Global burden of inflammatory bowel disease in Asia, 1990-2023: A global burden of disease study 2023

Abstract

Background:

The burden of inflammatory bowel disease (IBD) is increasing rapidly across Asia, yet country-level evidence by subtype, age, and sex remains limited. Thus, we aimed to investigate long-term burdens and regional disparities in IBD burden across 34 Asian countries.

Methods:

Using the Global Burden of Disease Study (GBD) 2023 estimates, we assessed the burden of IBD, including ulcerative colitis (UC) and Crohn’s disease (CD), across 34 countries in five Asian regions, from 1990 to 2023. IBD was defined using International Classification of Diseases, Tenth Revision (ICD-10) codes K50 for CD, K51 for UC, and K52 for indeterminate colitis to define IBD-related cases. Age-standardized disability-adjusted life year rates (ASDRs) and age-standardized prevalence rates (ASPRs) were estimated with 95% uncertainty intervals (UIs), and temporal trends were evaluated using joinpoint regression, average annual percentage changes (AAPCs), and period-specific β coefficients for pre- and post-COVID-19 trends. The Das Gupta decomposition analysis was used to quantify the contributions of population growth, population aging, and epidemiological change to changes in disability-adjusted life-years (DALYs) and prevalence.

Results:

From 1990 to 2023, ASPRs increased, whereas ASDRs declined for overall IBD, UC, and CD across the five Asian regions, although the magnitude varied by subregion. In 2023, Central Asia had the highest regional ASDR for overall IBD (17.08 [95% UI, 14.21–20.20] per 100,000 population), whereas Bangladesh had the highest national ASDR (24.58 [15.26–33.84]) and the highest UC ASDR. South Asia had the highest regional ASPR (48.83 [41.42–57.55]), whereas the Republic of Korea had the highest national ASPR (57.70 [49.62–67.05]) and the highest CD ASPR. AAPC analyses showed positive ASPR trends and negative ASDR trends across all five regions, with Mauritius and Thailand as the only countries showing increasing ASDR AAPCs. DALY rates increased sharply at older ages and were generally higher in males, but females had higher DALY rates at ages 95 years and older in East Asia and Southeast Asia. Decomposition analysis showed that DALYs and prevalence increased across all five subregions, with population growth and aging contributing positively and epidemiological effects generally contributing negatively to DALYs; Mauritius and Thailand were notable exceptions with positive epidemiological contributions to DALY increases.

Conclusion:

Marked heterogeneity and a rising IBD burden across Asia underscore an urgent public health challenge. Subtype-specific surveillance, earlier diagnosis, and long-term care strategies should be tailored to national burden patterns and health-system capacity.

INTRODUCTION

Inflammatory bowel disease (IBD), comprising ulcerative colitis (UC) and Crohn’s disease (CD) affects an estimated 10 million people worldwide, and has shifted from a largely Western disease to a global public health challenge.[1,2,3] This epidemiological transition is particularly evident in Asia, where prevalent IBD cases reached 1.34 million in 2021, more than doubling since 1990, while incident cases nearly tripled over the same period.[1,4] Beyond clinical complications, IBD imposes substantial functional limitations, reduces quality of life, and complicates long-term care planning.[5] As IBD is chronic, relapsing, and often requires long-term monitoring and treatment, rising case numbers are expected to increase demands on health-care systems and impose a substantial economic burden.[5]

Over recent decades, many Asian regions have experienced rapid growth in IBD burden, with projections suggesting continued increases in IBD prevalence, including an approximately fourfold increase in India, 2.3 to 2.5-fold in West Asia, and 1.6 to 1.7-fold in East and Southeast Asia by 2035, contrasting with more gradual trends in Western countries.[6] Importantly, this projected increase is unlikely to be uniform across Asia because the epidemiological composition and clinical characteristics of UC and CD vary substantially between regions.[6,7,8,9] Its implications are likely to vary substantially across Asia because socioeconomic development, health-system capacity, environmental exposures, and healthcare utilization differ widely across countries and subregions.[1,6,10] However, previous global and regional studies have had limited capacity to characterize within-Asia heterogeneity because population-based data remain scarce and heterogeneous, hospital-based cohorts are common, and country coverage is uneven.[7,9] Consequently, comprehensive assessments integrating country-level, subtype-specific, age-specific, and sex-specific burden patterns across Asia remain limited.[11,12]

To address these gaps, we used GBD 2023 estimates to provide a comprehensive assessment of the burden of IBD across 34 Asian countries, from 1990 to 2023. Specifically, we aimed to evaluate overall IBD as well as UC and CD separately, examine age- and sex-specific patterns across countries and subregions, and apply decomposition analyses to quantify the relative contributions of population growth, population aging, and epidemiological change to temporal trends in disease burden.

MATERIALS AND METHODS

Overview

GBD 2023, coordinated by the Institute for Health Metrics and Evaluation, provides standardized estimates of disease burden across 204 countries and territories worldwide.[13] We used GBD 2023 estimates to analyze the burden of IBD across Asia. According to the GBD regional classification, the analysis included 34 countries across five Asian regions (Central Asia, East Asia, South Asia, Southeast Asia, and high-income Asia Pacific).[13] Consistent with the GBD regional framework, Mauritius and Seychelles were included in the analysis despite not being conventionally classified as part of Asia geographically, although both have longstanding historical and cultural ties to Asia through the Indian Ocean world.[14] All secondary analyses were conducted within the official GBD 2023 analytical framework and complied with the GBD study protocol and the guidelines for accurate and transparent health estimates reporting (GATHER), as detailed in the Supplementary Methods.[15] This study was reviewed and granted exemption by the Institutional Review Board of Kyung Hee University (KHSIRB-25-128; approved on April 23, 2025), and the requirement for informed consent was waived given the use of publicly available, de-identified data.

Input data

Data for IBD, including CD and UC, were obtained from the GBD 2023.[13,15] CD and UC have been classified as level 4 causes within the GBD cause hierarchy since GBD 2021.[1,13,15] Separate disease-specific models were developed for CD and UC, and corresponding estimates were subsequently aggregated to generate overall IBD burden estimates.[1]

The GBD 2023 framework synthesizes multiple sources of epidemiological information, including disease registries, hospital records, administrative claims databases, surveys, and published studies.[13,16] To improve comparability across heterogeneous data sources, non-reference case definitions were adjusted to reference definitions using meta-regression-Bayesian, regularized, trimmed (MR-BRT) crosswalk analyses.[13,15] Age- and sex-specific estimates were generated using standardized GBD procedures, including sex-splitting of pooled observations and redistribution of broad age groups based on established age-pattern models.[13]

The GBD 2023 estimates used in this study were derived using disease modeling-meta-regression version 2.1 (DisMod-MR 2.1), a Bayesian hierarchical meta-regression framework that integrates available epidemiological evidence while ensuring internal consistency among key epidemiological parameters.[13,15] The modelling framework incorporates information across global, super-region, region, and country levels, allowing evidence from geographically and epidemiologically related locations to inform estimates in countries with sparse or incomplete primary data while preserving consistency with available local observations. Within the GBD framework, additional smoothing procedures, including spatiotemporal Gaussian process regression (ST-GPR), were used to improve the temporal and geographical consistency of estimates by borrowing information across neighboring locations and adjacent years while accounting for data uncertainty.[13,15]

Demographic inputs, including age- and sex-specific population estimates, were obtained from standard GBD demographic sources.[13] Data processing and model development followed established GBD protocols, including assessment of data completeness and quality, based on source-specific star ratings.[13,16]

Case definition

IBD is a group of chronic, non-infectious inflammatory disorders of the gastrointestinal tract, primarily comprising CD and UC.[13] CD is a chronic IBD that can involve any part of the gastrointestinal tract, most commonly the small and large intestine, whereas UC is defined as a chronic inflammatory condition confined to the colon and rectum.

Cases of CD and UC were identified using a combination of clinical and administrative data sources. The GBD 2023 included cases diagnosed based on endoscopic findings, imaging studies, or histopathological confirmation in individuals presenting with compatible clinical signs and symptoms.[15] In addition, cases identified from healthcare databases, including inpatient and outpatient records, using validated ICD code-based algorithms, were incorporated into the estimates.[15]

In some patients, definitive differentiation between CD and UC was not possible, and such cases were classified as indeterminate colitis until further diagnostic clarification.[13] IBD was defined using International Classification of Diseases, Tenth Revision (ICD-10) codes K50 for CD, K51 for UC, and K52 for indeterminate colitis.[13] These definitions were applied consistently to estimate the incidence and prevalence of IBD and its subtypes within the GBD 2023 framework.[13]

Estimation of epidemiological measures

Within the GBD 2023 framework, prevalence and disability-adjusted life-years (DALYs) for IBD were estimated for overall IBD as well as for CD and UC separately. DALYs were estimated as the sum of years of life lost (YLLs), calculated from cause-specific mortality and standard life expectancy, and years lived with disability (YLDs), derived by multiplying prevalence estimates by disease-specific disability weights.[13,15] Prevalence estimates were generated using DisMod-MR 2.1, a Bayesian compartmental meta-regression model.[13,15] In line with previous GBD cycles, CD and UC were modeled separately, with adjustments applied to account for indeterminate colitis cases assumed to represent underlying CD or UC.[13,15] Temporal and regional comparisons were conducted using age-standardized DALY rates (ASDRs) and age-standardized prevalence rates (ASPRs). Uncertainty was quantified using posterior draws provided by the GBD framework and reported as 95% uncertainty intervals (UIs).

Statistical analysis of temporal trends

Temporal trends in the burden of IBD were primarily evaluated using joinpoint regression analysis applied to age-standardized rates (ASRs).[17,18] Joinpoint regression identifies significant changes in temporal trends by fitting a series of piecewise log-linear models and determining the optimal number and location of inflection points (joinpoints) through Monte Carlo permutation tests.[18]

In(ASR)=α+βX+ε

Within each identified segment, the annual percentage change (APC) was calculated as follows:

APC=100×(e^β-1)

where β represents the slope coefficient of the segment-specific log-linear regression model. The average annual percentage change (AAPC) was subsequently estimated as a weighted average of segment-specific APC values, with weights proportional to the duration of each segment; thereby, providing an overall summary measure of temporal trends across the entire study period.[17,18,19] The AAPC was calculated as follows:

In addition, to evaluate changes associated with the COVID-19 period, separate log-linear regression analyses were conducted for the pre-COVID-19 (2015–2019) and during/post-COVID-19 (2019–2023) periods.[20] The corresponding β coefficients were estimated to quantify the direction and magnitude of changes in age-standardized rates across these periods. All statistical analyses and data visualizations were performed using Python (version 3.11.9; Python Software Foundation, Wilmington, DE, USA) and R software (version 4.4.2; R Foundation for Statistical Computing, Vienna, Austria).

Decomposition analysis

Using the Das Gupta decomposition method, we examined three components underlying temporal changes in the burden of IBD: population growth, population aging, and epidemiological change. The Das Gupta method was selected because it minimizes bias related to the sequence of factor substitution and is well-suited to settings in that demographic transitions and epidemiological shifts occur concurrently.[16] This analysis assessed the contributions of these components to changes in IBD-related prevalence and DALYs, between 1990 and 2023.[21,22] Following the Das Gupta framework, the total number of IBD cases or DALYs in a given year y was calculated as follows:

where a_i,y indicates the age-specific population proportion, i, p_y the total population size, and e_i,y the corresponding age-specific prevalence or DALY rate for IBD in year y. Decomposition analyses were performed separately for IBD-related DALYs and prevalence, based on age and sex-specific estimates obtained from the GBD 2023 results, allowing for a detailed assessment of the drivers of change in disease burden over time.[13,15] To assess the robustness of the decomposition findings to the choice of analytical period, additional decomposition analyses were conducted separately for the pre-COVID-19 period (1990–2019) and the during/post-COVID-19 period (2019–2023). Statistical uncertainty was assessed using bootstrap resampling, and 95% confidence intervals (CIs) were calculated from the 2.5^th and 97.5^th percentiles of the bootstrap distributions.

RESULTS

Regional and national burden of inflammatory bowel disease, ulcerative colitis, and Crohn’s disease in Asia, 1990–2023

The burden of IBD varied across Asian regions in 2023. As shown in Figure 1 and detailed in Table 1, Central Asia had the highest overall IBD ASDR, at 17.08 (95% UI, 14.21 to 20.20) per 100,000 population, whereas East Asia had the lowest, at 6.97 (5.53 to 9.02). South Asia had the highest overall IBD ASPR, at 48.83 (95% UI, 41.42 to 57.55) per 100,000 population, while Southeast Asia had the lowest, at 5.87 (5.06 to 6.86). For UC, South Asia had the highest ASDR, at 13.16 (95% UI, 9.52 to 17.29) per 100,000 population, and the highest ASPR, at 35.27 (28.14 to 43.86), as detailed in Table S1. For CD, Central Asia had the highest ASDR, at 4.80 (95% UI, 3.58 to 5.98), as well as the highest ASPR, at 14.45 (11.35 to 17.84) per 100,000 population, as shown in Table S2. At the national level, Bangladesh had the highest overall IBD ASDR, at 24.58 (95% UI, 15.26 to 33.84) per 100,000 population, and the highest UC ASDR, at 19.72 (11.60 to 28.00). In contrast, the Republic of Korea had the highest overall IBD ASPR, at 57.70 (95% UI, 49.62 to 67.05) per 100,000 population, and the highest CD ASPR, at 21.90 (17.35 to 27.90). Regional temporal trends are presented in Figure 2 and summarized in Tables S3-S5. Across 1990 to 2023, ASPRs increased whereas ASDRs declined for overall IBD, UC, and CD across all Asian regions, although the magnitude of change varied by subregion. Comparison of β coefficients before and during/post-COVID-19 showed heterogeneous short-term changes after 2019 for both UC and CD [Tables S1 and S2]. ASDR trends varied across subregions and between subtypes, whereas ASPR trends generally became less negative or more positive in East Asia, high-income Asia Pacific, and South Asia, with the largest post-2019 increase observed for CD in South Asia.

Figure 1.

Age-standardized DALY and prevalence rates of IBD across Asia in 1990 and 2023. (a) and (b) show the age-standardized DALY rates in 1990 and 2023, while (c) and (d) show the age-standardized prevalence rates in 1990 and 2023. Abbreviations: DALY = Disability-adjusted life year; IBD = Inflammatory bowel disease

Table 1.

Age-standardized DALY and prevalence rates (95% UI, per 100,000 population) in 1990 and 2023, with β coefficients (95% CI) for pre-COVID-19 (2015–2019) and during/post-COVID-19 (2019–2023) trends in IBD across five GBD regions and 34 Asian countries

Location	Age-standardized DALY rate				Age-standardized prevalence rate
	1990	2023	β coefficient, before COVID-19	β coefficient, during/post COVID-19	1990	2023	β coefficient, before COVID-19	β coefficient, during/post COVID-19
Central Asia	23.89 (20.36 to 28.13)	17.08 (14.21 to 20.20)	0.00 (−0.03 to 0.03)	−0.02 (−0.03 to−0.01)	46.68 (39.45 to 55.19)	47.41 (40.39 to 56.30)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Armenia	24.17 (19.27 to 28.70)	13.79 (10.75 to 17.62)	−0.01 (−0.05 to 0.02)	−0.05 (−0.08 to−0.02)	48.55 (41.46 to 57.98)	52.02 (43.98 to 61.41)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Azerbaijan	13.48 (10.07 to 17.70)	12.50 (9.19 to 16.52)	0.00 (0.00 to 0.01)	0.00 (−0.01 to 0.01)	44.81 (36.59 to 53.47)	47.60 (39.92 to 56.51)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Georgia	31.02 (23.91 to 40.74)	14.36 (11.35 to 17.94)	−0.02 (−0.05 to 0.01)	0.00 (−0.03 to 0.03)	51.58 (43.00 to 62.17)	53.36 (44.57 to 63.39)	0.00 (0.00 to 0.01)	0.00 (0.00 to 0.01)
Kazakhstan	24.90 (20.72 to 29.92)	20.44 (16.96 to 24.04)	0.00 (−0.05 to 0.04)	−0.05 (−0.08 to−0.02)	48.85 (41.35 to 58.53)	49.16 (41.71 to 58.17)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Kyrgyzstan	36.19 (29.78 to 44.51)	13.78 (10.99 to 17.25)	−0.01 (−0.04 to 0.03)	0.00 (−0.02 to 0.03)	42.41 (35.58 to 50.57)	46.96 (39.91 to 55.80)	0.01 (0.01 to 0.01)	0.00 (0.00 to 0.00)
Mongolia	26.33 (17.23 to 38.07)	18.68 (13.70 to 25.05)	0.01 (0.00 to 0.01)	0.01 (0.00 to 0.03)	39.74 (34.06 to 46.52)	41.78 (35.61 to 49.32)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Tajikistan	19.20 (13.88 to 26.29)	19.03 (13.34 to 26.15)	0.00 (−0.01 to 0.00)	0.04 (0.01 to 0.07)	40.77 (33.55 to 50.65)	41.81 (35.03 to 49.49)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Turkmenistan	19.88 (15.39 to 25.00)	19.88 (15.11 to 25.68)	0.01 (0.00 to 0.01)	−0.02 (−0.04 to 0.01)	41.65 (35.03 to 48.65)	44.92 (37.64 to 53.06)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Uzbekistan	22.05 (18.07 to 26.28)	16.55 (13.73 to 19.75)	0.02 (−0.02 to 0.06)	−0.01 (−0.02 to 0.00)	46.52 (39.42 to 55.34)	47.02 (39.64 to 56.92)	0.01 (0.00 to 0.01)	0.00 (0.00 to 0.01)
East Asia	15.42 (8.83 to 23.76)	6.97 (5.53 to 9.02)	−0.03 (−0.04 to−0.03)	−0.02 (−0.04 to 0.01)	5.77 (4.98 to 6.71)	9.40 (8.13 to 10.93)	−0.07 (−0.08 to−0.05)	0.00 (−0.01 to 0.02)
China	15.35 (8.44 to 24.01)	6.88 (5.43 to 9.05)	−0.04 (−0.04 to−0.03)	−0.02 (−0.04 to 0.01)	5.72 (4.94 to 6.64)	9.50 (8.22 to 11.03)	−0.07 (−0.08 to−0.05)	0.00 (−0.01 to 0.02)
Democratic People’s Republic of Korea	12.41 (7.57 to 20.10)	8.06 (4.48 to 12.92)	0.00 (−0.01 to 0.00)	−0.04 (−0.07 to 0.00)	7.40 (6.21 to 8.83)	6.28 (5.34 to 7.52)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.01)
Taiwan	21.28 (18.78 to 23.90)	10.15 (8.52 to 12.07)	−0.04 (−0.05 to−0.03)	0.01 (0.00 to 0.03)	6.76 (5.61 to 7.92)	7.01 (5.83 to 8.33)	−0.09 (−0.13 to−0.06)	−0.01 (−0.03 to 0.01)
High-income Asia Pacific	12.03 (9.68 to 14.79)	8.80 (6.69 to 11.08)	−0.01 (−0.02 to 0.00)	0.01 (0.01 to 0.02)	27.89 (24.10 to 32.26)	36.13 (31.43 to 42.37)	−0.02 (−0.03 to−0.02)	0.00 (0.00 to 0.00)
Brunei Darussalam	19.00 (12.50 to 27.98)	14.64 (10.14 to 20.06)	−0.01 (−0.03 to 0.00)	0.00 (−0.01 to 0.01)	9.91 (8.45 to 11.50)	10.94 (9.28 to 12.94)	0.00 (0.00 to 0.01)	0.00 (0.00 to 0.00)
Japan	8.55 (7.12 to 10.31)	7.31 (5.62 to 9.22)	0.01 (0.00 to 0.03)	0.02 (0.02 to 0.03)	24.59 (21.15 to 29.07)	27.28 (23.60 to 32.07)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Republic of Korea	28.71 (16.20 to 41.71)	13.05 (9.32 to 17.42)	−0.04 (−0.04 to−0.03)	0.00 (−0.01 to 0.01)	37.84 (32.77 to 43.29)	57.70 (49.62 to 67.05)	−0.05 (−0.05 to−0.04)	0.00 (−0.01 to 0.01)
Singapore	5.00 (4.32 to 5.83)	2.62 (2.09 to 3.25)	−0.01 (−0.02 to 0.01)	0.06 (0.02 to 0.09)	6.37 (5.40 to 7.42)	8.01 (6.83 to 9.44)	−0.02 (−0.02 to−0.02)	0.00 (0.00 to 0.00)
South Asia	20.82 (14.59 to 30.12)	17.03 (12.09 to 22.16)	−0.01 (−0.02 to 0.00)	0.00 (−0.04 to 0.04)	38.78 (32.75 to 45.65)	48.83 (41.42 to 57.55)	−0.01 (−0.02 to−0.01)	0.03 (0.01 to 0.04)
Bangladesh	31.44 (21.17 to 45.95)	24.58 (15.26 to 33.84)	0.02 (−0.01 to 0.04)	−0.01 (−0.06 to 0.05)	40.70 (34.21 to 48.47)	54.83 (45.78 to 64.98)	0.00 (0.00 to 0.00)	0.03 (0.01 to 0.05)
Bhutan	26.47 (16.41 to 44.82)	20.70 (12.53 to 32.25)	0.00 (−0.01 to 0.00)	0.00 (−0.02 to 0.01)	39.66 (33.80 to 47.05)	47.15 (39.59 to 55.41)	−0.01 (−0.01 to−0.01)	0.01 (0.00 to 0.02)
India	19.13 (13.59 to 27.07)	15.50 (11.17 to 20.39)	−0.02 (−0.03 to−0.01)	0.00 (−0.03 to 0.04)	38.58 (32.64 to 45.50)	49.01 (41.76 to 57.94)	−0.01 (−0.02 to−0.01)	0.02 (0.01 to 0.04)
Nepal	27.93 (17.61 to 44.00)	19.65 (13.58 to 27.87)	0.00 (0.00 to 0.01)	0.00 (−0.06 to 0.06)	38.96 (32.59 to 46.33)	47.45 (39.80 to 56.32)	0.00 (0.00 to 0.00)	0.02 (0.01 to 0.03)
Pakistan	24.52 (15.01 to 39.61)	21.93 (14.15 to 33.18)	0.00 (−0.01 to 0.01)	0.01 (−0.03 to 0.04)	38.86 (32.65 to 46.39)	41.64 (35.09 to 49.41)	0.00 (0.00 to 0.00)	0.02 (0.01 to 0.04)
Southeast Asia	9.94 (5.98 to 15.76)	7.67 (5.13 to 11.14)	0.01 (0.01 to 0.01)	−0.01 (−0.04 to 0.03)	5.32 (4.53 to 6.22)	5.87 (5.06 to 6.86)	0.01 (0.01 to 0.02)	0.01 (0.00 to 0.01)
Cambodia	8.27 (3.83 to 15.71)	6.58 (3.51 to 10.88)	0.00 (0.00 to 0.00)	0.00 (−0.03 to 0.04)	4.49 (3.77 to 5.31)	5.05 (4.24 to 5.93)	0.01 (0.01 to 0.01)	0.02 (0.01 to 0.02)
Indonesia	14.56 (8.33 to 24.47)	10.50 (6.38 to 16.13)	0.00 (0.00 to 0.00)	−0.01 (−0.07 to 0.05)	5.33 (4.52 to 6.31)	5.64 (4.85 to 6.66)	0.01 (0.01 to 0.01)	0.01 (0.01 to 0.01)
Lao People’s Democratic Republic	5.73 (3.13 to 10.33)	4.98 (3.13 to 7.70)	0.00 (0.00 to 0.00)	0.00 (−0.03 to 0.02)	4.40 (3.72 to 5.19)	5.18 (4.32 to 6.14)	0.01 (0.01 to 0.01)	0.01 (0.01 to 0.01)
Malaysia	16.08 (7.31 to 27.80)	10.53 (4.89 to 17.24)	0.02 (0.00 to 0.04)	−0.01 (−0.08 to 0.05)	6.62 (5.78 to 7.63)	8.23 (7.07 to 9.61)	0.10 (0.08 to 0.12)	−0.07 (−0.12 to−0.01)
Maldives	7.59 (4.50 to 12.84)	8.07 (5.34 to 12.29)	0.03 (0.02 to 0.05)	−0.03 (−0.06 to 0.01)	5.28 (4.44 to 6.17)	6.95 (5.93 to 8.18)	0.01 (0.00 to 0.01)	0.01 (0.01 to 0.02)
Mauritius	6.32 (5.37 to 7.62)	11.14 (9.41 to 13.01)	0.19 (0.05 to 0.32)	−0.04 (−0.12 to 0.04)	6.22 (5.23 to 7.56)	6.98 (5.90 to 8.15)	0.00 (0.00 to 0.01)	0.01 (0.00 to 0.01)
Myanmar	12.59 (5.80 to 22.77)	10.48 (5.21 to 18.25)	0.01 (0.01 to 0.01)	0.00 (−0.04 to 0.03)	4.60 (3.75 to 5.43)	5.28 (4.50 to 6.21)	0.01 (0.00 to 0.01)	0.01 (0.01 to 0.02)
Philippines	7.40 (4.63 to 12.15)	6.14 (4.48 to 8.36)	0.02 (0.01 to 0.03)	0.00 (−0.02 to 0.03)	4.87 (4.09 to 5.90)	4.55 (3.87 to 5.40)	0.00 (0.00 to 0.00)	0.01 (0.00 to 0.01)
Seychelles	9.11 (5.75 to 13.60)	6.25 (4.28 to 8.97)	−0.01 (−0.02 to−0.01)	0.01 (−0.05 to 0.07)	6.37 (5.30 to 7.68)	6.97 (5.87 to 8.16)	0.00 (0.00 to 0.00)	0.01 (0.01 to 0.01)
Sri Lanka	3.04 (2.28 to 4.16)	2.53 (1.89 to 3.25)	0.01 (0.00 to 0.01)	0.00 (−0.05 to 0.04)	7.38 (6.12 to 8.82)	9.10 (7.75 to 10.64)	−0.01 (−0.01 to 0.00)	0.01 (0.01 to 0.02)
Thailand	2.85 (1.93 to 4.26)	3.64 (2.75 to 5.06)	0.03 (0.03 to 0.04)	0.00 (−0.01 to 0.02)	5.07 (4.29 to 5.95)	6.12 (5.22 to 7.12)	0.01 (0.01 to 0.01)	0.01 (0.01 to 0.02)
Timor-Leste	10.17 (4.96 to 18.71)	8.46 (4.74 to 13.80)	0.00 (0.00 to 0.00)	0.01 (−0.01 to 0.04)	4.58 (3.76 to 5.46)	5.08 (4.33 to 6.00)	0.01 (0.01 to 0.01)	0.01 (0.00 to 0.01)
Viet Nam	6.37 (3.65 to 10.97)	5.49 (3.56 to 8.54)	0.00 (−0.01 to 0.01)	−0.01 (−0.05 to 0.02)	5.67 (4.76 to 6.69)	6.67 (5.79 to 7.71)	0.01 (0.00 to 0.01)	0.01 (0.01 to 0.02)

Abbreviation: CI=Confidence interval; DALY=Disability-adjusted life year; IBD=Inflammatory bowel disease; UI=Uncertainty interval

Table S1.

Age-standardized DALY and prevalence rates (95% UI, per 100,000 population) in 1990 and 2023, with β coefficients (95% CI) for pre-COVID-19 (2015-2019) and during/post-COVID-19 (2019-2023) trends in UC across five GBD regions and 34 Asian countries.

