Disease burden of pulmonary aspiration and foreign body in airway in Asian children: a review based on Global Burden of Disease data and projections for 2035.

Background: Pulmonary aspiration and foreign bodies (PAFB) represent one of the most common pediatric emergencies. The condition shows a marked age-related distribution, with children under five years of age being particularly vulnerable. As the region with the largest pediatric population worldwide, Asia may bear a substantial burden of PAFB; however, large-scale, population-based studies remain scarce. This study aimed to assess the epidemiological burden of pediatric PAFB in Asia from 1990 to 2021 and to provide evidence-based insights for public health policymaking. Methods: Data were obtained from the Global Burden of Disease (GBD) 2021 database, covering incidence, mortality, and disability-adjusted life years (DALYs) related to PAFB among children aged 0-14 years across Asian countries. Descriptive statistical analyses were conducted to examine trends over time. Correlation analyses were performed to explore associations between the sociodemographic index (SDI) and disease burden. The Bayesian Age-Period-Cohort (BAPC) model was used to project future trends in countries including China, India, Japan, and South Korea. Results: In 2021, an estimated 353,768 new PAFB cases occurred among Asian children aged 0-14 years, with an incidence rate of 32.457 per 100,000. A total of 11,159 deaths were reported, corresponding to a mortality rate of 1.024 per 100,000. The burden in terms of DALYs reached 992,887, with a DALY rate of 91.094 per 100,000. Between 1990 and 2021, the estimated annual percentage change (EAPC) was -2.59% for incidence, -3.43% for mortality, and -3.44% for DALYs. Central Asia experienced the highest disease burden, while Southeast Asia had the lowest. A significant negative correlation was observed between the SDI and disease burden. Projections indicate a continued decline in PAFB burden in China, India, Japan, and South Korea through 2035. Conclusions: Over the past three decades, the burden of pediatric PAFB in Asia has significantly declined, though regional disparities persist, with Central Asia remaining the most affected. The strong inverse relationship between the SDI and PAFB burden underscores the importance of socioeconomic development, public health education, and emergency response systems. Projections based on the BAPC model suggest continued improvements in disease burden across the Asia-Pacific region in the coming years.