The global, regional, and national burdens of urticaria in 204 countries and territories from 1990 to 2021: An observational epidemiological study based on the Global Burden of Disease Study 2021

Urticaria is a common dermatological condition with significant regional and national variations in incidence, prevalence, and disease burden. This study examined trends in these factors, along with disability-adjusted life years (DALYs), across 204 countries and regions from 1990 to 2021, to inform global public health policies. Data from the Global Burden of Disease database were analyzed to explore age-standardized DALYs rates, prevalence rates, and incidence rates of urticaria on a global scale and by region. The burden of urticaria has been contrasted among different countries and regions. Prevalence rates and DALYs were classified according to the Socio-demographic Index (SDI), and the correlation between them and the SDI was investigated. Additionally, the differences among various SDI levels, sex, and across different age groups were assessed. The global incidence, prevalence, and DALYs associated with urticaria remained largely stable, though marked regional variations were noted. In 2021, India had the highest incidence, Nepal showed the highest age-standardized rate, and Portugal had the lowest. Since 1990, the incidence and DALYs rates have risen in certain regions, especially those with a low and middle SDI. In South Asia and Western Europe, trends showed notable changes, whereas low SDI regions exhibited stable patterns. Higher incidence rates were observed in females and younger age groups, with a gradual decline observed with increasing age. The overall burden remained steady from 1990 to 2019, with a higher prevalence among females and a greater burden in the low to middle SDI regions. The findings highlight geographic disparities in the global burden of urticaria, particularly in low- to moderate-SDI regions. Females and children bear a disproportionately high burden. Our findings emphasize the need for region-specific strategies for prevention and treatment, with a focus on early screening and intervention in the female and pediatric populations.