Location	Age-standardized DALY rate				Age-standardized prevalence rate
	1990	2023	Β coefficient, before COVID-19 (2015-2019)	β coefficient, during/post COVID-19 (2019-2023)	1990	2023	Β coefficient, before COVID-19 (2015-2019)	Β coefficient, during/post COVID-19 (2019-2023)
Central Asia	16.92 (14.27 to 19.99)	12.28 (10.39 to 14.71)	0.00 (-0.03 to 0.04)	-0.02 (-0.03 to -0.01)	32.37 (26.16 to 40.33)	32.96 (26.23 to 41.61)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.01)
Armenia	18.91 (15.36 to 22.58)	10.21 (7.97 to 12.98)	-0.01 (-0.05 to 0.03)	-0.05 (-0.08 to -0.02)	33.66 (27.24 to 42.22)	36.09 (29.18 to 44.94)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.01)
Azerbaijan	9.49 (6.92 to 12.60)	8.50 (6.07 to 11.59)	0.00 (-0.01 to 0.00)	0.00 (0.00 to 0.01)	31.04 (23.99 to 39.34)	33.10 (26.23 to 41.61)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Georgia	15.01 (10.76 to 19.95)	8.76 (6.55 to 11.61)	-0.02 (-0.06 to 0.02)	-0.01 (-0.04 to 0.03)	35.49 (28.99 to 44.12)	37.01 (29.47 to 46.16)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.01)
Kazakhstan	16.99 (13.94 to 20.53)	13.73 (11.10 to 16.51)	-0.01 (-0.06 to 0.05)	-0.06 (-0.09 to -0.02)	33.90 (27.19 to 43.22)	34.07 (27.69 to 42.81)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Kyrgyzstan	25.83 (20.58 to 32.49)	10.03 (7.99 to 12.46)	-0.01 (-0.05 to 0.03)	0.00 (-0.02 to 0.03)	29.41 (23.37 to 37.43)	32.71 (26.24 to 41.35)	0.01 (0.01 to 0.01)	0.00 (0.00 to 0.00)
Mongolia	22.70 (14.41 to 33.37)	14.74 (10.60 to 19.62)	0.00 (-0.01 to 0.01)	0.02 (0.00 to 0.04)	27.68 (21.84 to 34.34)	29.23 (23.34 to 36.78)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Tajikistan	16.99 (11.86 to 24.59)	16.85 (11.50 to 23.84)	-0.01 (-0.01 to 0.00)	0.05 (0.01 to 0.08)	28.45 (21.94 to 36.56)	29.30 (23.11 to 36.10)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Turkmenistan	14.43 (11.36 to 18.09)	14.79 (11.19 to 19.32)	0.01 (0.00 to 0.01)	-0.02 (-0.05 to 0.01)	29.05 (23.56 to 36.15)	31.39 (24.87 to 38.67)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Uzbekistan	17.53 (14.60 to 21.18)	11.77 (9.54 to 14.17)	0.02 (-0.03 to 0.07)	-0.01 (-0.02 to 0.00)	32.24 (26.05 to 39.62)	32.64 (25.52 to 41.78)	0.01 (0.00 to 0.01)	0.00 (0.00 to 0.01)
East Asia	14.31 (8.12 to 22.21)	6.03 (4.63 to 7.98)	-0.03 (-0.04 to -0.03)	-0.02 (-0.04 to 0.01)	3.91 (3.19 to 4.80)	5.91 (4.87 to 7.41)	-0.07 (-0.09 to -0.05)	0.00 (-0.02 to 0.02)
China	14.35 (7.87 to 22.43)	5.94 (4.52 to 7.93)	-0.03 (-0.04 to -0.03)	-0.02 (-0.04 to 0.01)	3.86 (3.14 to 4.74)	5.95 (4.89 to 7.45)	-0.07 (-0.09 to -0.05)	0.00 (-0.02 to 0.02)
Democratic People’s Republic of Korea	11.15 (6.67 to 17.65)	7.20 (3.82 to 11.91)	0.00 (-0.01 to 0.00)	-0.04 (-0.07 to 0.00)	5.23 (4.19 to 6.57)	4.38 (3.48 to 5.56)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.01)
Taiwan	14.24 (12.23 to 16.37)	9.15 (7.70 to 10.89)	-0.04 (-0.05 to -0.03)	0.01 (0.00 to 0.03)	5.32 (4.27 to 6.46)	5.52 (4.45 to 6.85)	-0.09 (-0.12 to -0.06)	-0.01 (-0.03 to 0.01)
High-income Asia Pacific	8.84 (6.79 to 11.00)	5.97 (4.51 to 7.76)	-0.01 (-0.02 to -0.01)	0.01 (0.01 to 0.02)	19.74 (16.17 to 24.18)	24.83 (20.31 to 30.61)	-0.03 (-0.03 to -0.02)	0.00 (-0.01 to 0.00)
Brunei Darussalam	18.07 (11.65 to 26.64)	13.75 (9.35 to 19.03)	-0.01 (-0.03 to 0.00)	0.00 (-0.01 to 0.01)	6.78 (5.54 to 8.35)	7.32 (5.89 to 9.38)	0.01 (0.01 to 0.01)	0.00 (-0.01 to 0.00)
Japan	6.11 (4.99 to 7.52)	5.13 (3.93 to 6.52)	0.01 (0.00 to 0.03)	0.02 (0.02 to 0.03)	19.40 (16.01 to 24.05)	20.67 (17.19 to 25.86)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Republic of Korea	23.36 (11.40 to 35.30)	8.67 (5.99 to 12.50)	-0.05 (-0.05 to -0.05)	0.00 (-0.02 to 0.01)	20.70 (16.79 to 24.88)	35.80 (28.68 to 44.40)	-0.06 (-0.07 to -0.05)	0.00 (-0.01 to 0.01)
Singapore	3.42 (2.91 to 4.02)	1.62 (1.33 to 2.00)	-0.01 (-0.02 to 0.00)	0.07 (0.03 to 0.10)	3.74 (2.94 to 4.60)	4.61 (3.65 to 5.88)	-0.02 (-0.02 to -0.02)	0.00 (-0.01 to 0.00)
South Asia	16.72 (11.35 to 24.44)	13.16 (9.52 to 17.29)	-0.01 (-0.02 to 0.00)	0.00 (-0.04 to 0.04)	28.06 (22.37 to 34.64)	35.27 (28.14 to 43.86)	-0.01 (-0.01 to -0.01)	0.02 (0.01 to 0.04)
Bangladesh	26.22 (17.22 to 38.08)	19.72 (11.60 to 28.00)	0.02 (-0.01 to 0.05)	-0.01 (-0.07 to 0.05)	29.54 (23.43 to 36.71)	39.64 (30.80 to 49.71)	0.00 (0.00 to 0.00)	0.03 (0.01 to 0.05)
Bhutan	21.78 (13.19 to 37.39)	16.26 (9.46 to 24.94)	0.00 (-0.01 to 0.00)	0.00 (-0.02 to 0.01)	28.67 (22.79 to 36.14)	34.21 (26.72 to 43.27)	-0.01 (-0.01 to -0.01)	0.01 (0.00 to 0.02)
India	15.20 (10.30 to 21.78)	11.84 (8.49 to 15.45)	-0.02 (-0.03 to -0.01)	0.00 (-0.04 to 0.03)	27.89 (22.33 to 34.37)	35.39 (28.28 to 43.77)	-0.01 (-0.01 to -0.01)	0.02 (0.01 to 0.04)
Nepal	22.82 (13.83 to 37.38)	15.17 (10.00 to 21.43)	0.00 (0.00 to 0.01)	0.00 (-0.06 to 0.06)	28.17 (22.24 to 35.60)	34.37 (27.38 to 43.46)	0.01 (0.01 to 0.01)	0.02 (0.01 to 0.03)
Pakistan	20.09 (11.77 to 32.88)	17.49 (11.20 to 26.45)	0.00 (-0.01 to 0.01)	0.00 (-0.03 to 0.04)	28.28 (22.25 to 35.51)	30.17 (23.83 to 37.91)	0.00 (0.00 to 0.00)	0.02 (0.01 to 0.04)
Southeast Asia	8.95 (5.25 to 14.34)	6.57 (4.15 to 9.70)	0.01 (0.01 to 0.01)	-0.01 (-0.04 to 0.03)	3.69 (3.00 to 4.63)	4.06 (3.28 to 5.11)	0.01 (0.01 to 0.02)	0.01 (0.00 to 0.01)
Cambodia	7.41 (3.30 to 14.42)	5.78 (2.89 to 9.89)	0.00 (-0.01 to 0.00)	0.00 (-0.03 to 0.04)	3.09 (2.46 to 3.81)	3.46 (2.72 to 4.31)	0.01 (0.01 to 0.02)	0.01 (0.01 to 0.02)
Indonesia	13.28 (7.43 to 22.82)	9.18 (5.40 to 14.29)	0.00 (0.00 to 0.00)	-0.01 (-0.07 to 0.05)	3.75 (3.01 to 4.71)	3.95 (3.19 to 4.94)	0.01 (0.01 to 0.01)	0.01 (0.01 to 0.01)
Lao People’s Democratic Republic	5.15 (2.74 to 9.43)	4.23 (2.48 to 6.69)	0.00 (0.00 to 0.00)	0.00 (-0.03 to 0.02)	3.03 (2.37 to 3.79)	3.56 (2.80 to 4.47)	0.01 (0.01 to 0.01)	0.01 (0.01 to 0.01)
Malaysia	14.55 (6.23 to 25.57)	9.12 (3.95 to 15.16)	0.02 (0.00 to 0.04)	-0.01 (-0.08 to 0.05)	4.35 (3.59 to 5.22)	5.47 (4.43 to 6.80)	0.10 (0.08 to 0.12)	-0.07 (-0.13 to -0.01)
Maldives	6.00 (3.45 to 10.33)	6.13 (3.87 to 9.43)	0.04 (0.02 to 0.05)	-0.03 (-0.06 to 0.01)	3.67 (2.88 to 4.47)	4.85 (3.88 to 5.96)	0.01 (0.00 to 0.01)	0.01 (0.01 to 0.02)
Mauritius	5.00 (4.20 to 5.97)	7.15 (6.02 to 8.58)	0.22 (0.07 to 0.36)	-0.06 (-0.14 to 0.03)	4.28 (3.39 to 5.43)	4.81 (3.83 to 6.00)	0.01 (0.00 to 0.01)	0.01 (0.00 to 0.01)
Myanmar	11.33 (4.91 to 21.06)	8.89 (4.01 to 15.73)	0.01 (0.01 to 0.01)	0.00 (-0.04 to 0.03)	3.17 (2.47 to 4.01)	3.62 (2.93 to 4.55)	0.00 (0.00 to 0.01)	0.01 (0.01 to 0.02)
Philippines	6.75 (4.15 to 11.19)	5.36 (4.00 to 7.23)	0.02 (0.02 to 0.03)	0.00 (-0.02 to 0.03)	3.76 (3.02 to 4.76)	3.47 (2.82 to 4.38)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.01)
Seychelles	8.12 (4.91 to 12.56)	5.32 (3.44 to 7.80)	-0.02 (-0.02 to -0.01)	0.01 (-0.05 to 0.07)	4.39 (3.45 to 5.54)	4.83 (3.82 to 5.91)	0.00 (0.00 to 0.00)	0.01 (0.01 to 0.01)
Sri Lanka	2.29 (1.66 to 3.20)	1.81 (1.32 to 2.43)	0.01 (0.00 to 0.01)	0.00 (-0.05 to 0.04)	5.10 (4.01 to 6.45)	6.23 (4.94 to 7.90)	-0.01 (-0.01 to -0.01)	0.01 (0.01 to 0.02)
Thailand	2.30 (1.44 to 3.54)	2.98 (2.15 to 4.22)	0.04 (0.03 to 0.05)	0.00 (-0.01 to 0.01)	3.14 (2.51 to 3.91)	3.77 (3.02 to 4.73)	0.02 (0.01 to 0.02)	0.01 (0.01 to 0.02)
Timor-Leste	9.27 (4.40 to 17.32)	7.55 (4.11 to 12.59)	0.00 (0.00 to 0.00)	0.01 (-0.01 to 0.04)	3.18 (2.51 to 4.10)	3.51 (2.81 to 4.38)	0.01 (0.01 to 0.01)	0.01 (0.00 to 0.01)
Viet Nam	5.59 (2.87 to 9.84)	4.52 (2.76 to 7.33)	0.00 (-0.01 to 0.01)	-0.01 (-0.05 to 0.02)	3.90 (3.11 to 4.90)	4.61 (3.72 to 5.72)	0.01 (0.00 to 0.01)	0.01 (0.01 to 0.02)

Abbreviation: CI, confidence interval; DALY, disability-adjusted life year; GBD, global burden disease; UC, ulcerative colitis; UI, uncertainty interval

Table S2.

Age-standardized DALY and prevalence rates (95% UI, per 100,000 population) in 1990 and 2023, with β coefficients (95% CI) for pre-COVID-19 (2015-2019) and during/post-COVID-19 (2019-2023) trends in CD across five GBD regions and 34 Asian countries.

Location	Age-standardized DALY rate				Age-standardized prevalence rate
	1990	2023	β coefficient, before COVID-19 (2015-2019)	β coefficient, during/post COVID-19 (2019-2023)	1990	2023	β coefficient, before COVID-19 (2015-2019)	β coefficient, during/post COVID-19 (2019-2023)
Central Asia	6.97 (5.43 to 9.04)	4.80 (3.58 to 5.98)	0.01 (-0.01 to 0.02)	-0.02 (-0.04 to -0.01)	14.32 (11.31 to 17.91)	14.45 (11.35 to 17.84)	0.01 (0.00 to 0.01)	0.00 (0.00 to 0.00)
Armenia	5.26 (3.80 to 7.14)	3.58 (2.55 to 4.82)	-0.01 (-0.03 to 0.00)	-0.06 (-0.09 to -0.04)	14.89 (11.91 to 18.85)	15.92 (12.85 to 20.21)	0.00 (0.00 to 0.01)	0.00 (0.00 to 0.00)
Azerbaijan	3.99 (2.80 to 5.86)	3.99 (2.53 to 5.91)	0.00 (0.00 to 0.01)	-0.01 (-0.02 to 0.00)	13.77 (10.88 to 17.28)	14.51 (11.43 to 18.40)	0.00 (0.00 to 0.00)	0.00 (-0.01 to 0.00)
Georgia	16.02 (11.34 to 23.91)	5.60 (4.17 to 7.21)	-0.01 (-0.04 to 0.01)	0.00 (-0.03 to 0.03)	16.09 (12.63 to 19.70)	16.35 (12.81 to 20.53)	0.01 (0.01 to 0.01)	0.00 (0.00 to 0.01)
Kazakhstan	7.91 (6.05 to 10.56)	6.71 (5.12 to 8.50)	0.00 (-0.01 to 0.02)	-0.04 (-0.07 to -0.02)	14.95 (11.72 to 18.74)	15.09 (12.03 to 19.10)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Kyrgyzstan	10.35 (7.39 to 14.76)	3.75 (2.63 to 5.10)	0.00 (-0.01 to 0.01)	0.00 (-0.02 to 0.02)	12.99 (10.13 to 16.42)	14.24 (11.28 to 17.71)	0.01 (0.01 to 0.01)	0.00 (0.00 to 0.00)
Mongolia	3.63 (2.38 to 5.40)	3.94 (2.72 to 5.65)	0.01 (0.01 to 0.02)	-0.01 (-0.01 to -0.01)	12.07 (9.48 to 14.89)	12.55 (9.88 to 16.06)	0.00 (0.00 to 0.00)	0.00 (-0.01 to 0.00)
Tajikistan	2.21 (1.29 to 3.25)	2.19 (1.32 to 3.14)	0.00 (0.00 to 0.01)	0.00 (0.00 to 0.00)	12.32 (9.55 to 15.57)	12.51 (9.77 to 15.76)	0.01 (0.00 to 0.01)	0.00 (0.00 to 0.00)
Turkmenistan	5.45 (3.89 to 7.59)	5.09 (3.36 to 7.37)	0.01 (0.00 to 0.01)	0.00 (-0.02 to 0.01)	12.60 (9.96 to 15.82)	13.53 (10.60 to 16.90)	0.01 (0.01 to 0.01)	0.00 (0.00 to 0.00)
Uzbekistan	4.52 (3.27 to 6.25)	4.78 (3.65 to 5.97)	0.02 (0.00 to 0.04)	-0.01 (-0.02 to 0.01)	14.28 (11.26 to 18.14)	14.38 (11.17 to 17.94)	0.01 (0.01 to 0.01)	0.00 (0.00 to 0.00)
East Asia	1.11 (0.75 to 1.65)	0.95 (0.68 to 1.24)	-0.04 (-0.05 to -0.03)	0.00 (-0.02 to 0.01)	1.86 (1.45 to 2.39)	3.49 (2.74 to 4.41)	-0.07 (-0.08 to -0.05)	0.01 (-0.01 to 0.02)
China	0.99 (0.62 to 1.56)	0.95 (0.68 to 1.25)	-0.04 (-0.05 to -0.04)	0.00 (-0.02 to 0.01)	1.86 (1.45 to 2.39)	3.56 (2.79 to 4.49)	-0.07 (-0.08 to -0.05)	0.01 (-0.01 to 0.02)
Democratic People’s Republic of Korea	1.25 (0.68 to 2.35)	0.87 (0.48 to 1.49)	0.00 (0.00 to 0.00)	-0.02 (-0.04 to 0.00)	2.18 (1.63 to 2.87)	1.90 (1.45 to 2.41)	0.00 (0.00 to 0.00)	0.01 (0.00 to 0.01)
Taiwan	7.04 (5.58 to 8.53)	1.00 (0.73 to 1.30)	-0.05 (-0.07 to -0.03)	0.01 (-0.01 to 0.02)	1.44 (1.07 to 1.83)	1.49 (1.13 to 1.94)	-0.12 (-0.16 to -0.08)	-0.01 (-0.04 to 0.02)
High-income Asia Pacific	3.19 (2.48 to 3.91)	2.83 (2.12 to 3.68)	0.00 (-0.01 to 0.00)	0.01 (0.01 to 0.01)	8.15 (6.34 to 10.20)	11.30 (8.91 to 14.37)	-0.02 (-0.02 to -0.01)	0.00 (0.00 to 0.00)
Brunei Darussalam	0.93 (0.62 to 1.46)	0.89 (0.61 to 1.29)	0.00 (-0.01 to 0.00)	0.00 (-0.01 to 0.01)	3.14 (2.37 to 3.99)	3.63 (2.74 to 4.66)	-0.01 (-0.01 to -0.01)	0.00 (-0.01 to 0.01)
Japan	2.44 (1.94 to 3.02)	2.17 (1.70 to 2.81)	0.01 (-0.01 to 0.03)	0.02 (0.02 to 0.02)	5.19 (4.05 to 6.51)	6.61 (5.24 to 8.28)	0.00 (0.00 to 0.00)	0.00 (0.00 to 0.00)
Republic of Korea	5.36 (3.64 to 7.52)	4.38 (2.95 to 6.02)	-0.02 (-0.02 to -0.01)	0.00 (-0.01 to 0.00)	17.14 (13.39 to 21.54)	21.90 (17.35 to 27.90)	-0.02 (-0.03 to -0.01)	0.00 (0.00 to 0.00)
Singapore	1.59 (1.26 to 1.97)	1.00 (0.76 to 1.29)	0.00 (-0.01 to 0.01)	0.04 (0.01 to 0.07)	2.63 (1.99 to 3.34)	3.40 (2.63 to 4.31)	-0.01 (-0.01 to -0.01)	0.00 (0.00 to 0.01)
South Asia	4.11 (2.67 to 6.35)	3.87 (2.52 to 5.46)	-0.02 (-0.03 to -0.01)	0.01 (-0.02 to 0.04)	10.72 (8.70 to 13.42)	13.56 (10.83 to 16.69)	-0.02 (-0.03 to -0.02)	0.03 (0.01 to 0.05)
Bangladesh	5.23 (3.04 to 8.68)	4.86 (3.11 to 7.57)	0.01 (-0.01 to 0.03)	0.01 (-0.04 to 0.06)	11.16 (8.78 to 13.90)	15.19 (12.06 to 18.81)	-0.01 (-0.01 to 0.00)	0.03 (0.01 to 0.05)
Bhutan	4.70 (2.72 to 8.59)	4.44 (2.63 to 6.85)	-0.01 (-0.01 to -0.01)	0.00 (-0.01 to 0.02)	10.99 (8.77 to 13.86)	12.94 (10.43 to 16.07)	-0.01 (-0.01 to -0.01)	0.02 (0.00 to 0.03)
India	3.93 (2.62 to 5.96)	3.66 (2.40 to 5.13)	-0.02 (-0.03 to -0.01)	0.01 (-0.02 to 0.04)	10.69 (8.71 to 13.41)	13.62 (10.87 to 16.84)	-0.03 (-0.03 to -0.02)	0.03 (0.01 to 0.05)
Nepal	5.11 (2.70 to 8.69)	4.48 (2.79 to 6.56)	0.00 (0.00 to 0.00)	0.01 (-0.04 to 0.06)	10.79 (8.56 to 13.64)	13.07 (10.39 to 16.65)	0.00 (0.00 to 0.00)	0.03 (0.01 to 0.04)
Pakistan	4.43 (2.70 to 7.44)	4.44 (2.67 to 7.01)	0.00 (-0.01 to 0.01)	0.01 (-0.02 to 0.04)	10.58 (8.41 to 13.19)	11.47 (9.14 to 14.59)	0.00 (0.00 to 0.00)	0.03 (0.01 to 0.04)
Southeast Asia	0.99 (0.63 to 1.69)	1.09 (0.62 to 1.81)	0.01 (0.01 to 0.01)	0.00 (-0.04 to 0.04)	1.63 (1.25 to 2.12)	1.81 (1.39 to 2.28)	0.01 (0.01 to 0.01)	0.00 (0.00 to 0.01)
Cambodia	0.85 (0.42 to 1.70)	0.80 (0.43 to 1.47)	0.00 (0.00 to 0.00)	0.01 (-0.02 to 0.04)	1.41 (1.03 to 1.82)	1.59 (1.19 to 2.05)	0.01 (0.01 to 0.01)	0.02 (0.02 to 0.02)
Indonesia	1.28 (0.68 to 2.44)	1.33 (0.64 to 2.55)	0.00 (0.00 to 0.00)	0.00 (-0.07 to 0.06)	1.58 (1.23 to 2.02)	1.69 (1.31 to 2.17)	0.00 (0.00 to 0.01)	0.01 (0.00 to 0.01)
Lao People’s Democratic Republic	0.58 (0.34 to 1.07)	0.75 (0.40 to 1.31)	0.01 (0.00 to 0.01)	0.00 (-0.01 to 0.02)	1.37 (1.01 to 1.81)	1.61 (1.19 to 2.07)	0.01 (0.01 to 0.01)	0.01 (0.01 to 0.01)
Malaysia	1.53 (0.90 to 2.74)	1.41 (0.85 to 2.33)	0.03 (0.02 to 0.04)	-0.02 (-0.07 to 0.02)	2.27 (1.75 to 2.95)	2.76 (2.13 to 3.51)	0.10 (0.08 to 0.12)	-0.05 (-0.11 to 0.00)
Maldives	1.59 (0.85 to 3.08)	1.93 (1.17 to 3.15)	0.02 (0.01 to 0.02)	-0.02 (-0.07 to 0.02)	1.61 (1.22 to 2.07)	2.10 (1.60 to 2.73)	0.01 (0.00 to 0.01)	0.01 (0.01 to 0.01)
Mauritius	1.32 (1.03 to 1.71)	3.99 (3.07 to 5.01)	0.13 (0.01 to 0.25)	-0.01 (-0.07 to 0.06)	1.94 (1.44 to 2.50)	2.17 (1.63 to 2.81)	0.00 (0.00 to 0.00)	0.01 (0.01 to 0.01)
Myanmar	1.26 (0.66 to 2.44)	1.59 (0.70 to 3.08)	0.01 (0.01 to 0.01)	0.00 (-0.04 to 0.04)	1.44 (1.08 to 1.88)	1.66 (1.26 to 2.16)	0.01 (0.00 to 0.01)	0.01 (0.01 to 0.02)
Philippines	0.65 (0.43 to 1.04)	0.79 (0.51 to 1.19)	0.01 (0.00 to 0.02)	0.00 (-0.02 to 0.03)	1.12 (0.86 to 1.45)	1.08 (0.83 to 1.38)	0.00 (0.00 to 0.00)	0.01 (0.01 to 0.02)
Seychelles	0.99 (0.61 to 1.66)	0.93 (0.55 to 1.50)	0.00 (-0.01 to 0.00)	0.01 (-0.04 to 0.05)	1.97 (1.47 to 2.58)	2.14 (1.61 to 2.76)	0.00 (0.00 to 0.01)	0.01 (0.01 to 0.01)
Sri Lanka	0.75 (0.53 to 1.03)	0.73 (0.51 to 1.01)	0.01 (0.00 to 0.01)	0.00 (-0.04 to 0.04)	2.28 (1.74 to 2.96)	2.86 (2.18 to 3.60)	0.00 (0.00 to 0.01)	0.01 (0.01 to 0.02)
Thailand	0.54 (0.38 to 0.78)	0.67 (0.46 to 0.93)	0.00 (0.00 to 0.01)	0.01 (0.00 to 0.02)	1.93 (1.47 to 2.49)	2.36 (1.84 to 3.03)	0.00 (0.00 to 0.01)	0.01 (0.01 to 0.02)
Timor-Leste	0.90 (0.49 to 1.60)	0.92 (0.49 to 1.56)	0.00 (0.00 to 0.01)	0.02 (0.00 to 0.03)	1.40 (1.03 to 1.87)	1.57 (1.20 to 2.03)	0.01 (0.01 to 0.01)	0.01 (0.01 to 0.02)
Viet Nam	0.78 (0.49 to 1.23)	0.97 (0.55 to 1.63)	0.00 (0.00 to 0.00)	-0.01 (-0.04 to 0.03)	1.77 (1.33 to 2.37)	2.06 (1.56 to 2.60)	0.00 (0.00 to 0.01)	0.01 (0.01 to 0.02)

Abbreviation: CI, confidence interval; CD, Crohn’s disease; DALY, disability-adjusted life year; GBD, global burden disease; UI, uncertainty interval.

Figure 2.

Trends in age-standardized DALY and prevalence rates (per 100,000 population) of (a) IBD, (b) UC, and (c) CD across Asian regions, 1990-2023. Shaded areas indicate 95% UIs. Abbreviations: DALY = Disability-adjusted life year; IBD = Inflammatory bowel disease; UI = Uncertainty interval; UC = Ulcerative colitis; CD = Crohn’s disease

Table S3.

Trends in age-standardized DALY and prevalence rates of IBD across five GBD regions of Asia, 1990 to 2023 (95% UI, per 100,000 population).

