquier otro autor comparable y de una manera, al menos, tan destacada como el crédito de otro autor comparable.</li>
      <li>
        Para evitar toda confusión, el Licenciante aclara que, cuando la obra es una composición musical:
        <ol type="i">
          <li>Regalías por interpretación y ejecución bajo licencias generales. El Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública o la ejecución pública digital de la obra y de recolectar, sea individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, SAYCO), las regalías por la ejecución pública o por la ejecución pública digital de la obra (por ejemplo Webcast) licenciada bajo licencias generales, si la interpretación o ejecución de la obra está primordialmente orientada por o dirigida a la obtención de una ventaja comercial o una compensación monetaria privada.</li>
          <li>Regalías por Fonogramas. El Licenciante se reserva el derecho exclusivo de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, los consagrados por la SAYCO), una agencia de derechos musicales o algún agente designado, las regalías por cualquier fonograma que Usted cree a partir de la obra (“versión cover”) y distribuya, en los términos del régimen de derechos de autor, si la creación o distribución de esa versión cover está primordialmente destinada o dirigida a obtener una ventaja comercial o una compensación monetaria privada.</li>
        </ol>
      </li>
      <li>Gestión de Derechos de Autor sobre Interpretaciones y Ejecuciones Digitales (WebCasting). Para evitar toda confusión, el Licenciante aclara que, cuando la obra sea un fonograma, el Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública digital de la obra (por ejemplo, webcast) y de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, ACINPRO), las regalías por la ejecución pública digital de la obra (por ejemplo, webcast), sujeta a las disposiciones aplicables del régimen de Derecho de Autor, si esta ejecución pública digital está primordialmente dirigida a obtener una ventaja comercial o una compensación monetaria privada.</li>
    </ol>
  </li>
  <br/>
  <li>
    Representaciones, Garantías y Limitaciones de Responsabilidad.
    <p>A MENOS QUE LAS PARTES LO ACORDARAN DE OTRA FORMA POR ESCRITO, EL LICENCIANTE OFRECE LA OBRA (EN EL ESTADO EN EL QUE SE ENCUENTRA) “TAL CUAL”, SIN BRINDAR GARANTÍAS DE CLASE ALGUNA RESPECTO DE LA OBRA, YA SEA EXPRESA, IMPLÍCITA, LEGAL O CUALQUIERA OTRA, INCLUYENDO, SIN LIMITARSE A ELLAS, GARANTÍAS DE TITULARIDAD, COMERCIABILIDAD, ADAPTABILIDAD O ADECUACIÓN A PROPÓSITO DETERMINADO, AUSENCIA DE INFRACCIÓN, DE AUSENCIA DE DEFECTOS LATENTES O DE OTRO TIPO, O LA PRESENCIA O AUSENCIA DE ERRORES, SEAN O NO DESCUBRIBLES (PUEDAN O NO SER ESTOS DESCUBIERTOS). ALGUNAS JURISDICCIONES NO PERMITEN LA EXCLUSIÓN DE GARANTÍAS IMPLÍCITAS, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.</p>
  </li>
  <br/>
  <li>
    Limitación de responsabilidad.
    <p>A MENOS QUE LO EXIJA EXPRESAMENTE LA LEY APLICABLE, EL LICENCIANTE NO SERÁ RESPONSABLE ANTE USTED POR DAÑO ALGUNO, SEA POR RESPONSABILIDAD EXTRACONTRACTUAL, PRECONTRACTUAL O CONTRACTUAL, OBJETIVA O SUBJETIVA, SE TRATE DE DAÑOS MORALES O PATRIMONIALES, DIRECTOS O INDIRECTOS, PREVISTOS O IMPREVISTOS PRODUCIDOS POR EL USO DE ESTA LICENCIA O DE LA OBRA, AUN CUANDO EL LICENCIANTE HAYA SIDO ADVERTIDO DE LA POSIBILIDAD DE DICHOS DAÑOS. ALGUNAS LEYES NO PERMITEN LA EXCLUSIÓN DE CIERTA RESPONSABILIDAD, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.</p>
  </li>
  <br/>
  <li>
    Término.
    <ol type="a">
      <li>Esta Licencia y los derechos otorgados en virtud de ella terminarán automáticamente si Usted infringe alguna condición establecida en ella. Sin embargo, los individuos o entidades que han recibido Obras Derivadas o Colectivas de Usted de conformidad con esta Licencia, no verán terminadas sus licencias, siempre que estos individuos o entidades sigan cumpliendo íntegramente las condiciones de estas licencias. Las Secciones 1, 2, 5, 6, 7, y 8 subsistirán a cualquier terminación de esta Licencia.</li>
      <li>Sujeta a las condiciones y términos anteriores, la licencia otorgada aquí es perpetua (durante el período de vigencia de los derechos de autor de la obra). No obstante lo anterior, el Licenciante se reserva el derecho a publicar y/o estrenar la Obra bajo condiciones de licencia diferentes o a dejar de distribuirla en los términos de esta Licencia en cualquier momento; en el entendido, sin embargo, que esa elección no servirá para revocar esta licencia o que deba ser otorgada , bajo los términos de esta licencia), y esta licencia continuará en pleno vigor y efecto a menos que sea terminada como se expresa atrás. La Licencia revocada continuará siendo plenamente vigente y efectiva si no se le da término en las condiciones indicadas anteriormente.</li>
    </ol>
  </li>
  <br/>
  <li>
    Varios.
    <ol type="a">
      <li>Cada vez que Usted distribuya o ponga a disposición pública la Obra o una Obra Colectiva, el Licenciante ofrecerá al destinatario una licencia en los mismos términos y condiciones que la licencia otorgada a Usted bajo esta Licencia.</li>
      <li>Si alguna disposición de esta Licencia resulta invalidada o no exigible, según la legislación vigente, esto no afectará ni la validez ni la aplicabilidad del resto de condiciones de esta Licencia y, sin acción adicional por parte de los sujetos de este acuerdo, aquélla se entenderá reformada lo mínimo necesario para hacer que dicha disposición sea válida y exigible.</li>
      <li>Ningún término o disposición de esta Licencia se estimará renunciada y ninguna violación de ella será consentida a menos que esa renuncia o consentimiento sea otorgado por escrito y firmado por la parte que renuncie o consienta.</li>
      <li>Esta Licencia refleja el acuerdo pleno entre las partes respecto a la Obra aquí licenciada. No hay arreglos, acuerdos o declaraciones respecto a la Obra que no estén especificados en este documento. El Licenciante no se verá limitado por ninguna disposición adicional que pueda surgir en alguna comunicación emanada de Usted. Esta Licencia no puede ser modificada sin el consentimiento mutuo por escrito del Licenciante y Usted.</li>
    </ol>
  </li>
  <br/>
</ol>
 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