Location	Age-standardized DALY rate	Age-standardized Prevalence rate
Central Asia
1990	23.89 (20.36 to 28.13)	46.68 (39.45 to 55.19)
1991	23.35 (19.72 to 27.27)	46.43 (39.36 to 54.57)
1992	23.09 (19.54 to 26.98)	46.18 (39.24 to 53.96)
1993	22.83 (19.16 to 26.71)	45.96 (39.13 to 53.84)
1994	22.53 (18.97 to 26.36)	45.78 (39.06 to 53.80)
1995	21.97 (18.32 to 25.73)	45.68 (38.89 to 53.78)
1996	21.42 (17.99 to 24.86)	45.56 (38.83 to 53.86)
1997	21.04 (17.53 to 24.45)	45.34 (38.70 to 53.62)
1998	20.98 (17.69 to 24.75)	45.10 (38.48 to 53.28)
1999	21.22 (17.87 to 24.83)	44.87 (38.13 to 53.05)
2000	20.80 (17.46 to 24.31)	44.75 (37.98 to 52.99)
2001	20.19 (16.89 to 24.09)	44.71 (38.11 to 53.05)
2002	19.52 (16.33 to 23.30)	44.72 (38.21 to 53.01)
2003	19.07 (15.87 to 22.97)	44.74 (38.21 to 52.96)
2004	18.62 (15.40 to 22.71)	44.81 (38.30 to 52.89)
2005	17.05 (13.99 to 20.84)	44.91 (38.33 to 52.93)
2006	17.05 (13.92 to 20.82)	45.17 (38.59 to 52.89)
2007	17.36 (14.21 to 20.90)	45.63 (38.95 to 53.48)
2008	17.38 (14.32 to 21.07)	46.14 (39.28 to 54.14)
2009	17.53 (14.40 to 21.14)	46.59 (39.48 to 54.68)
2010	17.80 (14.66 to 21.44)	46.86 (39.59 to 54.94)
2011	17.62 (14.41 to 21.03)	46.91 (39.73 to 54.87)
2012	17.55 (14.42 to 20.94)	46.87 (39.72 to 54.73)
2013	17.58 (14.47 to 20.99)	46.78 (39.56 to 54.72)
2014	17.99 (14.87 to 21.27)	46.69 (39.59 to 54.84)
2015	18.30 (15.25 to 21.57)	46.66 (39.54 to 55.23)
2016	18.45 (15.32 to 21.76)	46.72 (39.62 to 55.33)
2017	19.12 (15.91 to 22.47)	46.85 (39.60 to 55.53)
2018	19.37 (16.24 to 22.78)	47.01 (39.78 to 55.91)
2019	18.29 (15.31 to 21.70)	47.16 (39.96 to 56.16)
2020	17.95 (14.94 to 21.04)	47.27 (40.14 to 56.23)
2021	17.29 (14.43 to 20.42)	47.41 (40.34 to 56.27)
2022	17.19 (14.32 to 20.21)	47.52 (40.31 to 56.15)
2023	17.08 (14.21 to 20.20)	47.41 (40.39 to 56.30)
East Asia
1990	15.42 (8.83 to 23.76)	5.77 (4.98 to 6.71)
1991	15.37 (8.93 to 23.33)	5.81 (5.03 to 6.72)
1992	15.42 (9.05 to 23.42)	5.87 (5.10 to 6.74)
1993	15.37 (9.25 to 23.10)	5.97 (5.19 to 6.84)
1994	15.22 (8.94 to 22.31)	6.09 (5.29 to 6.99)
1995	15.06 (8.66 to 22.02)	6.23 (5.42 to 7.17)
1996	15.00 (8.63 to 21.66)	6.43 (5.60 to 7.37)
1997	15.00 (8.62 to 21.44)	6.70 (5.85 to 7.65)
1998	15.07 (8.76 to 21.89)	7.00 (6.11 to 8.02)
1999	15.17 (8.77 to 22.31)	7.28 (6.35 to 8.38)
2000	15.41 (9.04 to 22.88)	7.48 (6.51 to 8.60)
2001	15.52 (9.02 to 23.02)	7.64 (6.66 to 8.77)
2002	15.46 (9.01 to 22.14)	7.83 (6.82 to 8.93)
2003	15.27 (9.07 to 21.52)	8.05 (7.00 to 9.19)
2004	15.19 (9.18 to 21.01)	8.31 (7.22 to 9.50)
2005	14.41 (8.94 to 19.21)	8.62 (7.49 to 9.87)
2006	13.29 (8.60 to 17.15)	9.22 (8.03 to 10.55)
2007	12.56 (8.38 to 16.24)	10.18 (8.87 to 11.63)
2008	12.13 (8.23 to 15.28)	11.24 (9.81 to 12.82)
2009	11.73 (8.23 to 14.45)	12.12 (10.60 to 13.81)
2010	11.24 (8.17 to 13.67)	12.56 (11.00 to 14.29)
2011	10.61 (7.94 to 12.86)	12.63 (11.05 to 14.40)
2012	10.03 (7.69 to 12.11)	12.63 (11.03 to 14.44)
2013	9.40 (7.31 to 11.23)	12.56 (10.93 to 14.38)
2014	8.97 (7.04 to 10.75)	12.42 (10.77 to 14.24)
2015	8.65 (6.84 to 10.38)	12.25 (10.58 to 14.06)
2016	8.39 (6.63 to 9.98)	11.80 (10.18 to 13.56)
2017	8.07 (6.40 to 9.57)	11.00 (9.49 to 12.68)
2018	7.81 (6.22 to 9.45)	10.12 (8.76 to 11.73)
2019	7.53 (6.03 to 9.28)	9.40 (8.15 to 10.95)
2020	7.41 (6.05 to 9.18)	9.09 (7.90 to 10.63)
2021	7.40 (5.99 to 9.34)	9.18 (7.95 to 10.71)
2022	7.43 (6.00 to 9.53)	9.31 (8.03 to 10.85)
2023	6.97 (5.53 to 9.02)	9.40 (8.13 to 10.93)
High-income Asia Pacific
1990	12.03 (9.68 to 14.79)	27.89 (24.10 to 32.26)
1991	11.58 (9.22 to 14.24)	28.69 (24.99 to 33.11)
1992	11.28 (8.93 to 13.76)	29.42 (25.73 to 33.91)
1993	11.08 (8.69 to 13.41)	30.07 (26.32 to 34.67)
1994	10.99 (8.58 to 13.28)	30.59 (26.70 to 35.34)
1995	10.85 (8.37 to 13.26)	30.94 (27.02 to 35.80)
1996	10.54 (8.18 to 12.65)	31.19 (27.17 to 35.98)
1997	10.34 (8.20 to 12.43)	31.44 (27.42 to 36.21)
1998	10.17 (8.11 to 12.19)	31.77 (27.68 to 36.65)
1999	10.02 (7.96 to 11.99)	32.24 (28.05 to 37.65)
2000	9.75 (7.73 to 11.89)	32.89 (28.58 to 38.54)
2001	9.77 (7.62 to 11.98)	34.85 (30.50 to 40.55)
2002	10.07 (7.79 to 12.49)	38.46 (33.82 to 44.17)
2003	10.54 (8.16 to 13.23)	42.66 (37.54 to 48.67)
2004	10.80 (8.37 to 13.64)	46.33 (40.82 to 52.53)
2005	11.05 (8.50 to 13.95)	48.41 (42.84 to 54.50)
2006	10.88 (8.39 to 13.70)	48.50 (43.33 to 54.32)
2007	10.65 (8.20 to 13.42)	47.38 (42.53 to 52.79)
2008	10.36 (7.92 to 12.95)	45.76 (41.74 to 50.70)
2009	10.01 (7.77 to 12.78)	44.33 (40.62 to 48.72)
2010	9.84 (7.60 to 12.55)	43.72 (40.22 to 47.67)
2011	9.64 (7.36 to 12.42)	43.44 (39.75 to 47.43)
2012	9.45 (7.21 to 12.05)	42.69 (38.93 to 46.77)
2013	9.18 (6.93 to 12.06)	41.72 (37.77 to 45.94)
2014	8.94 (6.81 to 11.60)	40.70 (36.47 to 45.11)
2015	8.81 (6.73 to 11.30)	39.86 (35.39 to 44.42)
2016	8.61 (6.47 to 11.09)	39.02 (34.71 to 43.92)
2017	8.63 (6.51 to 10.98)	38.01 (33.77 to 43.24)
2018	8.51 (6.50 to 10.83)	37.04 (32.62 to 42.47)
2019	8.38 (6.33 to 10.83)	36.29 (31.83 to 42.01)
2020	8.41 (6.38 to 10.88)	36.01 (31.38 to 42.13)
2021	8.54 (6.44 to 11.09)	36.00 (31.32 to 41.80)
2022	8.67 (6.56 to 11.21)	36.01 (31.24 to 41.80)
2023	8.80 (6.69 to 11.08)	36.13 (31.43 to 42.37)
South Asia
1990	20.82 (14.59 to 30.12)	38.78 (32.75 to 45.65)
1991	20.88 (14.61 to 30.59)	38.80 (32.79 to 45.65)
1992	20.85 (14.46 to 31.06)	38.89 (32.90 to 45.75)
1993	20.76 (14.33 to 30.63)	39.02 (33.07 to 45.91)
1994	20.69 (14.46 to 29.95)	39.19 (33.29 to 46.12)
1995	20.76 (14.48 to 28.88)	39.40 (33.53 to 46.38)
1996	20.80 (14.45 to 28.10)	39.81 (33.85 to 46.97)
1997	20.94 (14.55 to 28.05)	40.47 (34.39 to 47.77)
1998	21.08 (14.55 to 28.50)	41.19 (35.00 to 48.62)
1999	20.97 (14.51 to 28.13)	41.81 (35.55 to 49.40)
2000	20.87 (14.48 to 28.25)	42.15 (35.80 to 49.89)
2001	20.71 (14.68 to 28.40)	42.16 (35.81 to 49.93)
2002	20.52 (14.59 to 27.80)	42.01 (35.70 to 49.74)
2003	20.14 (14.40 to 27.21)	41.80 (35.58 to 49.46)
2004	19.65 (14.04 to 26.38)	41.65 (35.50 to 49.34)
2005	19.38 (13.93 to 26.07)	41.68 (35.47 to 49.19)
2006	19.27 (13.91 to 25.88)	42.10 (35.88 to 49.64)
2007	19.38 (13.95 to 25.78)	42.89 (36.51 to 50.53)
2008	19.46 (14.03 to 26.04)	43.82 (37.30 to 51.55)
2009	19.36 (14.09 to 25.91)	44.67 (38.07 to 52.56)
2010	19.26 (13.85 to 25.56)	45.21 (38.58 to 53.06)
2011	18.93 (13.74 to 25.11)	45.52 (38.91 to 53.44)
2012	18.61 (13.56 to 24.58)	45.83 (39.23 to 53.80)
2013	18.46 (13.49 to 24.30)	46.09 (39.46 to 54.11)
2014	18.24 (13.30 to 23.76)	46.28 (39.60 to 54.31)
2015	18.23 (13.34 to 23.77)	46.35 (39.55 to 54.38)
2016	18.16 (13.33 to 23.62)	46.09 (39.29 to 54.25)
2017	18.15 (13.14 to 23.45)	45.50 (38.69 to 53.54)
2018	17.71 (12.49 to 22.73)	44.81 (38.10 to 52.79)
2019	17.30 (12.27 to 22.22)	44.27 (37.61 to 52.16)
2020	16.28 (11.64 to 20.99)	44.14 (37.46 to 51.99)
2021	16.07 (11.50 to 21.07)	45.14 (38.25 to 53.22)
2022	16.99 (11.94 to 22.22)	46.78 (39.75 to 55.20)
2023	17.03 (12.09 to 22.16)	48.83 (41.42 to 57.55)
Southeast Asia
1990	9.94 (5.98 to 15.76)	5.32 (4.53 to 6.22)
1991	9.89 (5.93 to 16.07)	5.32 (4.54 to 6.21)
1992	9.87 (5.96 to 16.41)	5.31 (4.55 to 6.20)
1993	9.82 (5.91 to 16.36)	5.31 (4.56 to 6.20)
1994	9.74 (5.84 to 15.89)	5.30 (4.56 to 6.20)
1995	9.64 (5.74 to 15.17)	5.30 (4.56 to 6.18)
1996	9.53 (5.71 to 14.66)	5.29 (4.56 to 6.12)
1997	9.41 (5.62 to 14.44)	5.29 (4.55 to 6.10)
1998	9.32 (5.65 to 14.23)	5.29 (4.55 to 6.11)
1999	9.27 (5.79 to 14.26)	5.29 (4.56 to 6.13)
2000	9.18 (5.81 to 14.05)	5.29 (4.56 to 6.15)
2001	9.12 (5.86 to 14.05)	5.31 (4.58 to 6.18)
2002	9.06 (5.88 to 13.74)	5.34 (4.60 to 6.23)
2003	8.83 (5.78 to 13.77)	5.37 (4.63 to 6.27)
2004	8.75 (5.86 to 13.31)	5.41 (4.66 to 6.31)
2005	8.54 (5.75 to 12.84)	5.44 (4.69 to 6.33)
2006	8.45 (5.71 to 12.63)	5.47 (4.73 to 6.35)
2007	8.40 (5.67 to 12.51)	5.50 (4.78 to 6.38)
2008	8.25 (5.53 to 12.28)	5.55 (4.83 to 6.41)
2009	8.08 (5.55 to 11.83)	5.58 (4.85 to 6.42)
2010	7.91 (5.55 to 11.04)	5.59 (4.86 to 6.42)
2011	7.82 (5.58 to 11.19)	5.57 (4.85 to 6.39)
2012	7.80 (5.50 to 11.22)	5.53 (4.82 to 6.34)
2013	7.79 (5.53 to 11.26)	5.49 (4.77 to 6.29)
2014	7.80 (5.51 to 11.10)	5.46 (4.72 to 6.26)
2015	7.80 (5.55 to 10.79)	5.45 (4.70 to 6.25)
2016	7.83 (5.59 to 11.01)	5.48 (4.75 to 6.31)
2017	7.90 (5.57 to 11.20)	5.55 (4.81 to 6.41)
2018	7.95 (5.51 to 10.94)	5.64 (4.89 to 6.53)
2019	7.99 (5.44 to 10.89)	5.72 (4.95 to 6.65)
2020	7.78 (5.22 to 10.79)	5.78 (5.00 to 6.72)
2021	7.38 (4.94 to 10.25)	5.77 (4.99 to 6.71)
2022	8.00 (5.34 to 11.09)	5.78 (4.98 to 6.71)
2023	7.67 (5.13 to 11.14)	5.87 (5.06 to 6.86)

Abbreviation: DALY, disability-adjusted life year; GBD, global burden disease; IBD, inflammatory bowel disease; UI, uncertainty interval

Table S5.

Trends in age-standardized DALY and prevalence rates of CD across five GBD regions of Asia, 1990 to 2023 (95% UI, per 100,000 population).

Location	Age-standardized DALY rate	Age-standardized Prevalence rate
Central Asia
1990	6.97 (5.43 to 9.04)	14.32 (11.31 to 17.91)
1991	6.83 (5.36 to 8.76)	14.20 (11.24 to 17.79)
1992	6.75 (5.36 to 8.75)	14.09 (11.17 to 17.67)
1993	6.69 (5.31 to 8.45)	13.99 (11.10 to 17.58)
1994	6.59 (5.29 to 8.24)	13.92 (11.08 to 17.54)
1995	6.40 (5.15 to 8.02)	13.88 (11.04 to 17.55)
1996	6.26 (5.13 to 7.86)	13.84 (11.04 to 17.47)
1997	6.17 (4.96 to 7.76)	13.78 (11.02 to 17.35)
1998	6.18 (5.00 to 7.76)	13.71 (10.99 to 17.05)
1999	6.33 (5.11 to 7.91)	13.65 (10.98 to 16.97)
2000	6.22 (4.94 to 7.73)	13.61 (10.98 to 16.96)
2001	5.83 (4.62 to 7.27)	13.60 (10.95 to 16.91)
2002	5.32 (4.18 to 6.61)	13.59 (10.87 to 16.75)
2003	5.06 (3.97 to 6.24)	13.60 (10.82 to 16.70)
2004	4.91 (3.78 to 6.13)	13.61 (10.78 to 16.75)
2005	4.56 (3.42 to 5.77)	13.64 (10.77 to 16.84)
2006	4.57 (3.39 to 5.71)	13.72 (10.81 to 16.88)
2007	4.62 (3.44 to 5.85)	13.88 (10.89 to 17.12)
2008	4.62 (3.44 to 5.87)	14.06 (10.99 to 17.36)
2009	4.62 (3.47 to 5.83)	14.21 (11.09 to 17.57)
2010	4.67 (3.54 to 5.90)	14.30 (11.13 to 17.71)
2011	4.73 (3.57 to 5.96)	14.30 (11.13 to 17.73)
2012	4.77 (3.67 to 6.03)	14.26 (11.09 to 17.69)
2013	4.79 (3.66 to 6.10)	14.19 (11.06 to 17.61)
2014	4.92 (3.84 to 6.22)	14.14 (11.06 to 17.53)
2015	5.12 (4.04 to 6.51)	14.13 (11.09 to 17.50)
2016	5.13 (4.02 to 6.54)	14.17 (11.13 to 17.42)
2017	5.21 (4.09 to 6.59)	14.26 (11.18 to 17.40)
2018	5.31 (4.15 to 6.64)	14.36 (11.25 to 17.42)
2019	5.20 (4.01 to 6.45)	14.45 (11.32 to 17.61)
2020	5.05 (3.84 to 6.33)	14.49 (11.34 to 17.83)
2021	4.86 (3.72 to 6.17)	14.47 (11.42 to 17.70)
2022	4.80 (3.62 to 6.00)	14.44 (11.48 to 17.75)
2023	4.80 (3.58 to 5.98)	14.45 (11.35 to 17.84)
East Asia
1990	1.11 (0.75 to 1.65)	1.86 (1.45 to 2.39)
1991	1.16 (0.80 to 1.69)	1.93 (1.50 to 2.45)
1992	1.20 (0.84 to 1.68)	2.02 (1.57 to 2.56)
1993	1.22 (0.87 to 1.72)	2.12 (1.65 to 2.69)
1994	1.22 (0.87 to 1.75)	2.23 (1.74 to 2.84)
1995	1.21 (0.86 to 1.80)	2.35 (1.83 to 2.99)
1996	1.24 (0.88 to 1.81)	2.52 (1.97 to 3.19)
1997	1.26 (0.90 to 1.83)	2.73 (2.15 to 3.46)
1998	1.31 (0.94 to 1.85)	2.96 (2.32 to 3.74)
1999	1.33 (0.95 to 1.90)	3.13 (2.45 to 3.97)
2000	1.34 (0.95 to 1.98)	3.22 (2.50 to 4.09)
2001	1.33 (0.93 to 2.04)	3.21 (2.50 to 4.08)
2002	1.32 (0.91 to 2.04)	3.16 (2.46 to 4.01)
2003	1.30 (0.90 to 2.00)	3.10 (2.41 to 3.93)
2004	1.29 (0.91 to 1.92)	3.05 (2.38 to 3.87)
2005	1.23 (0.88 to 1.69)	3.04 (2.38 to 3.86)
2006	1.19 (0.87 to 1.57)	3.21 (2.52 to 4.08)
2007	1.20 (0.88 to 1.55)	3.60 (2.81 to 4.56)
2008	1.23 (0.89 to 1.58)	4.05 (3.16 to 5.13)
2009	1.27 (0.92 to 1.64)	4.45 (3.47 to 5.61)
2010	1.28 (0.91 to 1.65)	4.64 (3.64 to 5.83)
2011	1.25 (0.88 to 1.61)	4.66 (3.64 to 5.85)
2012	1.22 (0.86 to 1.56)	4.64 (3.61 to 5.82)
2013	1.18 (0.85 to 1.53)	4.59 (3.58 to 5.76)
2014	1.16 (0.81 to 1.50)	4.52 (3.52 to 5.68)
2015	1.14 (0.82 to 1.48)	4.44 (3.45 to 5.60)
2016	1.11 (0.82 to 1.42)	4.27 (3.33 to 5.39)
2017	1.06 (0.78 to 1.36)	3.99 (3.11 to 5.05)
2018	1.01 (0.75 to 1.29)	3.68 (2.88 to 4.66)
2019	0.97 (0.72 to 1.23)	3.44 (2.69 to 4.34)
2020	0.95 (0.70 to 1.21)	3.34 (2.62 to 4.23)
2021	0.96 (0.71 to 1.24)	3.39 (2.65 to 4.29)
2022	0.98 (0.71 to 1.27)	3.46 (2.70 to 4.39)
2023	0.95 (0.68 to 1.24)	3.49 (2.74 to 4.41)
High-income Asia Pacific
1990	3.19 (2.48 to 3.91)	8.15 (6.34 to 10.20)
1991	3.13 (2.42 to 3.91)	8.87 (6.96 to 11.05)
1992	3.15 (2.41 to 3.99)	9.49 (7.50 to 11.85)
1993	3.14 (2.38 to 3.99)	10.00 (7.94 to 12.54)
1994	3.14 (2.36 to 4.00)	10.36 (8.25 to 13.02)
1995	3.11 (2.35 to 3.99)	10.55 (8.42 to 13.22)
1996	3.03 (2.28 to 3.92)	10.57 (8.43 to 13.24)
1997	2.98 (2.24 to 3.85)	10.50 (8.36 to 13.16)
1998	2.93 (2.21 to 3.81)	10.40 (8.25 to 13.05)
1999	2.91 (2.20 to 3.76)	10.36 (8.19 to 12.99)
2000	2.86 (2.15 to 3.76)	10.43 (8.26 to 13.07)
2001	2.86 (2.15 to 3.70)	10.83 (8.71 to 13.35)
2002	2.94 (2.21 to 3.82)	11.61 (9.45 to 14.09)
2003	3.10 (2.30 to 4.04)	12.54 (10.25 to 15.06)
2004	3.17 (2.34 to 4.16)	13.39 (10.96 to 15.97)
2005	3.27 (2.47 to 4.24)	13.95 (11.43 to 16.60)
2006	3.27 (2.40 to 4.26)	14.16 (11.70 to 16.71)
2007	3.28 (2.48 to 4.35)	14.19 (11.88 to 16.59)
2008	3.25 (2.41 to 4.26)	14.12 (11.98 to 16.40)
2009	3.22 (2.38 to 4.31)	14.03 (11.93 to 16.27)
2010	3.20 (2.38 to 4.24)	13.98 (11.91 to 16.07)
2011	3.13 (2.37 to 4.13)	13.81 (11.83 to 15.95)
2012	3.05 (2.28 to 3.95)	13.38 (11.34 to 15.58)
2013	2.94 (2.20 to 3.95)	12.83 (10.78 to 15.10)
2014	2.83 (2.13 to 3.81)	12.30 (10.17 to 14.59)
2015	2.78 (2.02 to 3.74)	11.93 (9.74 to 14.23)
2016	2.73 (1.97 to 3.62)	11.70 (9.48 to 13.99)
2017	2.77 (2.02 to 3.61)	11.49 (9.26 to 13.96)
2018	2.75 (2.00 to 3.63)	11.34 (9.10 to 13.94)
2019	2.73 (1.98 to 3.54)	11.24 (9.01 to 13.88)
2020	2.74 (2.01 to 3.65)	11.23 (8.99 to 13.92)
2021	2.77 (2.05 to 3.76)	11.27 (8.96 to 13.97)
2022	2.81 (2.06 to 3.73)	11.31 (8.93 to 14.08)
2023	2.83 (2.12 to 3.68)	11.30 (8.91 to 14.37)
South Asia
1990	4.11 (2.67 to 6.35)	10.72 (8.70 to 13.42)
1991	4.11 (2.64 to 6.34)	10.72 (8.72 to 13.39)
1992	4.11 (2.68 to 6.38)	10.72 (8.70 to 13.39)
1993	4.09 (2.70 to 6.31)	10.74 (8.71 to 13.42)
1994	4.07 (2.63 to 6.27)	10.75 (8.72 to 13.46)
1995	4.07 (2.62 to 6.32)	10.78 (8.73 to 13.50)
1996	4.07 (2.63 to 6.19)	10.82 (8.76 to 13.54)
1997	4.08 (2.61 to 6.22)	10.87 (8.80 to 13.60)
1998	4.09 (2.61 to 6.27)	10.94 (8.85 to 13.64)
1999	4.08 (2.64 to 6.05)	11.01 (8.90 to 13.60)
2000	4.06 (2.59 to 6.04)	11.06 (8.94 to 13.62)
2001	4.03 (2.58 to 6.05)	11.11 (9.00 to 13.72)
2002	4.01 (2.63 to 6.09)	11.17 (9.04 to 13.74)
2003	3.96 (2.64 to 5.88)	11.23 (9.09 to 13.81)
2004	3.90 (2.64 to 5.62)	11.30 (9.14 to 13.98)
2005	3.87 (2.64 to 5.56)	11.38 (9.20 to 14.12)
2006	3.88 (2.68 to 5.63)	11.55 (9.34 to 14.33)
2007	3.93 (2.69 to 5.61)	11.83 (9.57 to 14.61)
2008	3.98 (2.72 to 5.58)	12.15 (9.83 to 14.94)
2009	4.02 (2.69 to 5.61)	12.45 (10.06 to 15.27)
2010	4.04 (2.68 to 5.65)	12.65 (10.22 to 15.49)
2011	4.03 (2.68 to 5.53)	12.79 (10.34 to 15.64)
2012	4.02 (2.68 to 5.58)	12.93 (10.46 to 15.80)
2013	4.02 (2.71 to 5.62)	13.06 (10.58 to 15.95)
2014	4.00 (2.74 to 5.63)	13.15 (10.67 to 16.07)
2015	4.01 (2.74 to 5.63)	13.19 (10.69 to 16.13)
2016	3.99 (2.75 to 5.52)	13.06 (10.61 to 15.98)
2017	3.96 (2.70 to 5.44)	12.78 (10.37 to 15.64)
2018	3.85 (2.61 to 5.32)	12.45 (10.08 to 15.24)
2019	3.76 (2.53 to 5.13)	12.18 (9.83 to 14.93)
2020	3.60 (2.37 to 4.98)	12.07 (9.74 to 14.82)
2021	3.61 (2.34 to 5.05)	12.40 (9.98 to 15.19)
2022	3.80 (2.45 to 5.38)	12.94 (10.38 to 15.92)
2023	3.87 (2.52 to 5.46)	13.56 (10.83 to 16.69)
Southeast Asia
1990	0.99 (0.63 to 1.69)	1.63 (1.25 to 2.12)
1991	1.00 (0.62 to 1.70)	1.64 (1.26 to 2.13)
1992	1.00 (0.60 to 1.69)	1.64 (1.26 to 2.14)
1993	1.00 (0.59 to 1.66)	1.64 (1.26 to 2.13)
1994	1.01 (0.58 to 1.66)	1.64 (1.26 to 2.12)
1995	1.01 (0.59 to 1.68)	1.65 (1.26 to 2.12)
1996	1.01 (0.59 to 1.72)	1.65 (1.26 to 2.12)
1997	1.01 (0.60 to 1.73)	1.64 (1.26 to 2.11)
1998	1.00 (0.60 to 1.71)	1.64 (1.26 to 2.10)
1999	1.01 (0.61 to 1.71)	1.64 (1.26 to 2.10)
2000	1.01 (0.62 to 1.71)	1.64 (1.26 to 2.09)
2001	1.01 (0.61 to 1.73)	1.64 (1.26 to 2.09)
2002	1.01 (0.62 to 1.75)	1.64 (1.26 to 2.08)
2003	1.01 (0.63 to 1.74)	1.65 (1.26 to 2.08)
2004	1.02 (0.64 to 1.75)	1.65 (1.26 to 2.08)
2005	1.01 (0.65 to 1.73)	1.66 (1.27 to 2.09)
2006	1.02 (0.64 to 1.70)	1.67 (1.29 to 2.10)
2007	1.03 (0.64 to 1.70)	1.70 (1.31 to 2.13)
2008	1.04 (0.64 to 1.67)	1.73 (1.33 to 2.15)
2009	1.05 (0.62 to 1.67)	1.75 (1.35 to 2.17)
2010	1.05 (0.62 to 1.69)	1.76 (1.37 to 2.18)
2011	1.06 (0.62 to 1.69)	1.75 (1.36 to 2.17)
2012	1.07 (0.64 to 1.70)	1.73 (1.35 to 2.14)
2013	1.08 (0.64 to 1.72)	1.72 (1.34 to 2.13)
2014	1.09 (0.67 to 1.70)	1.70 (1.32 to 2.12)
2015	1.09 (0.66 to 1.78)	1.69 (1.31 to 2.12)
2016	1.10 (0.64 to 1.81)	1.70 (1.32 to 2.13)
2017	1.11 (0.63 to 1.83)	1.72 (1.34 to 2.15)
2018	1.11 (0.66 to 1.83)	1.74 (1.36 to 2.18)
2019	1.12 (0.66 to 1.84)	1.77 (1.38 to 2.21)
2020	1.09 (0.64 to 1.75)	1.78 (1.39 to 2.23)
2021	1.04 (0.61 to 1.60)	1.78 (1.39 to 2.23)
2022	1.13 (0.62 to 1.87)	1.78 (1.38 to 2.25)
2023	1.09 (0.62 to 1.81)	1.81 (1.39 to 2.28)

Abbreviation: CD, Crohn’s disease; DALY, disability-adjusted life year; GBD, global burden disease; UI, uncertainty interval.

Table S4.

Trends in age-standardized DALY and prevalence rates of UC across five GBD regions of Asia, 1990 to 2023 (95% UI, per 100,000 population).

Location	Age-standardized DALY rate	Age-standardized Prevalence rate
Central Asia
1990	16.92 (14.27 to 19.99)	32.37 (26.16 to 40.33)
1991	16.52 (13.99 to 19.40)	32.23 (26.06 to 40.05)
1992	16.34 (13.68 to 19.11)	32.09 (25.93 to 39.57)
1993	16.15 (13.56 to 19.10)	31.96 (25.78 to 39.45)
1994	15.95 (13.40 to 18.96)	31.86 (25.70 to 39.49)
1995	15.56 (12.90 to 18.60)	31.80 (25.61 to 39.55)
1996	15.16 (12.43 to 17.95)	31.72 (25.71 to 39.32)
1997	14.87 (12.26 to 17.61)	31.56 (25.74 to 39.00)
1998	14.81 (12.34 to 17.50)	31.38 (25.71 to 38.75)
1999	14.90 (12.39 to 17.66)	31.22 (25.62 to 38.62)
2000	14.58 (12.08 to 17.52)	31.14 (25.54 to 38.71)
2001	14.36 (11.86 to 17.57)	31.11 (25.55 to 38.72)
2002	14.19 (11.65 to 17.24)	31.12 (25.41 to 38.78)
2003	14.01 (11.50 to 17.07)	31.15 (25.23 to 38.87)
2004	13.71 (11.26 to 16.85)	31.20 (25.03 to 38.97)
2005	12.49 (10.14 to 15.58)	31.27 (24.96 to 39.09)
2006	12.48 (10.20 to 15.51)	31.45 (25.15 to 39.17)
2007	12.74 (10.38 to 15.61)	31.75 (25.36 to 39.39)
2008	12.76 (10.55 to 15.51)	32.08 (25.59 to 39.94)
2009	12.91 (10.63 to 15.64)	32.38 (25.78 to 40.50)
2010	13.13 (10.91 to 15.97)	32.56 (25.84 to 40.76)
2011	12.89 (10.66 to 15.75)	32.61 (25.89 to 40.69)
2012	12.77 (10.57 to 15.45)	32.61 (25.92 to 40.46)
2013	12.79 (10.70 to 15.24)	32.59 (25.88 to 40.28)
2014	13.06 (10.88 to 15.57)	32.55 (25.83 to 40.17)
2015	13.18 (10.89 to 15.71)	32.54 (25.90 to 40.37)
2016	13.32 (11.05 to 15.79)	32.55 (26.39 to 40.41)
2017	13.91 (11.63 to 16.35)	32.59 (26.58 to 40.36)
2018	14.06 (11.82 to 16.67)	32.65 (26.52 to 40.53)
2019	13.09 (11.03 to 15.55)	32.71 (26.54 to 40.72)
2020	12.90 (10.72 to 15.46)	32.77 (26.65 to 40.92)
2021	12.43 (10.49 to 14.72)	32.94 (26.69 to 40.78)
2022	12.39 (10.36 to 14.58)	33.08 (26.65 to 40.96)
2023	12.28 (10.39 to 14.71)	32.96 (26.23 to 41.61)
East Asia
1990	14.31 (8.12 to 22.21)	3.91 (3.19 to 4.80)
1991	14.22 (8.08 to 21.60)	3.87 (3.17 to 4.77)
1992	14.22 (8.23 to 21.88)	3.85 (3.16 to 4.75)
1993	14.14 (8.26 to 21.06)	3.85 (3.16 to 4.74)
1994	13.99 (7.93 to 20.61)	3.86 (3.17 to 4.75)
1995	13.84 (7.72 to 20.17)	3.88 (3.19 to 4.77)
1996	13.76 (7.63 to 19.88)	3.91 (3.22 to 4.82)
1997	13.73 (7.56 to 19.97)	3.97 (3.26 to 4.89)
1998	13.76 (7.81 to 20.37)	4.05 (3.32 to 4.99)
1999	13.84 (7.73 to 20.58)	4.15 (3.39 to 5.13)
2000	14.07 (7.92 to 21.14)	4.27 (3.47 to 5.30)
2001	14.18 (7.89 to 21.01)	4.43 (3.62 to 5.50)
2002	14.14 (7.84 to 20.47)	4.67 (3.81 to 5.79)
2003	13.97 (7.93 to 19.95)	4.95 (4.04 to 6.15)
2004	13.90 (8.01 to 19.44)	5.26 (4.29 to 6.54)
2005	13.17 (7.77 to 17.84)	5.57 (4.56 to 6.93)
2006	12.10 (7.47 to 15.85)	6.01 (4.93 to 7.45)
2007	11.36 (7.23 to 14.91)	6.59 (5.42 to 8.13)
2008	10.90 (7.14 to 13.99)	7.19 (5.95 to 8.83)
2009	10.46 (7.02 to 13.00)	7.67 (6.37 to 9.40)
2010	9.96 (7.01 to 12.25)	7.92 (6.58 to 9.69)
2011	9.36 (6.79 to 11.50)	7.98 (6.63 to 9.78)
2012	8.81 (6.54 to 10.69)	7.99 (6.62 to 9.83)
2013	8.22 (6.16 to 9.97)	7.97 (6.58 to 9.82)
2014	7.82 (6.03 to 9.42)	7.90 (6.52 to 9.76)
2015	7.51 (5.82 to 9.10)	7.81 (6.42 to 9.66)
2016	7.28 (5.62 to 8.82)	7.53 (6.18 to 9.36)
2017	7.01 (5.42 to 8.47)	7.01 (5.75 to 8.77)
2018	6.80 (5.35 to 8.46)	6.44 (5.28 to 8.07)
2019	6.57 (5.23 to 8.14)	5.96 (4.88 to 7.47)
2020	6.46 (5.16 to 8.06)	5.76 (4.70 to 7.21)
2021	6.44 (5.16 to 8.20)	5.79 (4.73 to 7.25)
2022	6.46 (5.11 to 8.46)	5.85 (4.80 to 7.27)
2023	6.03 (4.63 to 7.98)	5.91 (4.87 to 7.41)
High-income Asia Pacific
1990	8.84 (6.79 to 11.00)	19.74 (16.17 to 24.18)
1991	8.45 (6.38 to 10.67)	19.82 (16.29 to 24.23)
1992	8.13 (6.16 to 10.12)	19.93 (16.42 to 24.35)
1993	7.93 (5.90 to 9.75)	20.07 (16.54 to 24.55)
1994	7.85 (5.81 to 9.56)	20.23 (16.64 to 24.82)
1995	7.75 (5.67 to 9.54)	20.40 (16.73 to 25.07)
1996	7.50 (5.54 to 9.17)	20.62 (16.93 to 25.30)
1997	7.37 (5.53 to 9.06)	20.94 (17.18 to 25.69)
1998	7.24 (5.58 to 8.91)	21.37 (17.50 to 26.18)
1999	7.11 (5.51 to 8.78)	21.88 (17.91 to 26.86)
2000	6.90 (5.46 to 8.52)	22.46 (18.43 to 27.74)
2001	6.91 (5.41 to 8.57)	24.02 (19.74 to 29.29)
2002	7.13 (5.54 to 8.97)	26.85 (22.08 to 32.51)
2003	7.44 (5.77 to 9.27)	30.12 (24.86 to 36.19)
2004	7.63 (5.77 to 9.76)	32.94 (27.27 to 39.30)
2005	7.77 (5.89 to 9.84)	34.46 (28.68 to 40.92)
2006	7.61 (5.77 to 9.66)	34.34 (28.99 to 40.28)
2007	7.38 (5.61 to 9.40)	33.19 (28.43 to 38.44)
2008	7.11 (5.34 to 9.04)	31.64 (27.48 to 36.28)
2009	6.80 (5.19 to 8.72)	30.30 (26.47 to 34.33)
2010	6.64 (5.02 to 8.45)	29.74 (26.04 to 33.62)
2011	6.51 (4.84 to 8.33)	29.63 (26.00 to 33.51)
2012	6.40 (4.73 to 8.21)	29.32 (25.45 to 33.35)
2013	6.24 (4.73 to 8.13)	28.88 (24.63 to 33.10)
2014	6.11 (4.43 to 8.07)	28.40 (23.80 to 32.88)
2015	6.02 (4.42 to 7.92)	27.93 (23.01 to 32.66)
2016	5.87 (4.30 to 7.77)	27.32 (22.50 to 32.29)
2017	5.86 (4.34 to 7.67)	26.52 (21.79 to 31.81)
2018	5.76 (4.26 to 7.43)	25.70 (21.03 to 31.32)
2019	5.66 (4.22 to 7.54)	25.05 (20.38 to 31.02)
2020	5.67 (4.22 to 7.54)	24.78 (20.06 to 30.82)
2021	5.77 (4.30 to 7.49)	24.73 (20.17 to 30.78)
2022	5.87 (4.46 to 7.59)	24.70 (20.24 to 30.51)
2023	5.97 (4.51 to 7.76)	24.83 (20.31 to 30.61)
South Asia
1990	16.72 (11.35 to 24.44)	28.06 (22.37 to 34.64)
1991	16.76 (11.26 to 25.37)	28.09 (22.43 to 34.70)
1992	16.75 (11.27 to 24.97)	28.16 (22.54 to 34.82)
1993	16.67 (11.21 to 24.64)	28.28 (22.71 to 34.98)
1994	16.62 (11.19 to 23.93)	28.44 (22.91 to 35.21)
1995	16.68 (11.12 to 23.22)	28.63 (23.13 to 35.50)
1996	16.72 (11.27 to 23.33)	28.99 (23.42 to 36.01)
1997	16.86 (11.34 to 23.45)	29.59 (23.90 to 36.78)
1998	16.98 (11.31 to 23.07)	30.25 (24.39 to 37.66)
1999	16.89 (11.31 to 22.98)	30.80 (24.82 to 38.42)
2000	16.81 (11.80 to 23.13)	31.08 (25.06 to 38.85)
2001	16.68 (11.71 to 23.22)	31.05 (25.02 to 38.77)
2002	16.52 (11.50 to 22.47)	30.84 (24.88 to 38.44)
2003	16.19 (11.27 to 21.77)	30.57 (24.66 to 38.02)
2004	15.76 (10.98 to 21.27)	30.35 (24.50 to 37.67)
2005	15.51 (10.83 to 21.02)	30.30 (24.43 to 37.56)
2006	15.39 (11.00 to 21.11)	30.55 (24.56 to 37.94)
2007	15.46 (11.01 to 21.17)	31.06 (25.12 to 38.66)
2008	15.48 (10.75 to 20.94)	31.67 (25.60 to 39.50)
2009	15.34 (10.71 to 21.05)	32.23 (25.96 to 40.15)
2010	15.21 (10.69 to 20.87)	32.56 (26.04 to 40.53)
2011	14.90 (10.49 to 20.48)	32.73 (26.28 to 40.65)
2012	14.59 (10.26 to 19.89)	32.90 (26.51 to 40.77)
2013	14.44 (10.15 to 19.08)	33.03 (26.62 to 40.85)
2014	14.24 (10.08 to 18.60)	33.12 (26.69 to 40.91)
2015	14.22 (10.23 to 18.67)	33.16 (26.73 to 40.91)
2016	14.17 (10.11 to 18.77)	33.03 (26.56 to 40.79)
2017	14.19 (10.11 to 18.64)	32.72 (26.42 to 40.57)
2018	13.86 (9.67 to 17.88)	32.36 (26.22 to 40.05)
2019	13.54 (9.50 to 17.25)	32.10 (26.09 to 39.82)
2020	12.68 (9.00 to 16.23)	32.06 (26.07 to 39.90)
2021	12.47 (8.77 to 16.14)	32.74 (26.51 to 40.68)
2022	13.19 (9.24 to 17.06)	33.84 (27.30 to 41.93)
2023	13.16 (9.52 to 17.29)	35.27 (28.14 to 43.86)
Southeast Asia
1990	8.95 (5.25 to 14.34)	3.69 (3.00 to 4.63)
1991	8.89 (5.15 to 14.67)	3.68 (2.99 to 4.62)
1992	8.86 (5.14 to 15.15)	3.67 (2.99 to 4.61)
1993	8.82 (5.02 to 15.18)	3.66 (2.99 to 4.59)
1994	8.73 (5.05 to 14.58)	3.66 (2.99 to 4.58)
1995	8.63 (4.97 to 13.89)	3.65 (2.99 to 4.57)
1996	8.52 (4.96 to 13.37)	3.65 (2.99 to 4.57)
1997	8.41 (4.94 to 13.24)	3.65 (2.98 to 4.56)
1998	8.32 (4.96 to 13.03)	3.64 (2.98 to 4.56)
1999	8.26 (5.02 to 13.31)	3.64 (2.98 to 4.56)
2000	8.18 (5.00 to 13.23)	3.65 (2.98 to 4.58)
2001	8.11 (4.99 to 12.94)	3.66 (2.99 to 4.60)
2002	8.05 (4.92 to 12.68)	3.69 (3.02 to 4.64)
2003	7.83 (4.87 to 12.45)	3.73 (3.05 to 4.68)
2004	7.74 (4.92 to 12.10)	3.76 (3.08 to 4.70)
2005	7.53 (4.79 to 11.55)	3.78 (3.09 to 4.72)
2006	7.43 (4.68 to 11.38)	3.79 (3.10 to 4.73)
2007	7.36 (4.67 to 11.25)	3.81 (3.11 to 4.75)
2008	7.21 (4.60 to 11.16)	3.82 (3.12 to 4.74)
2009	7.04 (4.57 to 10.59)	3.82 (3.12 to 4.73)
2010	6.86 (4.55 to 9.92)	3.82 (3.13 to 4.71)
2011	6.76 (4.57 to 9.91)	3.82 (3.12 to 4.70)
2012	6.73 (4.54 to 9.87)	3.80 (3.10 to 4.68)
2013	6.70 (4.53 to 9.83)	3.78 (3.09 to 4.66)
2014	6.71 (4.55 to 9.76)	3.76 (3.07 to 4.65)
2015	6.71 (4.49 to 9.57)	3.76 (3.07 to 4.65)
2016	6.74 (4.49 to 9.67)	3.78 (3.09 to 4.70)
2017	6.79 (4.54 to 9.71)	3.83 (3.13 to 4.79)
2018	6.84 (4.55 to 9.86)	3.90 (3.17 to 4.89)
2019	6.87 (4.51 to 9.68)	3.96 (3.22 to 4.96)
2020	6.69 (4.32 to 9.53)	4.00 (3.25 to 5.01)
2021	6.35 (4.13 to 9.15)	3.99 (3.24 to 5.02)
2022	6.87 (4.41 to 9.97)	4.00 (3.23 to 5.03)
2023	6.57 (4.15 to 9.70)	4.06 (3.28 to 5.11)

Abbreviation: DALY, disability-adjusted life year; GBD, global burden disease; UC, ulcerative colitis; UI, uncertainty interval.

Average annual percentage change patterns of age-standardized disability-adjusted life year rate and age-standardized prevalence rate for inflammatory bowel disease, ulcerative colitis, and Crohn’s disease across Asia, 1990–2023

As shown in Figure 3, AAPC estimates for IBD, UC, and CD generally showed declining ASDRs and increasing ASPRs across the five Asian regions. China illustrated this metric distinction, with a negative overall IBD ASDR AAPC (−2.36 [95% CI, −2.45 to −2.27]) per 100,000 population, despite varying segment − specific APCs across 1990–2023. As shown in Tables S6 and S7, for overall IBD, the largest decline in ASDR was observed in East Asia (AAPC, −2.32 [95% CI, −2.41 to −2.24]), followed by Central Asia (−1.03 [−1.12 to −0.95]), high − income Asia Pacific (−0.93 [−0.98 to −0.87]), Southeast Asia (−0.77 [−0.87 to −0.63]), and South Asia (−0.57 [−0.65 to −0.50]). In contrast, the largest increase in ASPR for overall IBD was observed in East Asia (AAPC, 1.50 [95% CI, 1.41 to 1.61]), followed by high-income Asia Pacific (0.79 [0.71 to 0.86]), South Asia (0.69 [0.67 to 0.71]), Southeast Asia (0.29 [0.27 to 0.30]), and Central Asia (0.06 [0.05 to 0.07]). At the country level, Mauritius (AAPC, 1.56 [95% CI, 0.45 to 2.37]) and Thailand (0.79 [0.73 to 0.86]) were the only countries showing increasing ASDR trends. In contrast, Tajikistan (0.01 [−0.07 to 0.11]) and Turkmenistan (0.00 [−0.05 to 0.05]) had ASDR AAPC estimates with 95% CIs crossing zero. For ASPR, declining trends were observed only in the Democratic People’s Republic of Korea (AAPC, −0.50 [95% CI, −0.51 to −0.49]) and the Philippines (−0.21 [−0.21 to −0.20]).

Figure 3.

AAPC in age-standardized DALY rates and prevalence rates (per 100,000 population) of IBD, UC, and CD across Asia, 1990–2023, for both sexes. (a) AAPCs in age-standardized DALY rates of IBD, UC, and CD. (b) AAPCs in age-standardized prevalence rates of IBD, UC, and CD. Abbreviations: AAPC = Average annual percentage change; DALY = Disability-adjusted life year; IBD = Inflammatory bowel disease; UC = Ulcerative colitis; CD = Crohn’s disease

Table S6.

Joinpoint regression analysis of age-standardized DALY rates for IBD across five GBD regions and 34 Asian countries, 1990 to 2023: APCs and AAPCs with 95% CIs.

Location	Period	APC (95% CI)	AAPC, 1990-2023 (95% CI)
Central Asia	1990-2001	-1.41 (-1.66 to -1.06)	-1.03 (-1.12 to -0.95)
	2001-2006	-3.49 (-5.19 to -2.65)
	2006-2018	0.88 (0.62 to 1.22)
	2018-2023	-2.24 (-3.32 to -1.43)
Armenia	1990-1994	-3.90 (-6.28 to -2.66)	-1.71 (-1.86 to -1.59)
	1994-1999	-0.17 (-1.04 to 1.68)
	1999-2011	-1.52 (-3.20 to -1.26)
	2011-2018	1.15 (0.36 to 2.35)
	2018-2021	-8.28 (-9.58 to -3.16)
	2021-2023	-1.99 (-5.27 to 0.23)
Azerbaijan	1990-1994	-0.40 (-0.71 to -0.04)	-0.24 (-0.27 to -0.21)
	1994-1998	-2.15 (-2.61 to -1.77)
	1998-2001	-0.81 (-1.53 to 0.35)
	2001-2011	0.40 (0.11 to 0.82)
	2011-2023	0.06 (-0.05 to 0.14)
Georgia	1990-1997	-4.16 (-8.21 to -2.44)	-2.52 (-2.80 to -2.25)
	1997-2000	1.56 (-14.60 to 4.24)
	2000-2005	-13.28 (-16.48 to 3.55)
	2005-2015	2.99 (-4.06 to 5.28)
	2015-2023	-2.17 (-4.02 to 0.16)
Kazakhstan	1990-2011	0.28 (0.19 to 0.42)	-0.65 (-0.78 to -0.58)
	2011-2014	-2.27 (-3.15 to -0.44)
	2014-2018	2.34 (1.23 to 3.95)
	2018-2021	-8.21 (-9.46 to -5.75)
	2021-2023	-2.10 (-4.95 to -0.03)
Kyrgyzstan	1990-2002	-3.35 (-4.00 to -2.44)	-2.99 (-3.20 to -2.75)
	2002-2005	-18.45 (-20.36 to -13.18)
	2005-2023	0.10 (-0.36 to 0.63)
Mongolia	1990-1992	2.47 (0.67 to 3.64)	-1.03 (-1.10 to -0.96)
	1992-2005	-1.17 (-1.35 to -1.02)
	2005-2015	-3.09 (-3.35 to -2.89)
	2015-2023	0.96 (0.69 to 1.23)
Tajikistan	1990-1994	1.08 (0.02 to 2.25)	0.01 (-0.07 to 0.11)
	1994-2001	-3.75 (-4.38 to -3.33)
	2001-2008	1.02 (0.59 to 2.23)
	2008-2018	-0.22 (-0.89 to 0.03)
	2018-2023	3.67 (2.91 to 4.85)
Turkmenistan	1990-1997	-3.31 (-3.52 to -3.10)	0.00 (-0.05 to 0.05)
	1997-2003	1.58 (1.36 to 1.94)
	2003-2006	-0.38 (-0.81 to 0.50)
	2006-2015	2.19 (2.01 to 2.49)
	2015-2021	0.65 (0.27 to 1.01)
	2021-2023	-3.94 (-4.87 to -2.50)
Uzbekistan	1990-2003	-1.42 (-1.81 to -0.86)	-0.72 (-0.92 to -0.54)
	2003-2006	-7.73 (-9.24 to -4.17)
	2006-2018	2.10 (1.61 to 3.55)
	2018-2023	-1.21 (-4.74 to 0.53)
East Asia	1990-2004	-0.12 (-0.33 to 0.08)	-2.32 (-2.41 to -2.24)
	2004-2016	-4.98 (-5.30 to -4.73)
	2016-2023	-2.07 (-2.64 to -1.31)
China	1990-1996	-0.38 (-1.89 to 0.33)	-2.36 (-2.45 to -2.27)
	1996-2003	0.78 (-4.98 to 1.82)
	2003-2016	-5.00 (-5.32 to -4.21)
	2016-2023	-2.18 (-2.72 to -1.45)
Democratic People’s Republic of Korea	1990-1993	-0.77 (-1.12 to -0.13)	-1.30 (-1.33 to -1.27)
	1993-1997	-1.81 (-2.16 to -1.51)
	1997-2006	-1.16 (-1.27 to -0.95)
	2006-2010	0.24 (-0.11 to 0.70)
	2010-2015	-1.55 (-1.96 to -1.30)
	2015-2021	-0.44 (-0.61 to -0.18)
	2021-2023	-6.54 (-7.09 to -6.11)
Taiwan	1990-1992	17.64 (5.53 to 28.23)	-2.32 (-2.69 to -1.87)
	1992-2001	-11.11 (-13.07 to -10.02)
	2001-2004	8.68 (1.56 to 12.20)
	2004-2023	-1.51 (-2.16 to -1.11)
High-income Asia Pacific	1990-1992	-2.99 (-3.59 to -1.80)	-0.93 (-0.98 to -0.87)
	1992-2001	-1.66 (-1.77 to 3.45)
	2001-2005	3.47 (-2.20 to 3.73)
	2005-2015	-2.39 (-2.57 to -2.24)
	2015-2020	-0.86 (-1.40 to -0.29)
	2020-2023	1.71 (1.00 to 2.88)
Brunei Darussalam	1990-2000	-1.89 (-2.07 to -1.75)	-0.81 (-0.86 to -0.77)
	2000-2012	-0.43 (-0.61 to -0.30)
	2012-2017	0.60 (0.28 to 1.26)
	2017-2020	-2.41 (-2.90 to -1.65)
	2020-2023	0.58 (-0.01 to 1.78)
Japan	1990-2000	-1.81 (-2.20 to -1.48)	-0.43 (-0.52 to -0.34)
	2000-2005	4.99 (3.92 to 6.46)
	2005-2010	-5.96 (-7.42 to -4.54)
	2010-2015	-0.58 (-4.26 to 0.60)
	2015-2023	1.67 (1.15 to 3.15)
Republic of Korea	1990-1998	-1.89 (-2.12 to -1.63)	-2.36 (-2.43 to -2.32)
	1998-2002	-3.60 (-4.33 to -2.19)
	2002-2010	-1.19 (-3.27 to -0.89)
	2010-2018	-4.49 (-4.84 to -1.18)
	2018-2021	-1.62 (-4.58 to -1.20)
	2021-2023	1.12 (-0.52 to 2.08)
Singapore	1990-1993	-6.07 (-10.98 to -0.97)	-1.88 (-2.14 to -1.58)
	1993-1996	4.47 (-6.05 to 7.43)
	1996-2002	-6.47 (-10.10 to -2.12)
	2002-2019	-2.43 (-2.98 to -1.91)
	2019-2023	6.42 (3.42 to 12.66)
South Asia	1990-1999	0.04 (-0.21 to 0.42)	-0.57 (-0.65 to -0.50)
	1999-2018	-0.85 (-0.94 to -0.75)
	2018-2021	-3.29 (-3.98 to -2.23)
	2021-2023	3.51 (1.79 to 4.88)
Bangladesh	1990-2006	-0.48 (-0.63 to -0.31)	-0.68 (-0.78 to -0.60)
	2006-2014	-2.69 (-3.28 to -2.29)
	2014-2018	3.22 (2.28 to 4.88)
	2018-2021	-4.57 (-5.66 to -3.13)
	2021-2023	4.20 (2.11 to 6.10)
Bhutan	1990-1997	0.25 (-0.07 to 0.64)	-0.74 (-0.78 to -0.68)
	1997-2014	-1.34 (-1.47 to -1.25)
	2014-2023	-0.34 (-0.56 to -0.02)
India	1990-2000	0.24 (0.07 to 0.42)	-0.62 (-0.67 to -0.57)
	2000-2005	-1.85 (-2.76 to -1.39)
	2005-2009	0.40 (-0.18 to 1.18)
	2009-2017	-0.86 (-1.13 to -0.66)
	2017-2020	-4.15 (-4.68 to -3.22)
	2020-2023	1.50 (0.75 to 2.39)
Nepal	1990-1996	-1.07 (-1.65 to -0.07)	-1.03 (-1.15 to -0.94)
	1996-2005	-2.72 (-3.86 to -2.35)
	2005-2014	-0.68 (-2.02 to -0.34)
	2014-2018	0.86 (-0.08 to 2.03)
	2018-2021	-3.07 (-4.15 to -1.80)
	2021-2023	4.59 (2.42 to 6.45)
Pakistan	1990-2002	0.14 (-0.07 to 0.42)	-0.32 (-0.42 to -0.23)
	2002-2021	-0.99 (-1.15 to -0.89)
	2021-2023	3.40 (0.78 to 4.87)
Southeast Asia	1990-2002	-0.87 (-1.16 to 1.11)	-0.77 (-0.87 to -0.63)
	2002-2011	-1.56 (-3.38 to 0.70)
	2011-2023	-0.07 (-0.81 to 0.59)
Cambodia	1990-2005	-1.18 (-1.48 to -1.00)	-0.76 (-0.83 to -0.69)
	2005-2023	-0.41 (-0.55 to -0.21)
	1990-2023	-1.16 (-1.26 to -1.06)
Indonesia	1990-2023	-1.16 (-1.26 to -1.06)	-1.16 (-1.26 to -1.06)
Lao People’s Democratic Republic	1990-1993	0.86 (0.37 to 1.55)	-0.42 (-0.45 to -0.38)
	1993-1998	-0.03 (-1.87 to 0.14)
	1998-2006	-2.35 (-2.49 to -2.21)
	2006-2009	0.82 (0.25 to 1.07)
	2009-2018	0.12 (-0.19 to 0.21)
	2018-2021	1.47 (0.98 to 1.81)
	2021-2023	-2.55 (-3.11 to -1.94)
Malaysia	1990-2004	-3.16 (-3.72 to -2.70)	-0.91 (-1.07 to -0.76)
	2004-2023	0.77 (0.46 to 1.13)
Maldives	1990-2012	-0.42 (-0.54 to -0.31)	0.05 (-0.05 to 0.13)
	2012-2018	3.65 (2.81 to 5.04)
	2018-2023	-2.08 (-3.10 to -1.13)
Mauritius	1990-2004	-5.30 (-7.51 to -3.41)	1.56 (0.45 to 2.37)
	2004-2007	71.30 (33.17 to 85.93)
	2007-2012	-22.40 (-34.29 to -15.21)
	2012-2018	20.17 (12.02 to 48.60)
	2018-2023	-3.47 (-16.07 to 4.24)
Myanmar	1990-2007	-1.45 (-1.64 to -1.29)	-0.59 (-0.66 to -0.52)
	2007-2023	0.33 (0.15 to 0.54)
Philippines	1990-2002	0.06 (-0.16 to 0.37)	-0.49 (-0.57 to -0.41)
	2002-2007	-1.36 (-2.38 to -0.01)
	2007-2011	-4.77 (-5.94 to -1.62)
	2011-2014	-0.49 (-4.30 to 1.24)
	2014-2021	2.12 (1.79 to 3.30)
	2021-2023	-1.76 (-3.23 to 0.19)
Seychelles	1990-1994	-0.69 (-1.48 to 0.83)	-1.08 (-1.17 to -1.00)
	1994-2008	-1.94 (-2.41 to -1.80)
	2008-2018	-0.72 (-0.92 to -0.23)
	2018-2021	-3.48 (-4.25 to -2.38)
	2021-2023	6.20 (4.44 to 7.78)
Sri Lanka	1990-2004	-1.39 (-1.69 to -1.12)	-0.48 (-0.57 to -0.38)
	2004-2009	3.13 (1.77 to 5.53)
	2009-2013	-2.49 (-4.05 to -0.93)
	2013-2023	-0.16 (-0.56 to 1.03)
Thailand	1990-1995	1.43 (1.04 to 2.12)	0.79 (0.73 to 0.86)
	1995-1998	-1.74 (-2.31 to -0.64)
	1998-2004	1.80 (1.40 to 2.44)
	2004-2012	-1.28 (-1.57 to -1.03)
	2012-2019	3.22 (2.93 to 3.60)
	2019-2023	0.43 (-0.49 to 1.12)
Timor-Leste	1990-2000	-0.97 (-1.31 to -0.47)	-0.60 (-0.68 to -0.51)
	2000-2006	-3.28 (-5.41 to -2.53)
	2006-2023	0.58 (0.40 to 0.78)
Viet Nam	1990-2008	-0.53 (-0.94 to -0.11)	-0.40 (-0.54 to -0.28)
	2008-2018	0.20 (-0.69 to 1.81)
	2018-2023	-1.12 (-3.15 to -0.16)

Abbreviation: AAPC, Average annual percentage changes; APC, Annual percentage changes; CI, Confidence intervals; DALY, disability-adjusted life year; GBD, Global burden of disease; IBD, Inflammatory bowel disease.

Table S7.

Joinpoint regression analysis of age-standardized Prevalence rates for IBD across five GBD regions and 34 Asian countries, 1990 to 2023: APCs and AAPCs with 95% CIs.

Location	Period	APC (95% CI)	AAPC, 1990-2023 (95% CI)
Central Asia	1990-2000	-0.42 (-0.45 to -0.38)	0.06 (0.05 to 0.07)
	2000-2005	0.05 (-0.04 to 0.18)
	2005-2010	0.93 (0.86 to 1.01)
	2010-2015	-0.12 (-0.25 to -0.05)
	2015-2023	0.24 (0.20 to 0.30)
Armenia	1990-1995	0.12 (0.11 to 0.14)	0.21 (0.20 to 0.21)
	1995-2000	-0.13 (-0.15 to -0.12)
	2000-2006	0.35 (0.33 to 0.37)
	2006-2009	0.50 (0.45 to 0.53)
	2009-2013	0.30 (0.26 to 0.33)
	2013-2021	0.16 (0.14 to 0.17)
	2021-2023	0.38 (0.31 to 0.43)
Azerbaijan	1990-1995	0.15 (0.04 to 0.27)	0.18 (0.16 to 0.19)
	1995-2000	-1.17 (-1.28 to -1.07)
	2000-2006	0.28 (0.14 to 0.38)
	2006-2015	1.11 (1.06 to 1.17)
	2015-2023	-0.08 (-0.13 to -0.03)
Georgia	1990-1995	0.00 (-0.08 to 0.08)	0.11 (0.09 to 0.12)
	1995-2000	-1.10 (-1.17 to -1.03)
	2000-2006	0.14 (0.04 to 0.21)
	2006-2021	0.54 (0.53 to 0.57)
	2021-2023	0.03 (-0.17 to 0.33)
Kazakhstan	1990-1994	-2.42 (-2.56 to -2.28)	0.03 (0.01 to 0.05)
	1994-2000	-0.16 (-0.30 to -0.06)
	2000-2005	0.41 (0.29 to 0.62)
	2005-2010	2.20 (2.10 to 2.31)
	2010-2018	-0.23 (-0.35 to -0.17)
	2018-2023	0.13 (-0.01 to 0.43)
Kyrgyzstan	1990-1995	0.53 (0.44 to 0.63)	0.29 (0.28 to 0.31)
	1995-2000	-0.96 (-1.06 to -0.87)
	2000-2005	0.41 (0.20 to 0.51)
	2005-2010	0.88 (0.76 to 1.13)
	2010-2015	0.26 (0.03 to 0.38)
	2015-2019	1.09 (0.92 to 1.33)
	2019-2023	-0.05 (-0.20 to 0.10)
Mongolia	1990-1994	0.55 (0.49 to 0.61)	0.15 (0.15 to 0.16)
	1994-1999	0.10 (0.05 to 0.16)
	1999-2005	-0.08 (-0.14 to -0.05)
	2005-2015	0.32 (0.30 to 0.33)
	2015-2020	-0.18 (-0.25 to -0.15)
	2020-2023	0.21 (0.11 to 0.37)
Tajikistan	1990-1993	0.13 (0.07 to 0.25)	0.08 (0.07 to 0.08)
	1993-1996	-0.20 (-0.32 to -0.12)
	1996-2000	-0.66 (-0.71 to -0.62)
	2000-2005	0.13 (0.07 to 0.16)
	2005-2010	0.45 (0.40 to 0.52)
	2010-2015	0.13 (0.05 to 0.18)
	2015-2023	0.23 (0.21 to 0.29)
Turkmenistan	1990-1992	0.55 (0.29 to 0.73)	0.23 (0.22 to 0.24)
	1992-1995	0.17 (-0.72 to 0.25)
	1995-2000	-0.67 (-0.73 to 0.90)
	2000-2005	0.87 (-0.03 to 0.93)
	2005-2010	-0.01 (-0.07 to 0.78)
	2010-2015	0.76 (0.13 to 0.83)
	2015-2023	0.17 (0.13 to 0.23)
Uzbekistan	1990-1994	0.41 (0.28 to 0.63)	0.03 (0.02 to 0.05)
	1994-1998	-0.05 (-0.33 to 0.13)
	1998-2005	-0.39 (-0.51 to -0.21)
	2005-2010	0.58 (0.46 to 0.67)
	2010-2015	-0.98 (-1.06 to -0.91)
	2015-2021	0.76 (0.71 to 0.86)
	2021-2023	-0.02 (-0.26 to 0.30)
East Asia	1990-1993	0.91 (-0.91 to 2.44)	1.50 (1.41 to 1.61)
	1993-2005	3.20 (2.99 to 3.66)
	2005-2010	8.24 (7.52 to 9.35)
	2010-2015	-0.77 (-1.46 to -0.11)
	2015-2020	-6.15 (-6.96 to -5.45)
	2020-2023	1.58 (0.32 to 2.96)
China	1990-1995	1.65 (0.56 to 2.21)	1.58 (1.50 to 1.65)
	1995-1999	4.54 (3.69 to 5.62)
	1999-2005	2.62 (1.90 to 2.99)
	2005-2009	10.00 (9.38 to 10.63)
	2009-2015	0.06 (-0.29 to 0.41)
	2015-2020	-6.44 (-6.87 to -6.03)
	2020-2023	1.75 (0.82 to 2.61)
Democratic People’s Republic of Korea	1990-1993	-2.51 (-2.75 to -2.36)	-0.50 (-0.51 to -0.49)
	1993-1999	-2.02 (-2.07 to -1.95)
	1999-2002	-0.14 (-0.24 to -0.04)
	2002-2005	0.46 (0.31 to 0.56)
	2005-2010	-0.17 (-0.31 to -0.11)
	2010-2020	0.16 (0.12 to 0.19)
	2020-2023	0.53 (0.38 to 0.77)
Taiwan	1990-1996	-0.59 (-1.51 to 0.41)	0.05 (-0.12 to 0.21)
	1996-2000	-12.94 (-13.94 to -10.88)
	2000-2012	7.86 (7.34 to 8.52)
	2012-2015	4.55 (-1.49 to 7.21)
	2015-2020	-8.76 (-11.00 to -7.72)
	2020-2023	0.77 (-1.95 to 5.35)
High-income Asia Pacific	1990-1993	2.59 (1.52 to 3.95)	0.79 (0.71 to 0.86)
	1993-2000	1.15 (0.60 to 8.15)
	2000-2005	8.55 (-1.81 to 8.88)
	2005-2020	-2.11 (-2.24 to -2.02)
	2020-2023	0.41 (-0.55 to 2.01)
Brunei Darussalam	1990-2005	0.46 (0.44 to 0.49)	0.29 (0.28 to 0.30)
	2005-2010	-0.40 (-0.49 to -0.28)
	2010-2018	0.64 (0.58 to 0.70)
	2018-2023	-0.06 (-0.19 to 0.06)
Japan	1990-1994	2.96 (2.00 to 4.58)	0.32 (0.24 to 0.41)
	1994-2000	-0.40 (-1.06 to 0.11)
	2000-2005	9.40 (8.83 to 9.99)
	2005-2010	-8.69 (-9.09 to -8.26)
	2010-2023	0.13 (-0.05 to 0.30)
Republic of Korea	1990-1995	1.36 (0.86 to 1.72)	1.28 (1.24 to 1.33)
	1995-2000	4.04 (3.57 to 4.54)
	2000-2004	7.39 (6.88 to 8.12)
	2004-2008	5.43 (4.85 to 5.88)
	2008-2011	1.03 (0.58 to 1.52)
	2011-2019	-4.51 (-4.67 to -4.37)
	2019-2023	-0.06 (-0.41 to 0.30)
Singapore	1990-1994	3.47 (3.14 to 3.82)	0.67 (0.63 to 0.71)
	1994-2001	-0.03 (-0.32 to 0.15)
	2001-2005	1.35 (0.69 to 2.12)
	2005-2010	3.96 (3.72 to 4.33)
	2010-2019	-1.75 (-1.90 to -1.63)
	2019-2023	-0.07 (-0.49 to 0.62)
South Asia	1990-1995	0.32 (0.03 to 0.50)	0.69 (0.67 to 0.71)
	1995-2000	1.47 (1.30 to 1.75)
	2000-2005	-0.37 (-0.53 to -0.22)
	2005-2010	1.77 (1.59 to 1.96)
	2010-2015	0.52 (0.30 to 0.70)
	2015-2020	-1.17 (-1.32 to -1.03)
	2020-2023	3.49 (3.22 to 3.75)
Bangladesh	1990-1995	-0.59 (-0.86 to -0.35)	0.89 (0.86 to 0.92)
	1995-2000	1.59 (1.34 to 2.01)
	2000-2005	0.47 (-0.04 to 0.73)
	2005-2014	1.38 (1.27 to 1.54)
	2014-2020	-0.35 (-0.53 to -0.15)
	2020-2023	4.01 (3.63 to 4.36)
Bhutan	1990-1997	0.62 (0.50 to 0.72)	0.51 (0.50 to 0.53)
	1997-2008	1.28 (1.23 to 1.35)
	2008-2011	0.24 (-0.31 to 0.75)
	2011-2020	-0.85 (-0.92 to -0.79)
	2020-2023	1.86 (1.65 to 2.06)
India	1990-1995	0.58 (0.19 to 0.78)	0.72 (0.69 to 0.75)
	1995-2000	1.68 (1.49 to 2.03)
	2000-2005	-0.58 (-0.74 to -0.42)
	2005-2010	2.00 (1.79 to 2.19)
	2010-2015	0.49 (0.27 to 0.69)
	2015-2020	-1.43 (-1.59 to -1.28)
	2020-2023	3.48 (3.17 to 3.77)
Nepal	1990-1993	0.29 (0.10 to 0.63)	0.58 (0.57 to 0.60)
	1993-2001	-0.10 (-0.28 to -0.05)
	2001-2005	0.26 (0.04 to 0.67)
	2005-2014	0.89 (0.84 to 0.97)
	2014-2020	0.39 (0.30 to 0.47)
	2020-2023	2.65 (2.49 to 2.80)
Pakistan	1990-1994	-1.55 (-1.94 to -1.33)	0.21 (0.18 to 0.23)
	1994-2000	-0.63 (-0.79 to -0.44)
	2000-2004	0.70 (0.49 to 1.01)
	2004-2018	0.27 (0.15 to 0.30)
	2018-2021	0.82 (0.46 to 1.00)
	2021-2023	3.96 (3.47 to 4.40)
Southeast Asia	1990-2000	-0.07 (-0.13 to -0.02)	0.29 (0.27 to 0.30)
	2000-2010	0.59 (0.54 to 0.65)
	2010-2015	-0.64 (-0.74 to -0.54)
	2015-2019	1.32 (1.16 to 1.53)
	2019-2023	0.57 (0.32 to 0.73)
Cambodia	1990-2000	-0.16 (-0.19 to -0.13)	0.35 (0.35 to 0.36)
	2000-2005	0.67 (0.60 to 0.75)
	2005-2010	0.26 (0.16 to 0.34)
	2010-2015	-0.42 (-0.50 to -0.35)
	2015-2018	0.96 (0.86 to 1.10)
	2018-2023	1.59 (1.52 to 1.70)
Indonesia	1990-2001	-0.11 (-0.13 to -0.08)	0.16 (0.15 to 0.17)
	2001-2005	0.45 (0.34 to 0.60)
	2005-2010	0.10 (-0.01 to 0.17)
	2010-2015	-0.58 (-0.63 to -0.50)
	2015-2021	0.78 (0.67 to 0.83)
	2021-2023	1.20 (0.94 to 1.34)
Lao People’s Democratic Republic	1990-1998	-0.15 (-0.19 to -0.13)	0.50 (0.49 to 0.50)
	1998-2001	0.24 (0.14 to 0.30)
	2001-2005	1.28 (1.23 to 1.35)
	2005-2009	0.64 (0.56 to 0.70)
	2009-2015	0.11 (0.06 to 0.15)
	2015-2018	0.83 (0.73 to 0.93)
	2018-2023	1.23 (1.18 to 1.31)
Malaysia	1990-1999	-0.37 (-1.21 to 0.22)	0.51 (0.35 to 0.66)
	1999-2010	2.45 (2.01 to 3.19)
	2010-2015	-3.97 (-5.78 to -2.71)
	2015-2020	9.13 (7.91 to 10.58)
	2020-2023	-9.49 (-11.35 to -7.71)
Maldives	1990-1992	2.40 (2.18 to 2.64)	0.84 (0.83 to 0.85)
	1992-1995	1.41 (1.20 to 1.54)
	1995-2000	0.34 (0.21 to 0.41)
	2000-2007	0.97 (0.91 to 1.04)
	2007-2017	0.33 (0.28 to 0.36)
	2017-2020	0.80 (0.45 to 1.15)
	2020-2023	1.50 (1.33 to 1.78)
Mauritius	1990-1995	-0.06 (-0.14 to -0.01)	0.35 (0.34 to 0.35)
	1995-2001	0.21 (0.15 to 0.27)
	2001-2004	0.65 (0.55 to 0.70)
	2004-2009	0.38 (0.33 to 0.43)
	2009-2016	0.24 (0.16 to 0.27)
	2016-2021	0.53 (0.48 to 0.61)
	2021-2023	1.16 (1.01 to 1.26)
Myanmar	1990-1994	-0.33 (-0.47 to -0.25)	0.42 (0.41 to 0.42)
	1994-2000	-0.12 (-0.16 to -0.04)
	2000-2005	0.95 (0.89 to 1.02)
	2005-2009	0.78 (0.26 to 0.83)
	2009-2016	0.10 (0.06 to 0.14)
	2016-2020	0.66 (0.59 to 0.75)
	2020-2023	1.54 (1.44 to 1.64)
Philippines	1990-1994	-0.49 (-0.60 to -0.43)	-0.21 (-0.21 to -0.20)
	1994-2001	-0.28 (-0.32 to -0.22)
	2001-2005	-0.70 (-0.76 to -0.35)
	2005-2010	-0.81 (-0.87 to 0.15)
	2010-2021	0.22 (0.21 to 0.24)
	2021-2023	0.82 (0.70 to 0.92)
Seychelles	1990-1995	0.06 (0.03 to 0.12)	0.27 (0.27 to 0.28)
	1995-2000	-0.04 (-0.08 to -0.01)
	2000-2005	0.56 (0.54 to 0.58)
	2005-2016	0.06 (0.05 to 0.07)
	2016-2020	0.46 (0.43 to 0.49)
	2020-2023	1.21 (1.16 to 1.26)
Sri Lanka	1990-2005	0.14 (0.06 to 0.22)	0.63 (0.58 to 0.67)
	2005-2010	6.08 (5.76 to 6.33)
	2010-2015	-2.69 (-3.25 to -2.28)
	2015-2019	-0.68 (-2.03 to 0.16)
	2019-2023	1.35 (0.80 to 2.49)
Thailand	1990-2000	0.17 (0.14 to 0.20)	0.57 (0.56 to 0.58)
	2000-2010	0.69 (0.66 to 0.72)
	2010-2015	-0.09 (-0.14 to -0.03)
	2015-2020	1.17 (1.04 to 1.23)
	2020-2023	1.56 (1.41 to 1.80)
Timor-Leste	1990-1999	-0.03 (-0.09 to 0.04)	0.30 (0.29 to 0.32)
	1999-2005	-0.48 (-0.72 to -0.37)
	2005-2015	0.43 (0.36 to 0.49)
	2015-2023	1.11 (1.04 to 1.21)
Viet Nam	1990-1995	-0.05 (-0.13 to 0.00)	0.49 (0.48 to 0.50)
	1995-2000	0.19 (0.14 to 0.26)
	2000-2005	0.97 (0.93 to 1.01)
	2005-2009	0.48 (0.41 to 0.58)
	2009-2016	0.24 (0.18 to 0.27)
	2016-2020	0.58 (0.51 to 0.67)
	2020-2023	1.59 (1.51 to 1.67)

Abbreviation: AAPC, Average annual percentage changes; APC, Annual percentage changes; CI, Confidence intervals; GBD, Global burden of disease; IBD, Inflammatory bowel disease.

Subtype-specific AAPC patterns are summarized in Tables S8–S11. East Asia showed the largest increase in both UC ASPR (AAPC, 1.29 [95% CI, 1.22 to 1.35]) and CD ASPR (1.96 [1.87 to 2.05]). In contrast, the steepest decline in ASDR occurred in East Asia for UC (AAPC, −2.52 [95% CI, −2.60 to −2.44]) and in Central Asia for CD (−1.18 [−1.26 to −1.12]), indicating subtype − specific heterogeneity that was not fully apparent in the aggregate IBD estimates.

Table S8.

Joinpoint regression analysis of age-standardized DALY rates for UC across five GBD regions and 34 Asian countries, 1990 to 2023: APCs and AAPCs with 95% CIs.

Location	Period	APC (95% CI)	AAPC, 1990-2023 (95% CI)
Central Asia	1990 to 2003	-1.41 (-1.64 to -0.94)	-0.99 (-1.09 to -0.88)
	2003 to 2006	-3.62 (-4.47 to -0.75)
	2006 to 2018	0.73 (0.43 to 1.20)
	2018 to 2023	-2.35 (-3.64 to -1.42)
Armenia	1990 to 1994	-4.08 (-6.21 to -2.87)	-1.87 (-2.00 to -1.75)
	1994 to 2008	-1.03 (-1.57 to -0.02)
	2008 to 2011	-4.50 (-5.50 to -0.29)
	2011 to 2014	3.12 (-4.36 to 4.45)
	2014 to 2018	0.32 (-0.87 to 1.87)
	2018 to 2021	-7.95 (-9.19 to -6.13)
	2021 to 2023	-1.46 (-3.97 to 0.63)
Azerbaijan	1990 to 1994	-0.26 (-0.49 to -0.01)	-0.33 (-0.35 to -0.31)
	1994 to 1998	-1.94 (-2.26 to -1.67)
	1998 to 2001	-0.98 (-1.51 to 0.26)
	2001 to 2004	0.44 (-0.24 to 0.66)
	2004 to 2018	-0.20 (-0.28 to -0.10)
	2018 to 2023	0.48 (0.29 to 0.78)
Georgia	1990 to 1997	-4.19 (-6.35 to -3.23)	-1.83 (-2.03 to -1.66)
	1997 to 2001	0.73 (-1.62 to 3.80)
	2001 to 2005	-8.20 (-11.32 to -5.79)
	2005 to 2015	1.98 (1.24 to 3.13)
	2015 to 2023	-2.39 (-3.64 to -1.47)
Kazakhstan	1990 to 2005	0.19 (0.00 to 0.32)	-0.65 (-0.73 to -0.59)
	2005 to 2011	1.35 (0.92 to 2.45)
	2011 to 2014	-2.42 (-3.20 to -1.18)
	2014 to 2018	2.29 (1.64 to 3.46)
	2018 to 2021	-9.54 (-10.37 to -8.78)
	2021 to 2023	-1.93 (-3.42 to -0.53)
Kyrgyzstan	1990 to 2002	-2.78 (-3.44 to -1.88)	-2.92 (-3.12 to -2.68)
	2002 to 2005	-17.92 (-19.80 to -12.48)
	2005 to 2023	-0.25 (-0.70 to 0.26)
Mongolia	1990 to 1992	2.53 (0.84 to 3.72)	-1.27 (-1.34 to -1.20)
	1992 to 2003	-1.23 (-1.44 to -1.04)
	2003 to 2010	-3.08 (-3.45 to -2.42)
	2010 to 2014	-4.75 (-5.64 to -3.98)
	2014 to 2018	-0.33 (-2.02 to 0.56)
	2018 to 2023	1.80 (1.29 to 2.82)
Tajikistan	1990 to 1994	1.21 (0.01 to 2.55)	0.02 (-0.08 to 0.13)
	1994 to 2001	-4.15 (-4.89 to -3.65)
	2001 to 2008	1.13 (0.63 to 2.58)
	2008 to 2018	-0.27 (-1.06 to 0.02)
	2018 to 2023	4.15 (3.26 to 5.52)
Turkmenistan	1990 to 1997	-3.90 (-4.12 to -3.66)	0.08 (0.01 to 0.14)
	1997 to 2007	1.36 (1.15 to 1.54)
	2007 to 2014	3.01 (2.67 to 3.64)
	2014 to 2021	0.88 (0.52 to 1.22)
	2021 to 2023	-4.88 (-5.94 to -3.12)
Uzbekistan	1990 to 2003	-1.55 (-3.02 to -0.40)	-1.08 (-1.29 to -0.89)
	2003 to 2006	-7.09 (-8.40 to 0.22)
	2006 to 2013	0.29 (-7.81 to 1.50)
	2013 to 2018	3.17 (1.23 to 6.12)
	2018 to 2023	-2.20 (-5.18 to -0.66)
East Asia	1990 to 2004	-0.16 (-0.36 to 0.03)	-2.52 (-2.60 to -2.44)
	2004 to 2015	-5.53 (-5.87 to -5.27)
	2015 to 2023	-2.39 (-2.85 to -1.78)
China	1990 to 2004	-0.06 (-0.28 to 0.15)	-2.57 (-2.65 to -2.48)
	2004 to 2015	-5.78 (-6.17 to -5.48)
	2015 to 2023	-2.40 (-2.92 to -1.72)
Democratic People’s Republic of Korea	1990 to 2005	-1.27 (-1.34 to -1.22)	-1.34 (-1.38 to -1.32)
	2005 to 2010	0.00 (-0.31 to 0.53)
	2010 to 2015	-1.64 (-2.15 to -1.36)
	2015 to 2021	-0.49 (-0.68 to -0.21)
	2021 to 2023	-6.87 (-7.45 to -6.34)
Taiwan	1990 to 1992	9.86 (-2.07 to 19.88)	-1.45 (-1.86 to -0.95)
	1992 to 2001	-10.89 (-13.32 to -9.75)
	2001 to 2005	16.60 (10.37 to 25.84)
	2005 to 2023	-1.36 (-1.99 to -0.81)
High-income Asia Pacific	1990 to 1992	-4.16 (-4.79 to -2.88)	-1.19 (-1.23 to -1.13)
	1992 to 2001	-1.84 (-1.97 to -1.62)
	2001 to 2005	3.49 (3.15 to 3.80)
	2005 to 2010	-3.44 (-3.94 to -3.11)
	2010 to 2019	-1.78 (-1.96 to -1.58)
	2019 to 2023	1.45 (0.99 to 2.12)
Brunei Darussalam	1990 to 2000	-1.93 (-2.12 to -1.79)	-0.85 (-0.90 to -0.81)
	2000 to 2012	-0.49 (-0.67 to -0.35)
	2012 to 2017	0.62 (0.29 to 1.34)
	2017 to 2020	-2.50 (-3.01 to -1.70)
	2020 to 2023	0.59 (-0.02 to 1.86)
Japan	1990 to 1992	-4.91 (-5.99 to -2.72)	-0.52 (-0.59 to -0.42)
	1992 to 2000	-1.76 (-2.00 to -0.99)
	2000 to 2005	5.96 (5.46 to 6.42)
	2005 to 2010	-6.51 (-7.00 to -6.01)
	2010 to 2016	-0.28 (-1.16 to 0.25)
	2016 to 2023	1.93 (1.49 to 2.62)
Republic of Korea	1990 to 1998	-2.03 (-2.25 to -1.76)	-2.97 (-3.03 to -2.92)
	1998 to 2003	-4.20 (-5.07 to -3.73)
	2003 to 2010	-2.61 (-2.90 to -1.94)
	2010 to 2020	-4.53 (-4.71 to -4.37)
	2020 to 2023	1.05 (0.37 to 1.70)
Singapore	1990 to 1993	-6.01 (-11.51 to -2.46)	-2.24 (-2.51 to -1.96)
	1993 to 1996	7.35 (2.49 to 10.51)
	1996 to 2002	-7.77 (-11.37 to -6.14)
	2002 to 2018	-3.48 (-3.96 to -2.90)
	2018 to 2023	5.69 (3.37 to 9.48)
South Asia	1990 to 1999	0.12 (-0.14 to 0.49)	-0.68 (-0.76 to -0.61)
	1999 to 2018	-1.04 (-1.13 to -0.93)
	2018 to 2021	-3.32 (-4.06 to -2.22)
	2021 to 2023	3.21 (1.38 to 4.70)
Bangladesh	1990 to 2005	-0.36 (-0.54 to -0.16)	-0.80 (-0.91 to -0.71)
	2005 to 2014	-2.90 (-3.45 to -2.53)
	2014 to 2018	3.21 (2.17 to 5.09)
	2018 to 2021	-4.80 (-6.00 to -3.14)
	2021 to 2023	3.89 (1.54 to 6.00)
Bhutan	1990 to 1997	0.26 (-0.08 to 0.69)	-0.86 (-0.91 to -0.81)
	1997 to 2013	-1.60 (-1.74 to -1.50)
	2013 to 2023	-0.46 (-0.66 to -0.20)
India	1990 to 2000	0.29 (0.05 to 0.53)	-0.74 (-0.80 to -0.68)
	2000 to 2005	-2.02 (-3.09 to 0.12)
	2005 to 2008	0.39 (-1.64 to 0.97)
	2008 to 2017	-0.99 (-1.28 to -0.73)
	2017 to 2020	-4.20 (-4.82 to -3.20)
	2020 to 2023	1.20 (0.31 to 2.95)
Nepal	1990 to 1997	-1.30 (-1.78 to -0.50)	-1.21 (-1.33 to -1.11)
	1997 to 2005	-3.05 (-4.49 to -2.64)
	2005 to 2014	-0.98 (-1.87 to -0.55)
	2014 to 2018	0.97 (0.00 to 2.28)
	2018 to 2021	-3.26 (-4.39 to -1.90)
	2021 to 2023	4.44 (2.14 to 6.41)
Pakistan	1990 to 2002	0.15 (-0.08 to 0.46)	-0.40 (-0.51 to -0.30)
	2002 to 2021	-1.12 (-1.30 to -1.01)
	2021 to 2023	3.28 (0.38 to 4.90)
Southeast Asia	1990 to 2002	-0.97 (-1.22 to -0.31)	-0.91 (-0.99 to -0.80)
	2002 to 2011	-1.88 (-3.80 to -1.41)
	2011 to 2023	-0.13 (-0.45 to 0.36)
Cambodia	1990 to 2005	-1.22 (-1.52 to -1.04)	-0.83 (-0.90 to -0.76)
	2005 to 2023	-0.50 (-0.64 to -0.29)
Indonesia	1990 to 2002	-0.87 (-1.41 to 1.18)	-1.18 (-1.36 to -0.96)
	2002 to 2010	-2.18 (-4.59 to -0.47)
	2010 to 2023	-0.84 (-1.42 to 1.15)
Lao People’s Democratic Republic	1990 to 1997	0.40 (0.22 to 0.61)	-0.61 (-0.65 to -0.57)
	1997 to 2002	-2.13 (-2.35 to -1.61)
	2002 to 2005	-3.73 (-4.04 to -3.20)
	2005 to 2018	0.03 (-0.07 to 0.11)
	2018 to 2021	1.52 (0.88 to 1.87)
	2021 to 2023	-2.77 (-3.58 to -1.94)
Malaysia	1990 to 2004	-3.39 (-3.93 to -2.92)	-1.05 (-1.20 to -0.89)
	2004 to 2023	0.71 (0.40 to 1.07)
Maldives	1990 to 2012	-0.66 (-0.79 to -0.55)	-0.12 (-0.23 to -0.03)
	2012 to 2019	3.35 (2.68 to 4.37)
	2019 to 2023	-3.05 (-4.36 to -1.63)
Mauritius	1990 to 2004	-7.42 (-9.64 to -5.44)	0.83 (-0.34 to 1.71)
	2004 to 2007	85.38 (42.84 to 103.03)
	2007 to 2012	-25.49 (-37.10 to -18.08)
	2012 to 2018	21.65 (12.80 to 50.99)
	2018 to 2023	-4.01 (-17.54 to 4.13)
Myanmar	1990 to 1993	-0.27 (-1.71 to 2.52)	-0.71 (-0.86 to -0.57)
	1993 to 2007	-1.81 (-3.19 to 0.93)
	2007 to 2023	0.19 (-0.43 to 0.62)
Philippines	1990 to 2002	0.04 (-0.17 to 0.35)	-0.62 (-0.70 to -0.54)
	2002 to 2007	-1.54 (-2.56 to -0.34)
	2007 to 2011	-5.45 (-6.69 to -2.80)
	2011 to 2014	-0.88 (-3.98 to 1.14)
	2014 to 2021	2.24 (1.90 to 3.49)
	2021 to 2023	-1.84 (-3.39 to 0.21)
Seychelles	1990 to 1994	-0.79 (-1.62 to 0.80)	-1.22 (-1.31 to -1.13)
	1994 to 2009	-2.04 (-2.48 to -1.91)
	2009 to 2018	-0.82 (-1.06 to -0.12)
	2018 to 2021	-3.75 (-4.54 to -2.60)
	2021 to 2023	6.46 (4.66 to 8.10)
Sri Lanka	1990 to 2004	-1.54 (-1.85 to -1.27)	-0.62 (-0.72 to -0.50)
	2004 to 2008	3.73 (1.89 to 5.96)
	2008 to 2014	-2.04 (-4.05 to -1.12)
	2014 to 2023	-0.11 (-0.59 to 1.42)
Thailand	1990 to 1995	1.35 (0.92 to 2.14)	0.82 (0.76 to 0.90)
	1995 to 1998	-1.97 (-2.61 to -0.75)
	1998 to 2004	1.92 (1.46 to 2.67)
	2004 to 2012	-1.71 (-1.99 to -1.44)
	2012 to 2019	4.13 (3.82 to 4.49)
	2019 to 2023	0.09 (-0.75 to 0.92)
Timor-Leste	1990 to 2000	-0.96 (-1.30 to -0.46)	-0.67 (-0.75 to -0.58)
	2000 to 2006	-3.45 (-5.50 to -2.69)
	2006 to 2023	0.50 (0.31 to 0.70)
Viet Nam	1990 to 2007	-0.74 (-1.60 to -0.55)	-0.52 (-0.62 to -0.41)
	2007 to 2023	-0.28 (-0.49 to 0.77)

Abbreviation: AAPC, Average annual percentage changes; APC, Annual percentage changes; CI, Confidence intervals; DALY, disability-adjusted life year; GBD, Global burden of disease; UC, ulcerative colitis.

Table S11.

Joinpoint regression analysis of age-standardized Prevalence rates for CD across five GBD regions and 34 Asian countries, 1990 to 2023: APCs and AAPCs with 95% CIs.

Location	Period	APC (95% CI)	AAPC, 1990-2023 (95% CI)
Central Asia	1990 to 1993	-0.75 (-0.96 to -0.58)	0.03 (0.02 to 0.04)
	1993 to 2000	-0.40 (-0.47 to -0.28)
	2000 to 2005	0.01 (-0.06 to 0.16)
	2005 to 2010	1.04 (0.98 to 1.11)
	2010 to 2015	-0.31 (-0.38 to -0.25)
	2015 to 2020	0.55 (0.48 to 0.64)
	2020 to 2023	-0.16 (-0.31 to 0.01)
Armenia	1990 to 1995	0.03 (0.01 to 0.07)	0.20 (0.20 to 0.21)
	1995 to 2000	-0.10 (-0.13 to -0.07)
	2000 to 2006	0.40 (0.38 to 0.41)
	2006 to 2009	0.57 (0.51 to 0.60)
	2009 to 2016	0.25 (0.23 to 0.27)
	2016 to 2020	0.44 (0.40 to 0.49)
	2020 to 2023	-0.19 (-0.23 to -0.15)
Azerbaijan	1990 to 1995	0.08 (-0.01 to 0.18)	0.16 (0.14 to 0.17)
	1995 to 2000	-1.27 (-1.35 to -1.19)
	2000 to 2006	0.11 (0.04 to 0.18)
	2006 to 2014	1.27 (1.21 to 1.32)
	2014 to 2019	0.42 (0.31 to 0.57)
	2019 to 2023	-0.43 (-0.59 to -0.27)	0.05 (0.04 to 0.07)
Georgia	1990 to 1995	-0.19 (-0.27 to -0.09)
	1995 to 2000	-0.95 (-1.03 to -0.87)
	2000 to 2005	-0.13 (-0.24 to -0.06)
	2005 to 2016	0.52 (0.38 to 0.54)
	2016 to 2021	0.65 (0.57 to 0.80)
	2021 to 2023	-0.37 (-0.55 to -0.12)	0.05 (0.03 to 0.06)
Kazakhstan	1990 to 1994	-2.55 (-2.68 to -2.41)
	1994 to 2000	-0.04 (-0.21 to 0.05)
	2000 to 2005	0.34 (0.23 to 0.56)
	2005 to 2010	2.28 (2.17 to 2.38)
	2010 to 2015	-0.44 (-0.61 to -0.32)
	2015 to 2023	0.17 (0.09 to 0.26)
Kyrgyzstan	1990 to 1995	0.35 (0.25 to 0.46)	0.26 (0.25 to 0.28)
	1995 to 2000	-1.02 (-1.16 to -0.92)
	2000 to 2004	0.39 (-0.27 to 0.53)
	2004 to 2010	0.79 (0.70 to 1.04)
	2010 to 2015	0.36 (0.08 to 0.48)
	2015 to 2020	1.05 (0.94 to 1.26)
	2020 to 2023	-0.41 (-0.62 to -0.19)
Mongolia	1990 to 1994	0.50 (0.39 to 0.58)	0.12 (0.11 to 0.13)
	1994 to 2005	-0.09 (-0.12 to -0.07)
	2005 to 2009	0.49 (0.38 to 0.61)
	2009 to 2021	0.16 (0.14 to 0.18)
	2021 to 2023	-0.42 (-0.57 to -0.20)
Tajikistan	1990 to 1995	0.07 (-0.01 to 0.15)	0.04 (0.02 to 0.05)
	1995 to 2000	-1.01 (-1.08 to -0.94)
	2000 to 2005	0.14 (-0.04 to 0.22)
	2005 to 2010	0.52 (0.42 to 0.71)
	2010 to 2015	-0.01 (-0.21 to 0.09)
	2015 to 2019	0.53 (0.40 to 0.71)
	2019 to 2023	0.13 (-0.06 to 0.24)	0.22 (0.21 to 0.23)
Turkmenistan	1990 to 1995	-0.02 (-0.08 to 0.05)
	1995 to 2000	-0.51 (-0.57 to -0.46)
	2000 to 2005	0.80 (0.75 to 0.85)
	2005 to 2010	0.14 (0.05 to 0.20)
	2010 to 2019	0.61 (0.58 to 0.64)
	2019 to 2023	-0.07 (-0.14 to -0.01)
Uzbekistan	1990 to 1999	-0.03 (-0.08 to 0.04)	0.01 (0.00 to 0.03)
	1999 to 2005	-0.34 (-0.49 to -0.25)
	2005 to 2010	0.82 (0.72 to 0.91)
	2010 to 2015	-1.35 (-1.44 to -1.27)
	2015 to 2019	1.19 (1.05 to 1.35)
	2019 to 2023	0.18 (0.01 to 0.34)
East Asia	1990 to 1995	4.75 (3.49 to 5.44)	1.96 (1.87 to 2.05)
	1995 to 1999	8.33 (7.41 to 9.59)
	1999 to 2005	-0.95 (-1.37 to -0.53)
	2005 to 2010	9.34 (8.80 to 9.88)
	2010 to 2015	-1.16 (-1.82 to -0.45)
	2015 to 2020	-5.91 (-6.78 to -5.18)
	2020 to 2023	2.10 (0.85 to 3.33)
China	1990 to 1995	4.93 (3.66 to 5.65)	2.01 (1.92 to 2.10)
	1995 to 1999	8.62 (7.69 to 9.91)
	1999 to 2005	-0.99 (-1.42 to -0.57)
	2005 to 2010	9.41 (8.85 to 9.96)
	2010 to 2015	-1.23 (-1.91 to -0.51)
	2015 to 2020	-5.92 (-6.83 to -5.17)
	2020 to 2023	2.13 (0.84 to 3.44)
Democratic People’s Republic of Korea	1990 to 1997	-2.03 (-2.14 to -1.97)	-0.41 (-0.42 to -0.40)
	1997 to 2000	-1.52 (-1.71 to -1.38)
	2000 to 2005	0.32 (0.22 to 0.48)
	2005 to 2016	0.04 (-0.03 to 0.07)
	2016 to 2023	0.48 (0.41 to 0.58)
Taiwan	1990 to 1995	0.38 (-0.49 to 1.31)	0.11 (-0.01 to 0.23)
	1995 to 2000	-8.84 (-9.61 to -8.03)
	2000 to 2004	4.02 (2.11 to 5.31)
	2004 to 2013	9.17 (8.73 to 9.86)
	2013 to 2016	0.98 (-0.36 to 3.03)
	2016 to 2020	-12.55 (-13.56 to -11.65)
	2020 to 2023	1.34 (-0.23 to 2.88)
High-income Asia Pacific	1990 to 1992	8.37 (6.46 to 9.88)	0.98 (0.92 to 1.06)
	1992 to 1995	3.50 (0.42 to 4.16)
	1995 to 2000	-0.62 (-1.18 to -0.02)
	2000 to 2005	6.50 (5.77 to 6.96)
	2005 to 2010	-0.04 (-0.70 to 0.48)
	2010 to 2017	-3.07 (-3.63 to -2.66)
	2017 to 2023	-0.10 (-0.53 to 0.61)
Brunei Darussalam	1990 to 1994	0.91 (0.77 to 1.14)	0.44 (0.42 to 0.45)
	1994 to 2005	0.49 (0.45 to 0.52)
	2005 to 2010	1.68 (1.61 to 1.75)
	2010 to 2015	0.08 (-0.01 to 0.17)
	2015 to 2021	-0.82 (-0.91 to -0.75)
	2021 to 2023	0.84 (0.57 to 1.08)
Japan	1990 to 1992	15.19 (13.32 to 17.19)	0.72 (0.66 to 0.81)
	1992 to 1995	5.34 (3.78 to 6.28)
	1995 to 2000	-2.11 (-2.65 to -1.65)
	2000 to 2005	6.48 (6.02 to 6.96)
	2005 to 2010	-7.69 (-8.03 to -7.32)
	2010 to 2023	-0.06 (-0.21 to 0.09)
Republic of Korea	1990 to 2000	0.96 (0.79 to 1.13)	0.72 (0.67 to 0.77)
	2000 to 2007	5.62 (4.86 to 5.99)
	2007 to 2010	4.05 (3.48 to 5.16)
	2010 to 2015	-5.59 (-6.31 to -5.05)
	2015 to 2018	-2.65 (-4.64 to -0.92)
	2018 to 2023	0.15 (-0.32 to 1.11)
Singapore	1990 to 1994	2.65 (2.30 to 3.00)	0.77 (0.74 to 0.81)
	1994 to 2001	0.84 (0.50 to 0.99)
	2001 to 2005	1.58 (1.16 to 2.56)
	2005 to 2010	3.20 (2.97 to 3.50)
	2010 to 2019	-1.51 (-1.62 to -1.42)
	2019 to 2023	0.21 (-0.12 to 0.76)
South Asia	1990 to 1995	0.11 (-0.19 to 0.27)	0.71 (0.68 to 0.73)
	1995 to 2005	0.52 (0.47 to 0.61)
	2005 to 2010	2.26 (2.10 to 2.42)
	2010 to 2015	0.91 (0.75 to 1.05)
	2015 to 2020	-2.02 (-2.13 to -1.90)
	2020 to 2023	4.07 (3.82 to 4.30)
Bangladesh	1990 to 1995	-0.62 (-0.89 to -0.38)	0.92 (0.89 to 0.96)
	1995 to 2000	1.63 (1.39 to 2.05)
	2000 to 2005	0.43 (-0.10 to 0.69)
	2005 to 2014	1.57 (1.46 to 1.71)
	2014 to 2020	-0.52 (-0.68 to -0.35)
	2020 to 2023	4.21 (3.82 to 4.56)
Bhutan	1990 to 1996	0.46 (0.30 to 0.54)	0.49 (0.48 to 0.50)
	1996 to 2001	0.90 (0.73 to 1.10)
	2001 to 2005	1.63 (1.45 to 1.86)
	2005 to 2010	0.92 (0.76 to 1.02)
	2010 to 2015	-0.52 (-0.63 to -0.38)
	2015 to 2020	-1.23 (-1.37 to -1.12)
	2020 to 2023	2.25 (2.07 to 2.43)
India	1990 to 2005	0.48 (0.43 to 0.52)	0.74 (0.71 to 0.77)
	2005 to 2010	2.65 (2.43 to 2.88)
	2010 to 2015	0.88 (0.67 to 1.12)
	2015 to 2020	-2.41 (-2.59 to -2.24)
	2020 to 2023	4.10 (3.74 to 4.44)
Nepal	1990 to 2000	-0.11 (-0.16 to -0.08)	0.58 (0.57 to 0.59)
	2000 to 2005	0.18 (0.05 to 0.34)
	2005 to 2010	0.81 (0.64 to 0.92)
	2010 to 2015	1.14 (1.07 to 1.26)
	2015 to 2020	-0.09 (-0.16 to -0.03)
	2020 to 2023	3.41 (3.28 to 3.53)
Pakistan	1990 to 1994	-1.41 (-1.90 to -1.17)	0.22 (0.20 to 0.25)
	1994 to 2000	-0.82 (-0.95 to -0.49)
	2000 to 2005	0.67 (0.50 to 1.04)
	2005 to 2010	-0.04 (-0.44 to 0.14)
	2010 to 2015	0.83 (0.65 to 1.23)
	2015 to 2020	0.11 (-0.12 to 0.26)
	2020 to 2023	3.45 (3.16 to 3.73)
Southeast Asia	1990 to 2005	0.05 (0.02 to 0.09)	0.29 (0.27 to 0.30)
	2005 to 2010	1.39 (1.26 to 1.51)
	2010 to 2015	-0.99 (-1.12 to -0.85)
	2015 to 2019	1.17 (0.98 to 1.41)
	2019 to 2023	0.52 (0.18 to 0.71)
Cambodia	1990 to 1994	0.03 (-0.12 to 0.27)	0.38 (0.37 to 0.39)
	1994 to 2000	-0.21 (-0.38 to 0.44)
	2000 to 2009	0.45 (0.32 to 0.51)
	2009 to 2015	-0.26 (-0.35 to -0.17)
	2015 to 2019	0.85 (0.74 to 0.96)
	2019 to 2023	1.98 (1.86 to 2.09)
Indonesia	1990 to 1994	0.25 (0.15 to 0.41)	0.19 (0.18 to 0.20)
	1994 to 2002	-0.12 (-0.25 to -0.09)
	2002 to 2005	0.09 (-0.04 to 0.73)
	2005 to 2010	1.13 (1.07 to 1.22)
	2010 to 2015	-0.87 (-0.92 to -0.80)
	2015 to 2021	0.48 (0.36 to 0.53)
	2021 to 2023	0.87 (0.62 to 1.03)
Lao People’s Democratic Republic	1990 to 1995	0.05 (-0.02 to 0.19)	0.50 (0.49 to 0.51)
	1995 to 2000	-0.21 (-0.32 to -0.15)
	2000 to 2006	0.91 (0.86 to 1.00)
	2006 to 2010	0.58 (0.38 to 0.72)
	2010 to 2015	0.00 (-0.08 to 0.06)
	2015 to 2023	1.21 (1.17 to 1.24)
Malaysia	1990 to 2010	0.55 (0.39 to 0.73)	0.51 (0.37 to 0.63)
	2010 to 2015	-2.37 (-4.59 to -1.26)
	2015 to 2020	9.11 (7.97 to 10.57)
	2020 to 2023	-8.26 (-10.00 to -6.57)
Maldives	1990 to 1992	2.59 (2.42 to 2.75)	0.82 (0.81 to 0.83)
	1992 to 1995	1.52 (1.42 to 1.62)
	1995 to 2000	0.52 (0.42 to 0.58)
	2000 to 2007	0.76 (0.71 to 0.84)
	2007 to 2017	0.34 (0.30 to 0.36)
	2017 to 2020	0.73 (0.47 to 0.97)
	2020 to 2023	1.29 (1.17 to 1.47)
Mauritius	1990 to 2000	0.11 (0.10 to 0.12)	0.35 (0.35 to 0.35)
	2000 to 2008	0.42 (0.41 to 0.44)
	2008 to 2014	0.33 (0.31 to 0.38)
	2014 to 2017	0.22 (0.19 to 0.27)
	2017 to 2020	0.37 (0.33 to 0.41)
	2020 to 2023	1.11 (1.07 to 1.15)
Myanmar	1990 to 1995	0.03 (-0.03 to 0.12)	0.44 (0.43 to 0.45)
	1995 to 2000	-0.30 (-0.37 to -0.25)
	2000 to 2009	0.81 (0.78 to 0.83)
	2009 to 2016	0.07 (0.03 to 0.10)
	2016 to 2020	0.86 (0.74 to 0.94)
	2020 to 2023	1.57 (1.43 to 1.79)
Philippines	1990 to 2000	-0.21 (-0.22 to -0.19)	-0.10 (-0.10 to -0.09)
	2000 to 2005	-0.60 (-0.66 to -0.39)
	2005 to 2010	-0.43 (-0.54 to -0.37)
	2010 to 2015	-0.26 (-0.33 to -0.20)
	2015 to 2018	0.20 (-0.02 to 0.26)
	2018 to 2021	0.51 (0.43 to 0.57)
	2021 to 2023	1.59 (1.48 to 1.70)
Seychelles	1990 to 1995	0.32 (0.28 to 0.36)	0.25 (0.25 to 0.26)
	1995 to 2000	-0.04 (-0.09 to 0.00)
	2000 to 2005	0.33 (0.29 to 0.38)
	2005 to 2010	-0.10 (-0.16 to -0.06)
	2010 to 2016	0.09 (0.06 to 0.14)
	2016 to 2020	0.58 (0.52 to 0.63)
	2020 to 2023	0.99 (0.92 to 1.10)
Sri Lanka	1990 to 2000	0.33 (0.13 to 0.57)	0.67 (0.61 to 0.72)
	2000 to 2005	-1.87 (-2.54 to -1.41)
	2005 to 2010	7.63 (7.24 to 8.03)
	2010 to 2016	-2.77 (-3.16 to -2.44)
	2016 to 2023	1.17 (0.84 to 1.51)
Thailand	1990 to 2002	0.18 (0.07 to 0.24)	0.58 (0.55 to 0.60)
	2002 to 2005	0.84 (0.36 to 2.51)
	2005 to 2010	3.00 (2.80 to 3.27)
	2010 to 2015	-1.49 (-1.76 to -1.30)
	2015 to 2019	0.33 (-0.33 to 0.73)
	2019 to 2023	1.47 (1.16 to 2.02)
Timor-Leste	1990 to 1999	0.07 (0.00 to 0.15)	0.31 (0.30 to 0.33)
	1999 to 2005	-0.50 (-0.76 to -0.38)
	2005 to 2015	0.41 (0.33 to 0.48)
	2015 to 2023	1.09 (1.00 to 1.19)
Viet Nam	1990 to 1993	-0.14 (-0.20 to -0.09)	0.46 (0.46 to 0.47)
	1993 to 1996	0.11 (0.04 to 0.23)
	1996 to 2000	0.34 (0.29 to 0.42)
	2000 to 2009	0.52 (0.51 to 0.53)
	2009 to 2017	0.36 (0.35 to 0.38)
	2017 to 2020	0.61 (0.57 to 0.64)
	2020 to 2023	1.52 (1.48 to 1.56)

Abbreviation: AAPC, Average annual percentage changes; APC, Annual percentage changes; CD, Crohn’s disease; CI, Confidence intervals; GBD, Global burden of disease.

Table S9.

Joinpoint regression analysis of age-standardized Prevalence rates for UC across five GBD regions and 34 Asian countries, 1990 to 2023: APCs and AAPCs with 95% CIs.

Location	Period	APC (95% CI)	AAPC, 1990-2023 (95% CI)
Central Asia	1990 to 2001	-0.37 (-0.40 to -0.34)	0.06 (0.06 to 0.07)
	2001 to 2005	0.14 (-0.06 to 0.35)
	2005 to 2010	0.87 (0.79 to 1.00)
	2010 to 2016	-0.05 (-0.19 to 0.02)
	2016 to 2023	0.22 (0.17 to 0.34)
Armenia	1990 to 1995	0.16 (0.13 to 0.20)	-1.87 (-2.00 to -1.75)
	1995 to 2000	-0.15 (-0.18 to -0.12)
	2000 to 2006	0.33 (0.29 to 0.35)
	2006 to 2009	0.48 (0.41 to 0.52)
	2009 to 2014	0.29 (0.23 to 0.33)
	2014 to 2021	0.07 (0.04 to 0.09)
	2021 to 2023	0.73 (0.65 to 0.81)
Azerbaijan	1990 to 1995	0.18 (0.06 to 0.30)	-0.33 (-0.35 to -0.31)
	1995 to 2000	-1.12 (-1.23 to -1.00)
	2000 to 2006	0.34 (0.18 to 0.43)
	2006 to 2015	1.08 (1.02 to 1.15)
	2015 to 2019	-0.32 (-0.52 to -0.03)
	2019 to 2023	0.18 (-0.01 to 0.54)
Georgia	1990 to 1995	0.08 (0.00 to 0.17)	-1.83 (-2.03 to -1.66)
	1995 to 2000	-1.17 (-1.24 to -1.10)
	2000 to 2008	0.27 (0.19 to 0.32)
	2008 to 2015	0.62 (0.55 to 0.84)
	2015 to 2023	0.43 (0.33 to 0.48)
Kazakhstan	1990 to 1994	-2.37 (-2.49 to -2.24)	-0.65 (-0.73 to -0.59)
	1994 to 2000	-0.21 (-0.33 to -0.12)
	2000 to 2005	0.44 (0.33 to 0.60)
	2005 to 2010	2.20 (2.11 to 2.29)
	2010 to 2020	-0.21 (-0.27 to -0.17)
	2020 to 2023	0.26 (0.01 to 0.62)
Kyrgyzstan	1990 to 1995	0.61 (0.52 to 0.71)	-2.92 (-3.12 to -2.68)
	1995 to 2000	-0.93 (-1.03 to -0.84)
	2000 to 2005	0.39 (0.20 to 0.49)
	2005 to 2010	0.90 (0.77 to 1.15)
	2010 to 2015	0.23 (0.00 to 0.36)
	2015 to 2019	1.04 (0.86 to 1.27)
	2019 to 2023	-0.03 (-0.19 to 0.13)
Mongolia	1990 to 1994	0.56 (0.50 to 0.62)	-1.27 (-1.34 to -1.20)
	1994 to 1999	0.18 (0.14 to 0.24)
	1999 to 2005	-0.08 (-0.14 to -0.04)
	2005 to 2009	0.23 (0.07 to 0.31)
	2009 to 2015	0.40 (0.37 to 0.46)
	2015 to 2020	-0.36 (-0.39 to -0.33)
	2020 to 2023	0.40 (0.33 to 0.46)
Tajikistan	1990 to 1995	0.03 (-0.02 to 0.09)	0.02 (-0.08 to 0.13)
	1995 to 2000	-0.45 (-0.52 to -0.40)
	2000 to 2005	0.11 (0.02 to 0.16)
	2005 to 2010	0.42 (0.36 to 0.54)
	2010 to 2023	0.18 (0.16 to 0.19)
Turkmenistan	1990 to 1995	0.43 (0.32 to 0.55)	0.08 (0.01 to 0.14)
	1995 to 2000	-0.78 (-0.88 to -0.68)
	2000 to 2005	0.92 (0.80 to 1.04)
	2005 to 2010	-0.09 (-0.29 to 0.05)
	2010 to 2014	0.90 (0.72 to 1.16)
	2014 to 2023	0.16 (0.10 to 0.21)
Uzbekistan	1990 to 1996	0.41 (0.26 to 0.60)	-1.08 (-1.29 to -0.89)
	1996 to 2005	-0.40 (-0.54 to 0.27)
	2005 to 2010	0.47 (-0.47 to 0.72)
	2010 to 2015	-0.85 (-1.04 to 0.54)
	2015 to 2021	0.69 (-0.87 to 0.95)
	2021 to 2023	0.10 (-0.27 to 0.62)
East Asia	1990 to 1995	-0.23 (-1.22 to 0.30)	1.29 (1.22 to 1.35)
	1995 to 2000	1.88 (1.10 to 2.95)
	2000 to 2005	5.58 (4.75 to 6.45)
	2005 to 2009	9.09 (8.46 to 10.08)
	2009 to 2015	0.26 (-0.06 to 0.56)
	2015 to 2020	-6.51 (-6.87 to -6.17)
	2020 to 2023	1.40 (0.60 to 2.14)
China	1990 to 1995	-0.19 (-1.14 to 0.36)	-2.57 (-2.65 to -2.48)
	1995 to 2000	2.22 (1.36 to 3.22)
	2000 to 2005	5.64 (4.78 to 6.52)
	2005 to 2009	9.19 (8.55 to 10.19)
	2009 to 2015	0.18 (-0.15 to 0.49)
	2015 to 2020	-6.55 (-6.92 to -6.21)
	2020 to 2023	1.42 (0.61 to 2.17)
Democratic People’s Republic of Korea	1990 to 1993	-2.62 (-2.86 to -2.46)	-1.34 (-1.38 to -1.32)
	1993 to 1997	-2.14 (-2.29 to -1.97)
	1997 to 2000	-1.57 (-1.71 to -1.44)
	2000 to 2005	0.37 (0.27 to 0.46)
	2005 to 2009	-0.27 (-0.43 to -0.12)
	2009 to 2021	0.14 (0.10 to 0.16)
	2021 to 2023	0.64 (0.35 to 0.80)
Taiwan	1990 to 1996	-0.58 (-1.31 to 0.23)	-1.45 (-1.86 to -0.95)
	1996 to 2000	-13.39 (-14.19 to -12.55)
	2000 to 2011	8.04 (7.68 to 8.52)
	2011 to 2015	4.47 (1.21 to 5.91)
	2015 to 2020	-8.13 (-9.81 to -7.27)
	2020 to 2023	0.84 (-1.59 to 4.78)
High-income Asia Pacific	1990 to 1996	0.71 (-0.56 to 1.15)	0.69 (0.61 to 0.76)
	1996 to 2000	2.11 (1.50 to 6.33)
	2000 to 2005	9.74 (9.19 to 10.37)
	2005 to 2009	-3.83 (-4.81 to -3.09)
	2009 to 2015	-1.33 (-1.68 to -0.02)
	2015 to 2019	-2.89 (-3.89 to -2.22)
	2019 to 2023	-0.25 (-1.00 to 1.56)
Brunei Darussalam	1990 to 1994	0.10 (-0.27 to 0.28)	-0.85 (-0.90 to -0.81)
	1994 to 2005	0.49 (0.45 to 0.55)
	2005 to 2010	-1.55 (-1.63 to -1.47)
	2010 to 2019	1.09 (1.04 to 1.15)
	2019 to 2023	-0.11 (-0.26 to 0.09)
Japan	1990 to 2000	0.19 (-0.07 to 0.48)	-0.52 (-0.59 to -0.42)
	2000 to 2005	10.38 (9.81 to 10.95)
	2005 to 2010	-9.01 (-9.44 to -8.55)
	2010 to 2023	0.19 (0.00 to 0.38)
Republic of Korea	1990 to 1996	1.99 (1.41 to 2.49)	-2.97 (-3.03 to -2.92)
	1996 to 2005	7.64 (7.34 to 8.05)
	2005 to 2010	3.96 (3.18 to 4.68)
	2010 to 2015	-3.09 (-3.63 to -2.17)
	2015 to 2019	-6.09 (-7.41 to -5.24)
	2019 to 2023	-0.30 (-1.14 to 1.33)
Singapore	1990 to 1992	5.25 (4.28 to 6.19)	-2.24 (-2.51 to -1.96)
	1992 to 1995	2.27 (0.86 to 2.73)
	1995 to 2000	-0.99 (-1.53 to -0.68)
	2000 to 2005	0.97 (0.66 to 1.50)
	2005 to 2010	4.53 (4.29 to 4.78)
	2010 to 2020	-1.85 (-1.98 to -1.75)
	2020 to 2023	0.27 (-0.39 to 1.43)
South Asia	1990 to 1995	0.40 (0.16 to 0.57)	0.69 (0.67 to 0.71)
	1995 to 2000	1.81 (1.67 to 2.02)
	2000 to 2005	-0.69 (-0.82 to -0.56)
	2005 to 2010	1.58 (1.41 to 1.75)
	2010 to 2015	0.37 (0.15 to 0.58)
	2015 to 2020	-0.84 (-1.02 to -0.67)
	2020 to 2023	3.28 (3.01 to 3.53)
Bangladesh	1990 to 1995	-0.57 (-0.82 to -0.35)	-0.80 (-0.91 to -0.71)
	1995 to 2000	1.57 (1.33 to 1.99)
	2000 to 2005	0.46 (-0.05 to 0.71)
	2005 to 2013	1.36 (1.23 to 1.60)
	2013 to 2021	0.10 (-0.05 to 0.23)
	2021 to 2023	5.66 (5.12 to 6.23)
Bhutan	1990 to 1996	0.61 (0.48 to 0.71)	-0.86 (-0.91 to -0.81)
	1996 to 2007	1.27 (1.23 to 1.33)
	2007 to 2010	0.78 (0.20 to 0.99)
	2010 to 2018	-0.82 (-0.92 to -0.78)
	2018 to 2021	-0.18 (-0.42 to -0.03)
	2021 to 2023	2.45 (2.14 to 2.75)
India	1990 to 1995	0.68 (0.41 to 0.86)	-0.74 (-0.80 to -0.68)
	1995 to 2000	2.09 (1.94 to 2.33)
	2000 to 2005	-0.96 (-1.09 to -0.83)
	2005 to 2010	1.76 (1.58 to 1.93)
	2010 to 2015	0.33 (0.11 to 0.55)
	2015 to 2020	-1.04 (-1.22 to -0.86)
	2020 to 2023	3.24 (2.95 to 3.51)
Nepal	1990 to 1994	0.32 (0.17 to 0.59)	-1.21 (-1.33 to -1.11)
	1994 to 2001	-0.13 (-0.33 to -0.06)
	2001 to 2005	0.27 (0.09 to 0.58)
	2005 to 2010	0.95 (0.83 to 1.17)
	2010 to 2021	0.65 (0.60 to 0.68)
	2021 to 2023	3.24 (3.01 to 3.48)
Pakistan	1990 to 1994	-1.61 (-1.75 to -1.46)	-0.40 (-0.51 to -0.30)
	1994 to 2000	-0.55 (-0.63 to -0.46)
	2000 to 2005	0.67 (0.57 to 0.83)
	2005 to 2018	0.22 (0.18 to 0.24)
	2018 to 2021	0.87 (0.65 to 1.01)
	2021 to 2023	3.74 (3.46 to 4.04)
Southeast Asia	1990 to 2000	-0.12 (-0.18 to -0.07)	0.29 (0.27 to 0.30)
	2000 to 2005	0.81 (0.66 to 1.11)
	2005 to 2010	0.25 (0.04 to 0.43)
	2010 to 2015	-0.48 (-0.67 to -0.35)
	2015 to 2019	1.39 (1.21 to 1.62)
	2019 to 2023	0.59 (0.33 to 0.76)
Cambodia	1990 to 2000	-0.17 (-0.19 to -0.15)	-0.83 (-0.90 to -0.76)
	2000 to 2005	0.76 (0.70 to 0.82)
	2005 to 2010	0.25 (0.17 to 0.32)
	2010 to 2015	-0.49 (-0.55 to -0.43)
	2015 to 2018	1.09 (1.01 to 1.21)
	2018 to 2023	1.49 (1.43 to 1.60)
Indonesia	1990 to 2000	-0.18 (-0.22 to -0.15)	-1.18 (-1.36 to -0.96)
	2000 to 2005	0.56 (0.48 to 0.62)
	2005 to 2015	-0.39 (-0.42 to -0.36)
	2015 to 2021	0.89 (-0.32 to 0.94)
	2021 to 2023	1.36 (1.01 to 1.53)
Lao People’s Democratic Republic	1990 to 1998	-0.19 (-0.25 to -0.16)	-0.61 (-0.65 to -0.57)
	1998 to 2001	0.35 (0.14 to 0.50)
	2001 to 2005	1.39 (1.28 to 1.51)
	2005 to 2009	0.62 (0.52 to 0.77)
	2009 to 2015	0.12 (0.00 to 0.18)
	2015 to 2018	0.72 (0.37 to 1.00)
	2018 to 2023	1.20 (1.13 to 1.37)
Malaysia	1990 to 2000	-0.44 (-1.08 to 0.09)	-1.05 (-1.20 to -0.89)
	2000 to 2009	3.92 (3.28 to 4.90)
	2009 to 2015	-3.65 (-4.97 to -2.56)
	2015 to 2020	8.78 (7.51 to 10.40)
	2020 to 2023	-9.93 (-11.85 to -8.09)
Maldives	1990 to 1992	2.32 (2.07 to 2.60)	-0.12 (-0.23 to -0.03)
	1992 to 1995	1.37 (1.06 to 1.50)
	1995 to 2000	0.26 (0.13 to 0.33)
	2000 to 2007	1.06 (1.00 to 1.13)
	2007 to 2017	0.33 (0.27 to 0.37)
	2017 to 2020	0.84 (0.43 to 1.21)
	2020 to 2023	1.59 (1.40 to 1.91)
Mauritius	1990 to 1995	-0.13 (-0.36 to -0.03)	0.83 (-0.34 to 1.71)
	1995 to 2001	0.25 (0.02 to 0.37)
	2001 to 2004	0.70 (0.28 to 0.80)
	2004 to 2009	0.39 (0.25 to 0.62)
	2009 to 2015	0.19 (-0.01 to 0.30)
	2015 to 2021	0.54 (0.38 to 0.66)
	2021 to 2023	1.12 (0.80 to 1.28)
Myanmar	1990 to 1994	-0.52 (-0.67 to -0.42)	-0.71 (-0.86 to -0.57)
	1994 to 2000	-0.04 (-0.09 to 0.02)
	2000 to 2005	1.00 (0.94 to 1.09)
	2005 to 2009	0.78 (0.49 to 0.85)
	2009 to 2016	0.11 (0.04 to 0.15)
	2016 to 2020	0.58 (0.48 to 0.72)
	2020 to 2023	1.53 (1.41 to 1.66)
Philippines	1990 to 1994	-0.58 (-0.68 to -0.51)	-0.62 (-0.70 to -0.54)
	1994 to 2001	-0.30 (-0.33 to -0.24)
	2001 to 2005	-0.71 (-0.78 to -0.56)
	2005 to 2010	-0.94 (-1.01 to -0.90)
	2010 to 2015	0.39 (0.34 to 0.46)
	2015 to 2021	0.18 (0.08 to 0.21)
	2021 to 2023	0.56 (0.39 to 0.68)
Seychelles	1990 to 2000	-0.05 (-0.06 to -0.03)	-1.22 (-1.31 to -1.13)
	2000 to 2005	0.69 (0.66 to 0.71)
	2005 to 2016	0.08 (0.07 to 0.09)
	2016 to 2020	0.38 (0.32 to 0.46)
	2020 to 2023	1.32 (1.26 to 1.39)
Sri Lanka	1990 to 2001	0.11 (-0.10 to 0.24)	-0.62 (-0.72 to -0.50)
	2001 to 2005	1.19 (0.49 to 2.61)
	2005 to 2010	5.36 (4.95 to 5.76)
	2010 to 2015	-2.51 (-3.08 to -2.14)
	2015 to 2019	-1.09 (-1.91 to 0.17)
	2019 to 2023	1.28 (0.76 to 2.29)
Thailand	1990 to 1999	0.14 (0.06 to 0.20)	0.82 (0.76 to 0.90)
	1999 to 2005	0.71 (0.62 to 0.87)
	2005 to 2010	-0.85 (-0.97 to -0.75)
	2010 to 2014	0.82 (0.52 to 1.00)
	2014 to 2023	1.53 (1.48 to 1.61)
Timor-Leste	1990 to 1999	-0.07 (-0.13 to 0.01)	-0.67 (-0.75 to -0.58)
	1999 to 2005	-0.47 (-0.72 to -0.36)
	2005 to 2015	0.43 (0.37 to 0.50)
	2015 to 2023	1.12 (1.04 to 1.22)
Viet Nam	1990 to 1996	-0.02 (-0.15 to 0.02)	-0.52 (-0.62 to -0.41)
	1996 to 2000	0.15 (0.08 to 0.27)
	2000 to 2005	1.16 (1.11 to 1.22)
	2005 to 2009	0.46 (0.37 to 0.60)
	2009 to 2016	0.19 (0.11 to 0.24)
	2016 to 2020	0.59 (0.50 to 0.72)
	2020 to 2023	1.61 (1.50 to 1.72)

Abbreviation: AAPC, Average annual percentage changes; APC, Annual percentage changes; CI, Confidence intervals; GBD, Global burden of disease; UC, ulcerative colitis.

Table S10.

Joinpoint regression analysis of age-standardized DALY rates for CD across five GBD regions and 34 Asian countries, 1990 to 2023: APCs and AAPCs with 95% CIs.

Location	Period	APC (95% CI)	AAPC, 1990-2023 (95% CI)
Central Asia	1990 to 1997	-1.68 (-2.62 to -1.30)	-1.18 (-1.26 to -1.12)
	1997 to 2000	-0.05 (-5.77 to 0.61)
	2000 to 2005	-6.04 (-6.51 to 0.52)
	2005 to 2012	0.67 (-0.23 to 1.24)
	2012 to 2018	1.87 (1.19 to 2.93)
	2018 to 2023	-2.34 (-3.08 to -1.68)
Armenia	1990 to 1994	-2.21 (-3.72 to -1.34)	-1.19 (-1.29 to -1.10)
	1994 to 1999	1.21 (0.48 to 2.67)
	1999 to 2006	-2.34 (-3.05 to -1.86)
	2006 to 2018	1.08 (0.84 to 1.31)
	2018 to 2021	-7.95 (-8.71 to 0.66)
	2021 to 2023	-3.93 (-6.30 to -2.39)
Azerbaijan	1990 to 1994	-0.72 (-1.08 to -0.24)	-0.02 (-0.06 to 0.02)
	1994 to 1998	-2.66 (-3.24 to -2.25)
	1998 to 2002	-0.57 (-1.21 to 0.10)
	2002 to 2012	1.59 (1.47 to 1.74)
	2012 to 2019	0.25 (0.08 to 0.70)
	2019 to 2023	-0.53 (-1.22 to -0.17)
Georgia	1990 to 1997	-4.37 (-7.04 to -3.02)	-3.36 (-3.64 to -3.11)
	1997 to 2000	5.19 (-0.06 to 8.40)
	2000 to 2003	-29.21 (-31.68 to -25.38)
	2003 to 2006	-5.96 (-9.11 to 1.15)
	2006 to 2015	4.37 (3.18 to 7.52)
	2015 to 2023	-1.62 (-3.48 to -0.24)
Kazakhstan	1990 to 2000	1.65 (1.30 to 2.05)	-0.56 (-0.66 to -0.48)
	2000 to 2014	-1.50 (-1.78 to -1.29)
	2014 to 2018	2.01 (0.65 to 3.59)
	2018 to 2023	-4.28 (-5.17 to -3.45)
Kyrgyzstan	1990 to 2000	-3.05 (-3.53 to -2.55)	-3.14 (-3.29 to -3.01)
	2000 to 2004	-18.26 (-19.27 to -17.14)
	2004 to 2010	-1.52 (-3.43 to -0.51)
	2010 to 2015	3.92 (2.27 to 7.00)
	2015 to 2023	-0.48 (-1.67 to 0.24)
Mongolia	1990 to 1992	1.37 (0.27 to 2.19)	0.25 (0.20 to 0.30)
	1992 to 2001	-0.52 (-0.80 to -0.39)
	2001 to 2005	1.65 (1.11 to 2.36)
	2005 to 2015	0.15 (-0.13 to 0.27)
	2015 to 2019	1.46 (0.94 to 2.08)
	2019 to 2023	-0.95 (-1.53 to -0.53)
Tajikistan	1990 to 1993	0.18 (-0.03 to 0.47)	-0.04 (-0.06 to -0.03)
	1993 to 1996	-0.44 (-0.94 to -0.17)
	1996 to 2001	-0.99 (-1.12 to 0.20)
	2001 to 2011	0.26 (0.22 to 0.33)
	2011 to 2015	-0.19 (-0.39 to -0.02)
	2015 to 2020	0.52 (0.42 to 0.74)
	2020 to 2023	0.00 (-0.28 to 0.19)
Turkmenistan	1990 to 1997	-1.81 (-2.44 to -1.38)	-0.21 (-0.30 to -0.12)
	1997 to 2001	2.35 (-1.07 to 3.69)
	2001 to 2007	-1.27 (-2.32 to 2.17)
	2007 to 2021	0.52 (-1.22 to 1.30)
	2021 to 2023	-1.49 (-3.02 to 0.38)
Uzbekistan	1990 to 1994	-2.87 (-5.61 to -1.13)	0.14 (-0.01 to 0.30)
	1994 to 2003	-0.51 (-4.99 to 1.24)
	2003 to 2006	-6.66 (-7.86 to 3.22)
	2006 to 2018	4.08 (3.67 to 4.56)
	2018 to 2023	-1.30 (-2.94 to -0.06)
East Asia	1990 to 2001	1.60 (1.28 to 1.95)	-0.52 (-0.65 to -0.42)
	2001 to 2007	-2.16 (-3.96 to -1.45)
	2007 to 2010	3.03 (0.82 to 4.13)
	2010 to 2020	-3.03 (-3.99 to -2.74)
	2020 to 2023	0.06 (-1.93 to 2.50)
China	1990 to 1995	1.66 (0.67 to 2.17)	-0.10 (-0.16 to -0.03)
	1995 to 2001	3.49 (3.09 to 4.18)
	2001 to 2006	-2.06 (-2.71 to -1.58)
	2006 to 2010	2.08 (1.28 to 3.09)
	2010 to 2016	-2.49 (-2.80 to -1.78)
	2016 to 2019	-4.65 (-5.22 to -3.60)
	2019 to 2023	-0.11 (-0.71 to 0.87)
Democratic People’s Republic of Korea	1990 to 1993	-1.78 (-2.18 to -1.16)	-1.12 (-1.15 to -1.08)
	1993 to 1999	-2.82 (-3.10 to -2.67)
	1999 to 2006	-0.99 (-1.16 to -0.85)
	2006 to 2010	0.46 (0.16 to 0.87)
	2010 to 2021	-0.19 (-0.28 to -0.13)
	2021 to 2023	-3.53 (-4.02 to -3.02)
Taiwan	1990 to 1992	25.52 (12.61 to 35.78)	-5.82 (-6.17 to -5.42)
	1992 to 1998	-8.73 (-11.35 to -5.71)
	1998 to 2009	-13.74 (-16.11 to -12.76)
	2009 to 2023	-1.85 (-2.63 to -0.93)
High-income Asia Pacific	1990 to 1994	-0.31 (-0.74 to 0.52)	-0.34 (-0.39 to -0.28)
	1994 to 2001	-1.39 (-1.78 to -1.19)
	2001 to 2005	3.80 (3.07 to 4.17)
	2005 to 2010	-0.48 (-0.84 to 0.38)
	2010 to 2015	-2.96 (-3.58 to -2.09)
	2015 to 2020	-0.21 (-2.60 to 0.12)
	2020 to 2023	1.15 (0.36 to 2.15)
Brunei Darussalam	1990 to 1992	-0.24 (-0.68 to 0.07)	-0.13 (-0.16 to -0.11)
	1992 to 2001	-1.02 (-1.13 to -0.98)
	2001 to 2005	0.37 (-0.70 to 0.50)
	2005 to 2010	0.79 (0.65 to 1.06)
	2010 to 2017	0.19 (0.08 to 0.29)
	2017 to 2021	-0.76 (-1.03 to -0.58)
	2021 to 2023	0.82 (0.40 to 1.14)
Japan	1990 to 1994	0.66 (-0.10 to 1.87)	-0.35 (-0.41 to -0.27)
	1994 to 2001	-1.65 (-2.23 to -1.30)
	2001 to 2005	3.71 (3.03 to 4.66)
	2005 to 2010	-4.94 (-5.72 to -4.44)
	2010 to 2014	-0.99 (-2.54 to 0.33)
	2014 to 2023	1.38 (1.12 to 1.78)
Republic of Korea	1990 to 2001	-1.24 (-1.37 to -1.11)	-0.60 (-0.65 to -0.56)
	2001 to 2010	3.15 (-0.85 to 3.29)
	2010 to 2015	-5.21 (-5.72 to 3.10)
	2015 to 2018	-2.07 (-5.04 to -1.14)
	2018 to 2023	-0.23 (-0.62 to 0.70)
Singapore	1990 to 2002	-3.60 (-4.11 to -3.18)	-1.20 (-1.37 to -1.06)
	2002 to 2008	0.74 (-0.42 to 3.76)
	2008 to 2019	-1.65 (-3.15 to -1.22)
	2019 to 2023	4.56 (2.39 to 8.49)
South Asia	1990 to 2001	-0.12 (-0.22 to 0.04)	-0.19 (-0.24 to -0.15)
	2001 to 2005	-1.24 (-1.96 to -0.76)
	2005 to 2010	0.95 (0.63 to 1.89)
	2010 to 2017	-0.23 (-0.44 to -0.02)
	2017 to 2020	-3.34 (-3.85 to -2.48)
	2020 to 2023	2.41 (1.69 to 3.16)
Bangladesh	1990 to 1995	-1.57 (-2.90 to -0.95)	-0.19 (-0.28 to -0.11)
	1995 to 2014	-0.40 (-0.50 to -0.27)
	2014 to 2018	2.24 (1.50 to 3.44)
	2018 to 2021	-3.26 (-4.16 to -2.06)
	2021 to 2023	5.34 (3.64 to 6.89)
Bhutan	1990 to 1995	0.81 (0.51 to 1.19)	-0.16 (-0.19 to -0.12)
	1995 to 2008	-0.46 (-0.74 to -0.38)
	2008 to 2011	0.16 (-0.33 to 0.41)
India	2011 to 2020	-0.65 (-1.06 to -0.54)	-0.21 (-0.24 to -0.18)
	2020 to 2023	0.74 (0.14 to 1.62)
	1990 to 2000	0.05 (-0.05 to 0.16)
	2000 to 2005	-1.36 (-1.71 to -1.08)
	2005 to 2010	1.38 (1.09 to 1.71)
	2010 to 2017	-0.38 (-0.54 to -0.21)
Nepal	2017 to 2020	-4.05 (-4.38 to -3.73)	-0.37 (-0.46 to -0.28)
	2020 to 2023	2.51 (2.08 to 2.93)
	1990 to 1994	-0.41 (-1.15 to 1.07)
	1994 to 2004	-1.89 (-2.38 to -1.67)
	2004 to 2018	0.41 (0.29 to 0.59)
	2018 to 2021	-2.35 (-3.09 to -1.34)
Pakistan	2021 to 2023	5.08 (3.32 to 6.54)	0.01 (-0.06 to 0.07)
	1990 to 2003	0.08 (-0.04 to 0.26)
	2003 to 2021	-0.46 (-0.58 to -0.38)
	2021 to 2023	3.84 (2.10 to 4.78)
Southeast Asia	1990 to 2005	0.10 (-0.11 to 0.26)	0.33 (0.24 to 0.40)
	2005 to 2018	0.79 (0.35 to 1.27)
	2018 to 2021	-1.71 (-2.46 to 0.76)
	2021 to 2023	2.25 (-0.28 to 3.85)
Cambodia	1990 to 2003	-1.17 (-1.33 to -1.02)	-0.18 (-0.25 to -0.11)
	2003 to 2011	0.68 (0.35 to 1.62)
	2011 to 2021	-0.19 (-1.06 to 0.00)
	2021 to 2023	2.95 (1.06 to 4.32)
Indonesia	1990 to 2018	0.25 (0.17 to 0.34)	0.18 (0.05 to 0.29)
	2018 to 2021	-3.00 (-4.02 to -1.16)
	2021 to 2023	4.20 (1.11 to 6.63)
Lao People’s Democratic Republic	1990 to 1997	0.19 (-0.04 to 0.33)	0.76 (0.73 to 0.78)
	1997 to 2006	0.77 (0.46 to 0.92)
	2006 to 2011	2.23 (0.75 to 2.52)
	2011 to 2018	0.67 (0.39 to 2.24)
	2018 to 2021	1.15 (0.76 to 1.38)
	2021 to 2023	-1.24 (-1.69 to -0.67)
Malaysia	1990 to 2005	-1.16 (-1.46 to -0.94)	-0.14 (-0.26 to -0.02)
	2005 to 2015	1.02 (-0.06 to 1.44)
	2015 to 2020	3.04 (1.94 to 5.14)
	2020 to 2023	-3.95 (-6.88 to -1.97)
Maldives	1990 to 2008	0.21 (-0.03 to 0.41)	0.47 (0.33 to 0.57)
	2008 to 2018	2.28 (1.82 to 3.36)
	2018 to 2023	-2.12 (-3.67 to -1.05)
Mauritius	1990 to 2004	-0.21 (-1.37 to 0.82)	3.36 (2.80 to 3.82)
	2004 to 2007	48.07 (35.80 to 55.53)
	2007 to 2011	-20.68 (-27.23 to -15.85)
	2011 to 2018	14.32 (11.08 to 20.96)
	2018 to 2023	-1.32 (-7.72 to 3.08)
Myanmar	1990 to 2003	-0.21 (-0.56 to 0.07)	0.68 (0.57 to 0.77)
	2003 to 2015	1.85 (1.58 to 2.86)
	2015 to 2023	0.39 (-0.39 to 0.87)
Philippines	1990 to 2008	0.25 (0.15 to 0.35)	0.64 (0.57 to 0.70)
	2008 to 2021	1.50 (1.37 to 1.74)
	2021 to 2023	-1.51 (-2.69 to 0.23)
Seychelles	1990 to 1994	0.13 (-0.54 to 1.46)	-0.16 (-0.24 to -0.08)
	1994 to 2004	-1.22 (-1.71 to -1.02)
	2004 to 2018	0.28 (0.17 to 0.46)
	2018 to 2021	-2.29 (-2.96 to -1.33)
	2021 to 2023	4.87 (3.33 to 6.16)
Sri Lanka	1990 to 2005	-0.98 (-1.35 to -0.71)	-0.13 (-0.25 to -0.03)
	2005 to 2009	4.18 (2.26 to 6.35)
	2009 to 2023	-0.43 (-0.79 to -0.15)
Thailand	1990 to 1995	1.82 (1.61 to 2.09)	0.64 (0.61 to 0.67)
	1995 to 1998	-1.07 (-1.42 to -0.50)
	1998 to 2001	1.94 (1.46 to 2.33)
	2001 to 2006	0.46 (-0.08 to 0.65)
	2006 to 2009	1.63 (0.99 to 1.94)
	2009 to 2017	-0.63 (-0.82 to -0.51)
	2017 to 2023	1.24 (1.03 to 1.54)
Timor-Leste	1990 to 1995	-0.29 (-0.73 to 0.45)	0.08 (0.03 to 0.14)
	1995 to 2005	-1.72 (-2.15 to -1.56)
	2005 to 2008	-0.04 (-1.41 to 1.55)
	2008 to 2012	3.01 (2.25 to 3.89)
	2012 to 2019	0.42 (-0.26 to 0.69)
	2019 to 2023	1.72 (1.18 to 2.77)
Viet Nam	1990 to 1999	0.39 (-0.75 to 0.80)	0.69 (0.59 to 0.77)
	1999 to 2015	1.40 (1.24 to 1.86)
	2015 to 2023	-0.38 (-0.95 to 0.03)

Abbreviation: AAPC, Average annual percentage changes; APC, Annual percentage changes; CD, Crohn’s disease; CI, Confidence intervals; DALY, disability-adjusted life year; GBD, Global burden of disease.

Age- and sex-specific patterns of inflammatory bowel disease burden, ulcerative colitis, and Crohn’s disease in Asia

Age- and sex-specific patterns of IBD burden in 2023 are shown in Figure 4 and detailed in Table S12. DALY rates increased sharply at older ages. In South Asia, DALY rates rose from 79.11 (95% UI, 51.37 to 119.88) per 100,000 population at ages 85–89 years to 145.09 (95% UI, 87.32 to 228.79) at ages 95 years and older. In contrast, prevalence rates generally increased with age and peaked at ages 50–54 years in Central Asia, at 113.99 (95% UI, 88.00 to 145.42) per 100,000 population, and at ages 60–64 years in South Asia, at 126.97 (95% UI, 96.58 to 168.60) per 100,000 population. Across most age groups, males had a higher IBD burden than females. However, this pattern reversed at ages 95 years and older in East Asia and Southeast Asia, where females had higher DALY rates than males in 2023. In East Asia, DALY rates at ages 95 years and older were 162.81 (95% UI, 77.22 to 274.80) per 100,000 population in females and 133.68 (95% UI, 76.53 to 211.14) per 100,000 population in males. A similar pattern was observed in Southeast Asia, where DALY rates were higher in females than in males at ages 95 years and older (87.73 [95% UI, 38.68 to 176.20] vs. 72.01 [95% UI, 38.96 to 124.78] per 100,000 population).

Figure 4.

Specific Age-group (a) DALY, (b) Prevalence (per 100,000 population) of UC, CD by sex across Asian regions in 2023. Estimates are stratified by age group and sex, with male and female values represented by the left and right bars, respectively. Abbreviations: DALY = Disability-adjusted life year; IBD = Inflammatory bowel disease; UC = Ulcerative colitis; CD = Crohn’s disease

Table S12.

Age-specific DALY and prevalence rates of IBD by sex across the five GBD regions of Asia in 1990 and 2023 (95% UI).

Location	DALY rate		Prevalence rate
Central Asia	1990	2023	1990	2023
Both
2-4 years	20.59 (16.21 to 26.19)	13.48 (10.57 to 17.02)	0.02 (0.01 to 0.03)	0.02 (0.01 to 0.03)
5-20 years	6.28 (4.89 to 8.20)	4.25 (3.33 to 5.42)	0.51 (0.37 to 0.69)	0.52 (0.38 to 0.68)
15-21 years	4.02 (3.26 to 5.08)	3.21 (2.70 to 3.87)	2.44 (1.89 to 3.21)	2.57 (1.99 to 3.38)
15-19 years	5.00 (4.13 to 6.21)	3.58 (2.96 to 4.36)	7.33 (5.85 to 9.20)	7.90 (6.25 to 9.95)
20-24 years	12.13 (10.24 to 14.98)	7.46 (6.10 to 9.06)	16.81 (13.53 to 21.39)	18.33 (14.74 to 23.24)
25-29 years	17.21 (14.16 to 21.52)	10.79 (8.56 to 13.83)	31.58 (25.54 to 38.74)	34.80 (28.04 to 43.19)
30-34 years	19.96 (15.92 to 24.42)	14.87 (11.68 to 19.27)	50.24 (40.40 to 61.74)	54.87 (44.36 to 69.51)
35-39 years	29.86 (24.45 to 37.16)	22.21 (17.85 to 28.53)	70.30 (57.20 to 90.29)	74.95 (59.96 to 93.62)
40-44 years	30.77 (24.86 to 37.90)	23.97 (18.54 to 31.25)	89.42 (72.08 to 110.93)	93.03 (74.84 to 116.84)
45-49 years	40.02 (32.45 to 48.30)	31.42 (24.97 to 39.00)	104.73 (83.99 to 128.26)	107.13 (84.60 to 135.59)
50-54 years	39.68 (32.09 to 47.67)	30.70 (23.84 to 38.57)	114.09 (89.51 to 143.09)	113.99 (88.00 to 145.42)
55-59 years	45.44 (37.00 to 54.45)	33.22 (26.20 to 42.34)	113.84 (89.18 to 146.54)	111.69 (84.97 to 143.59)
60-64 years	47.46 (39.07 to 56.95)	34.31 (27.89 to 42.51)	108.84 (84.43 to 143.07)	104.26 (79.35 to 135.67)
65-69 years	52.48 (43.39 to 62.66)	35.88 (29.77 to 44.14)	99.14 (76.35 to 130.47)	94.92 (72.37 to 124.12)
70-74 years	56.46 (46.57 to 67.72)	38.19 (32.15 to 45.39)	90.96 (68.53 to 123.20)	87.39 (65.76 to 113.49)
75-79 years	58.03 (47.33 to 69.67)	37.00 (31.19 to 43.44)	83.83 (60.94 to 111.81)	78.39 (59.30 to 102.67)
80-84 years	57.61 (46.49 to 69.54)	38.76 (33.07 to 44.75)	75.17 (55.07 to 99.86)	68.84 (51.97 to 89.94)
85-89 years	52.58 (41.59 to 64.07)	35.93 (29.80 to 42.60)	67.24 (48.34 to 89.20)	59.75 (45.43 to 78.66)
90-94 years	63.72 (51.57 to 77.56)	48.23 (39.44 to 58.15)	62.18 (43.52 to 88.04)	52.77 (38.74 to 70.34)
95+ years	44.16 (35.39 to 54.59)	37.55 (29.76 to 46.48)	56.85 (40.21 to 78.08)	46.95 (33.67 to 62.43)
Male
2-4 years	19.71 (14.30 to 27.58)	13.79 (9.98 to 19.57)	0.02 (0.01 to 0.03)	0.02 (0.01 to 0.03)
5-20 years	6.68 (4.74 to 9.55)	5.16 (3.83 to 7.29)	0.51 (0.37 to 0.69)	0.52 (0.38 to 0.68)
15-21 years	3.00 (2.23 to 4.09)	2.70 (2.12 to 3.60)	2.41 (1.83 to 3.10)	2.53 (1.94 to 3.31)
15-19 years	4.74 (3.62 to 6.22)	3.40 (2.66 to 4.44)	7.19 (5.80 to 8.98)	7.73 (6.12 to 9.51)
20-24 years	11.93 (9.47 to 15.63)	7.41 (5.87 to 9.48)	16.49 (13.44 to 20.45)	17.80 (14.32 to 22.52)
25-29 years	17.28 (13.54 to 21.77)	10.21 (8.11 to 12.95)	30.90 (25.22 to 38.00)	33.33 (27.12 to 41.39)
30-34 years	22.73 (17.75 to 28.29)	15.26 (11.99 to 20.05)	49.14 (39.76 to 61.40)	52.41 (42.86 to 65.27)
35-39 years	34.70 (27.12 to 42.19)	23.53 (19.01 to 31.01)	68.73 (55.83 to 89.84)	72.13 (58.72 to 93.59)
40-44 years	36.00 (28.72 to 44.13)	26.05 (20.77 to 34.99)	87.45 (70.85 to 110.15)	90.33 (71.49 to 114.06)
45-49 years	47.09 (37.40 to 57.10)	34.94 (27.67 to 44.00)	103.17 (82.48 to 127.23)	105.25 (82.26 to 134.52)
50-54 years	44.19 (35.45 to 54.32)	32.39 (25.45 to 40.91)	112.46 (88.71 to 141.46)	111.97 (86.34 to 147.44)
55-59 years	49.49 (39.08 to 61.74)	35.32 (28.35 to 44.97)	112.00 (86.98 to 141.39)	109.57 (82.38 to 140.00)
60-64 years	57.55 (46.71 to 71.06)	41.17 (33.46 to 51.46)	106.24 (81.20 to 137.79)	101.78 (77.30 to 133.88)
65-69 years	58.84 (47.10 to 72.25)	40.43 (32.42 to 49.29)	96.64 (74.30 to 126.05)	92.31 (70.59 to 122.24)
70-74 years	66.02 (52.98 to 83.42)	47.56 (39.72 to 56.43)	87.65 (67.90 to 113.23)	83.51 (63.30 to 109.33)
75-79 years	63.96 (48.92 to 82.09)	44.76 (35.71 to 54.19)	80.37 (61.13 to 105.69)	75.92 (58.68 to 102.06)
80-84 years	63.30 (48.95 to 83.57)	45.70 (36.91 to 57.20)	73.79 (54.77 to 97.11)	68.90 (51.21 to 90.73)
85-89 years	54.70 (42.20 to 69.98)	40.99 (33.57 to 50.99)	65.44 (48.76 to 87.06)	59.94 (45.96 to 79.25)
90-94 years	83.68 (64.56 to 107.37)	60.93 (46.98 to 81.17)	58.92 (43.02 to 79.50)	51.77 (38.65 to 69.44)
95+ years	98.01 (74.55 to 124.77)	79.36 (58.72 to 105.33)	56.24 (40.03 to 76.03)	46.69 (32.49 to 62.80)
Female
2-4 years	21.51 (16.00 to 28.48)	13.15 (8.75 to 17.71)	0.02 (0.01 to 0.03)	0.02 (0.01 to 0.03)
5-20 years	5.86 (4.17 to 8.20)	3.28 (2.38 to 4.49)	0.51 (0.37 to 0.69)	0.52 (0.38 to 0.68)
15-21 years	5.06 (3.78 to 6.76)	3.76 (2.85 to 4.80)	2.47 (1.89 to 3.33)	2.61 (1.98 to 3.52)
15-19 years	5.26 (4.02 to 6.90)	3.76 (2.89 to 4.74)	7.47 (5.84 to 9.66)	8.09 (6.38 to 10.14)
20-24 years	12.33 (9.64 to 16.01)	7.52 (5.81 to 9.39)	17.12 (13.59 to 22.28)	18.89 (15.10 to 23.88)
25-29 years	17.14 (13.06 to 23.23)	11.39 (8.66 to 14.64)	32.24 (25.58 to 40.84)	36.31 (28.63 to 45.93)
30-34 years	17.24 (12.83 to 22.71)	14.47 (10.46 to 19.43)	51.31 (41.54 to 62.77)	57.38 (45.22 to 73.23)
35-39 years	25.17 (19.71 to 33.93)	20.88 (15.63 to 27.20)	71.81 (58.31 to 91.43)	77.77 (61.26 to 97.11)
40-44 years	25.70 (19.34 to 34.93)	21.90 (16.20 to 29.35)	91.33 (72.54 to 115.46)	95.71 (75.50 to 120.42)
45-49 years	33.21 (25.23 to 42.74)	28.03 (20.53 to 36.36)	106.22 (84.73 to 131.05)	108.93 (86.51 to 138.27)
50-54 years	35.45 (27.17 to 46.18)	29.13 (20.53 to 38.57)	115.62 (90.42 to 146.74)	115.85 (88.75 to 148.66)
55-59 years	41.81 (31.67 to 54.74)	31.37 (22.68 to 41.97)	115.49 (90.33 to 152.22)	113.57 (86.06 to 148.57)
60-64 years	39.40 (30.04 to 50.78)	28.54 (21.31 to 36.81)	110.92 (85.78 to 149.65)	106.35 (80.18 to 138.77)
65-69 years	48.75 (37.88 to 61.99)	32.22 (25.91 to 40.71)	100.60 (77.03 to 136.49)	97.02 (74.19 to 126.73)
70-74 years	51.77 (39.67 to 66.30)	31.40 (23.79 to 39.75)	92.58 (69.20 to 129.18)	90.21 (66.73 to 120.69)
75-79 years	55.20 (42.88 to 70.52)	31.97 (25.90 to 40.07)	85.48 (60.38 to 116.77)	79.99 (58.77 to 107.13)
80-84 years	55.03 (42.16 to 70.23)	34.87 (27.12 to 42.52)	75.80 (54.86 to 105.24)	68.81 (50.33 to 89.99)
85-89 years	51.72 (38.76 to 68.15)	33.41 (25.95 to 41.93)	67.97 (48.28 to 92.35)	59.65 (44.67 to 79.21)
90-94 years	55.13 (41.79 to 71.39)	41.92 (33.16 to 53.32)	63.58 (43.05 to 93.76)	53.27 (39.00 to 71.23)
95+ years	24.62 (18.14 to 32.80)	20.71 (16.02 to 26.18)	57.08 (40.14 to 80.02)	47.06 (33.80 to 62.58)
East Asia
Both
2-4 years	39.76 (17.76 to 65.22)	12.13 (7.50 to 18.04)	0.01 (0.01 to 0.02)	0.02 (0.01 to 0.02)
5-20 years	3.88 (1.73 to 6.10)	1.41 (0.87 to 2.23)	0.24 (0.16 to 0.32)	0.30 (0.21 to 0.38)
15-21 years	2.79 (1.29 to 4.52)	1.28 (0.89 to 1.85)	0.97 (0.71 to 1.24)	1.29 (0.95 to 1.65)
15-19 years	1.69 (0.92 to 2.73)	1.21 (0.88 to 1.63)	2.31 (1.81 to 2.96)	3.34 (2.60 to 4.21)
20-24 years	2.76 (1.57 to 4.21)	2.24 (1.68 to 3.16)	4.32 (3.44 to 5.56)	6.48 (5.17 to 8.30)
25-29 years	4.36 (2.54 to 6.32)	3.30 (2.50 to 4.43)	6.60 (5.33 to 8.27)	10.00 (7.99 to 12.81)
30-34 years	4.43 (2.89 to 6.28)	3.56 (2.58 to 4.72)	8.29 (6.68 to 10.65)	12.53 (9.92 to 16.16)
35-39 years	5.58 (3.66 to 8.01)	4.19 (3.11 to 5.56)	8.88 (7.12 to 11.63)	14.25 (11.25 to 18.72)
40-44 years	7.16 (4.52 to 10.47)	4.98 (3.74 to 6.48)	9.34 (7.25 to 11.91)	15.82 (12.49 to 19.91)
45-49 years	10.06 (5.89 to 15.22)	6.36 (4.69 to 8.51)	9.94 (7.74 to 12.76)	17.22 (13.49 to 22.43)
50-54 years	12.78 (7.71 to 18.29)	7.50 (5.63 to 9.92)	10.53 (7.95 to 13.61)	18.13 (13.76 to 23.79)
55-59 years	15.42 (9.39 to 22.37)	8.71 (6.47 to 11.30)	10.70 (8.30 to 13.90)	18.46 (14.47 to 24.06)
60-64 years	22.82 (13.68 to 34.41)	11.79 (8.35 to 16.24)	10.72 (8.09 to 13.94)	18.58 (14.31 to 24.25)
65-69 years	30.56 (18.31 to 45.09)	14.30 (10.34 to 19.64)	10.59 (8.06 to 13.97)	18.14 (13.99 to 24.20)
70-74 years	50.47 (28.58 to 81.51)	20.68 (14.12 to 27.73)	10.40 (8.09 to 14.03)	17.58 (13.91 to 23.59)
75-79 years	72.58 (41.01 to 116.70)	28.88 (20.75 to 37.87)	10.34 (8.08 to 13.80)	16.95 (13.21 to 21.99)
80-84 years	115.66 (57.39 to 182.32)	48.61 (32.56 to 68.82)	10.08 (7.60 to 13.15)	16.18 (12.35 to 20.99)
85-89 years	156.28 (79.31 to 275.39)	73.01 (45.36 to 99.14)	9.54 (7.21 to 12.47)	15.08 (11.52 to 19.19)
90-94 years	243.12 (113.32 to 454.39)	116.05 (72.76 to 172.93)	9.11 (6.62 to 12.17)	14.27 (10.48 to 19.16)
95+ years	352.90 (175.18 to 659.10)	152.79 (87.15 to 230.59)	8.00 (5.60 to 10.99)	13.17 (9.46 to 17.58)
Male
2-4 years	33.73 (11.08 to 58.63)	12.32 (6.47 to 21.90)	0.01 (0.01 to 0.02)	0.02 (0.01 to 0.02)
5-20 years	4.57 (1.60 to 8.56)	1.82 (0.96 to 3.11)	0.23 (0.16 to 0.31)	0.29 (0.21 to 0.38)
15-21 years	2.80 (1.16 to 4.84)	1.41 (0.82 to 2.34)	0.93 (0.68 to 1.20)	1.26 (0.93 to 1.62)
15-19 years	1.56 (0.86 to 2.79)	1.22 (0.81 to 1.87)	2.23 (1.75 to 2.84)	3.22 (2.51 to 4.06)
20-24 years	3.15 (1.62 to 5.44)	2.62 (1.74 to 4.01)	4.14 (3.28 to 5.33)	6.20 (4.91 to 8.03)
25-29 years	4.81 (2.58 to 8.66)	3.88 (2.69 to 5.58)	6.25 (5.04 to 7.85)	9.47 (7.57 to 12.17)
30-34 years	4.98 (2.82 to 8.02)	4.16 (2.88 to 5.49)	7.77 (6.17 to 9.97)	11.88 (9.40 to 15.30)
35-39 years	5.86 (3.09 to 10.13)	4.81 (3.38 to 6.75)	8.35 (6.69 to 11.02)	13.69 (10.87 to 18.18)
40-44 years	6.99 (3.76 to 12.44)	5.59 (3.85 to 7.71)	8.85 (6.83 to 11.30)	15.39 (12.11 to 19.60)
45-49 years	11.22 (5.80 to 20.07)	7.80 (5.52 to 11.14)	9.46 (7.36 to 12.24)	16.84 (13.05 to 22.04)
50-54 years	13.17 (6.93 to 23.15)	8.94 (6.12 to 12.78)	10.02 (7.54 to 13.17)	17.75 (13.43 to 23.69)
55-59 years	15.82 (8.70 to 26.96)	10.76 (7.40 to 15.44)	10.16 (7.89 to 13.36)	18.13 (14.00 to 23.65)
60-64 years	21.32 (10.75 to 37.34)	14.19 (9.62 to 21.68)	10.22 (7.69 to 13.44)	18.26 (13.87 to 24.04)
65-69 years	28.44 (14.63 to 47.86)	17.41 (11.37 to 26.51)	10.15 (7.69 to 13.68)	17.88 (13.59 to 24.10)
70-74 years	45.27 (20.94 to 76.16)	24.92 (15.10 to 37.25)	10.05 (7.83 to 13.45)	17.39 (13.63 to 23.20)
75-79 years	59.82 (28.55 to 101.44)	34.04 (21.78 to 52.54)	10.04 (7.82 to 13.41)	16.86 (12.87 to 22.33)
80-84 years	92.88 (43.73 to 157.61)	55.89 (33.87 to 85.42)	9.83 (7.48 to 12.93)	16.17 (12.32 to 21.24)
85-89 years	129.42 (59.68 to 221.75)	85.31 (50.57 to 120.40)	9.31 (6.99 to 12.06)	15.14 (11.56 to 19.74)
90-94 years	185.35 (86.06 to 332.11)	126.78 (78.98 to 190.30)	8.76 (6.27 to 11.85)	14.36 (10.60 to 19.43)
95+ years	202.74 (101.83 to 355.85)	133.68 (76.53 to 211.14)	7.91 (5.57 to 10.69)	13.27 (9.34 to 18.14)
Female
2-4 years	46.45 (16.19 to 89.46)	11.92 (5.26 to 19.82)	0.01 (0.01 to 0.02)	0.02 (0.01 to 0.02)
5-20 years	3.12 (1.02 to 6.42)	0.95 (0.48 to 1.68)	0.24 (0.17 to 0.32)	0.30 (0.22 to 0.39)
15-21 years	2.79 (1.01 to 5.79)	1.15 (0.62 to 1.84)	1.01 (0.73 to 1.35)	1.33 (0.98 to 1.70)
15-19 years	1.82 (0.81 to 3.36)	1.20 (0.80 to 1.69)	2.39 (1.87 to 3.06)	3.47 (2.71 to 4.45)
20-24 years	2.34 (1.21 to 4.00)	1.81 (1.21 to 2.48)	4.51 (3.59 to 5.83)	6.81 (5.45 to 8.64)
25-29 years	3.88 (1.97 to 6.93)	2.65 (1.82 to 3.72)	6.97 (5.62 to 8.79)	10.61 (8.52 to 13.48)
30-34 years	3.83 (2.10 to 6.30)	2.90 (2.08 to 4.02)	8.85 (7.11 to 11.32)	13.25 (10.50 to 16.92)
35-39 years	5.28 (2.87 to 9.28)	3.55 (2.47 to 4.84)	9.45 (7.60 to 12.28)	14.85 (11.71 to 19.29)
40-44 years	7.33 (3.71 to 13.43)	4.34 (3.11 to 6.18)	9.88 (7.70 to 12.74)	16.28 (12.86 to 20.45)
45-49 years	8.78 (4.51 to 15.94)	4.87 (3.48 to 6.92)	10.48 (8.15 to 13.53)	17.61 (13.99 to 22.87)
50-54 years	12.36 (6.43 to 22.05)	6.03 (4.32 to 8.59)	11.11 (8.43 to 14.23)	18.51 (14.22 to 23.75)
55-59 years	14.99 (6.94 to 26.47)	6.67 (4.50 to 9.53)	11.28 (8.83 to 14.50)	18.79 (14.82 to 24.35)
60-64 years	24.40 (11.39 to 42.83)	9.43 (6.00 to 13.48)	11.24 (8.48 to 14.57)	18.90 (14.44 to 24.98)
65-69 years	32.60 (15.60 to 56.63)	11.28 (7.21 to 17.38)	11.01 (8.36 to 14.40)	18.41 (14.27 to 24.17)
70-74 years	54.96 (23.54 to 98.13)	16.78 (10.28 to 25.92)	10.71 (8.31 to 14.44)	17.75 (13.97 to 23.93)
75-79 years	82.19 (32.75 to 152.77)	24.38 (14.30 to 37.63)	10.57 (8.21 to 13.83)	17.03 (13.30 to 21.80)
80-84 years	129.22 (48.27 to 222.97)	42.79 (22.52 to 71.94)	10.22 (7.65 to 13.39)	16.18 (12.47 to 20.83)
85-89 years	168.82 (62.59 to 336.99)	64.57 (33.84 to 110.02)	9.64 (7.23 to 12.47)	15.04 (11.49 to 19.25)
90-94 years	264.29 (97.27 to 556.27)	109.56 (55.07 to 197.74)	9.23 (6.68 to 12.34)	14.22 (10.36 to 19.17)
95+ years	401.95 (164.88 to 817.34)	162.81 (77.22 to 274.80)	8.04 (5.59 to 11.22)	13.11 (9.49 to 17.45)
High-income Asia Pacific
Both
2-4 years	1.44 (0.81 to 2.15)	0.42 (0.33 to 0.52)	0.02 (0.02 to 0.03)	0.02 (0.01 to 0.03)
5-20 years	1.41 (0.79 to 2.24)	0.33 (0.27 to 0.41)	0.53 (0.40 to 0.68)	0.50 (0.38 to 0.64)
15-21 years	1.71 (1.12 to 2.40)	0.68 (0.51 to 0.90)	2.55 (1.96 to 3.17)	2.56 (2.04 to 3.14)
15-19 years	4.28 (3.04 to 5.50)	2.04 (1.56 to 2.69)	7.36 (5.90 to 9.39)	7.56 (6.12 to 9.30)
20-24 years	8.20 (6.18 to 10.52)	4.48 (3.35 to 6.13)	15.98 (12.99 to 20.02)	17.25 (13.97 to 21.32)
25-29 years	11.68 (8.30 to 15.01)	7.35 (5.23 to 10.37)	27.12 (22.45 to 33.71)	31.52 (25.61 to 38.98)
30-34 years	12.44 (9.10 to 16.89)	9.23 (6.32 to 13.06)	37.16 (30.63 to 45.13)	44.59 (36.60 to 54.98)
35-39 years	12.04 (9.25 to 15.32)	10.60 (7.53 to 14.44)	41.47 (34.18 to 51.58)	52.78 (43.45 to 66.43)
40-44 years	12.68 (9.81 to 16.39)	12.43 (8.76 to 17.22)	45.67 (36.99 to 55.35)	61.80 (49.87 to 75.41)
45-49 years	14.42 (11.43 to 18.54)	14.17 (10.21 to 18.67)	51.62 (41.87 to 63.38)	68.73 (57.02 to 84.28)
50-54 years	16.51 (12.91 to 20.46)	16.04 (11.91 to 20.79)	56.09 (43.99 to 68.49)	75.91 (60.70 to 92.42)
55-59 years	17.97 (14.58 to 22.36)	17.39 (12.78 to 23.06)	58.28 (46.23 to 73.44)	80.23 (64.36 to 99.74)
60-64 years	19.67 (16.08 to 24.60)	18.70 (13.42 to 25.56)	59.57 (47.69 to 75.09)	83.66 (67.59 to 104.31)
65-69 years	24.43 (20.09 to 30.38)	20.36 (15.56 to 26.63)	59.96 (46.76 to 77.87)	82.15 (64.65 to 105.01)
70-74 years	31.51 (24.51 to 39.53)	23.67 (18.95 to 29.07)	58.80 (46.18 to 76.90)	76.87 (61.03 to 99.57)
75-79 years	41.21 (30.67 to 52.96)	25.38 (20.68 to 31.14)	55.75 (43.17 to 72.13)	73.77 (57.87 to 95.77)
80-84 years	68.88 (48.24 to 89.25)	32.71 (25.86 to 40.87)	51.72 (37.99 to 66.45)	69.48 (52.92 to 86.28)
85-89 years	110.94 (79.39 to 142.82)	47.26 (34.96 to 63.85)	46.70 (34.69 to 60.70)	65.19 (50.11 to 81.58)
90-94 years	155.65 (113.01 to 204.48)	61.24 (42.81 to 82.17)	45.32 (32.22 to 60.35)	63.96 (47.75 to 82.05)
95+ years	230.29 (150.92 to 326.40)	87.56 (57.53 to 119.05)	40.50 (28.67 to 54.23)	60.30 (45.03 to 77.77)
Male
2-4 years	1.81 (0.98 to 2.96)	0.70 (0.54 to 0.91)	0.02 (0.02 to 0.03)	0.02 (0.02 to 0.03)
5-20 years	1.34 (0.76 to 2.47)	0.38 (0.30 to 0.49)	0.55 (0.43 to 0.72)	0.53 (0.40 to 0.65)
15-21 years	1.31 (0.93 to 1.88)	0.71 (0.53 to 0.94)	2.70 (2.09 to 3.36)	2.74 (2.16 to 3.38)
15-19 years	4.42 (3.12 to 6.25)	2.33 (1.78 to 3.08)	7.80 (6.24 to 9.87)	8.14 (6.50 to 9.99)
20-24 years	8.11 (6.06 to 10.97)	5.08 (3.53 to 7.23)	17.17 (13.82 to 21.45)	18.75 (15.18 to 23.17)
25-29 years	12.65 (9.04 to 17.72)	8.62 (5.94 to 12.27)	28.59 (23.33 to 35.50)	34.32 (28.02 to 42.12)
30-34 years	13.43 (9.47 to 18.84)	10.59 (6.84 to 15.18)	38.63 (31.61 to 47.21)	48.05 (39.08 to 59.73)
35-39 years	13.00 (9.67 to 17.74)	11.82 (8.04 to 16.46)	42.30 (34.80 to 52.61)	55.74 (45.76 to 70.33)
40-44 years	13.78 (10.25 to 19.21)	13.63 (9.60 to 18.87)	46.18 (37.32 to 56.72)	64.17 (51.68 to 78.30)
45-49 years	15.36 (11.53 to 20.87)	15.95 (11.68 to 22.57)	52.19 (42.27 to 64.45)	71.27 (58.32 to 87.97)
50-54 years	17.47 (13.11 to 22.98)	18.32 (13.65 to 24.27)	56.88 (44.58 to 70.09)	78.25 (62.56 to 96.46)
55-59 years	20.38 (16.19 to 25.51)	20.89 (15.31 to 27.05)	59.42 (47.45 to 75.29)	83.50 (67.12 to 105.13)
60-64 years	21.26 (16.68 to 26.87)	22.47 (16.22 to 29.82)	61.36 (48.47 to 77.83)	87.78 (71.30 to 110.99)
65-69 years	25.83 (20.22 to 32.06)	25.14 (19.12 to 32.78)	62.73 (48.53 to 81.85)	87.16 (68.74 to 110.71)
70-74 years	33.06 (25.17 to 41.38)	30.23 (23.97 to 36.62)	62.34 (48.56 to 82.01)	82.06 (65.38 to 107.69)
75-79 years	41.89 (31.58 to 51.85)	33.38 (27.52 to 40.27)	59.87 (45.97 to 78.36)	79.88 (61.52 to 104.71)
80-84 years	67.83 (49.65 to 86.15)	44.10 (35.98 to 53.90)	55.82 (40.48 to 72.46)	76.21 (58.13 to 95.69)
85-89 years	102.86 (76.06 to 128.01)	61.29 (48.81 to 73.74)	50.89 (37.52 to 68.35)	72.41 (55.20 to 91.54)
90-94 years	149.08 (114.16 to 184.11)	86.76 (70.05 to 106.84)	46.76 (33.65 to 62.46)	70.21 (52.57 to 89.16)
95+ years	182.10 (134.47 to 228.80)	116.90 (91.26 to 146.65)	42.88 (30.49 to 57.33)	68.04 (51.06 to 87.42)
Female
2-4 years	1.05 (0.48 to 1.76)	0.12 (0.08 to 0.17)	0.02 (0.01 to 0.03)	0.02 (0.01 to 0.03)
5-20 years	1.47 (0.64 to 2.63)	0.28 (0.21 to 0.38)	0.49 (0.38 to 0.63)	0.48 (0.36 to 0.60)
15-21 years	2.13 (1.15 to 3.40)	0.66 (0.47 to 0.88)	2.40 (1.84 to 3.06)	2.38 (1.87 to 2.94)
15-19 years	4.13 (2.50 to 5.93)	1.74 (1.20 to 2.41)	6.88 (5.47 to 9.00)	6.95 (5.59 to 8.48)
20-24 years	8.29 (5.05 to 11.95)	3.85 (2.82 to 5.20)	14.73 (11.96 to 18.50)	15.67 (12.73 to 19.54)
25-29 years	10.69 (6.87 to 15.20)	6.00 (3.90 to 8.50)	25.62 (21.17 to 31.81)	28.56 (23.46 to 35.41)
30-34 years	11.43 (7.72 to 15.73)	7.75 (5.13 to 11.50)	35.65 (29.44 to 43.91)	40.84 (33.70 to 50.24)
35-39 years	11.06 (8.20 to 14.76)	9.29 (5.97 to 13.19)	40.62 (33.31 to 50.91)	49.62 (40.38 to 63.04)
40-44 years	11.56 (8.43 to 15.56)	11.16 (7.38 to 16.60)	45.15 (36.51 to 54.78)	59.30 (47.55 to 73.94)
45-49 years	13.48 (9.97 to 17.71)	12.36 (7.96 to 17.16)	51.04 (41.36 to 62.45)	66.13 (54.20 to 82.36)
50-54 years	15.57 (11.65 to 20.62)	13.70 (9.13 to 18.45)	55.33 (43.42 to 67.01)	73.50 (59.66 to 89.25)
55-59 years	15.68 (11.79 to 19.72)	13.90 (9.39 to 20.06)	57.19 (45.22 to 71.22)	76.96 (61.99 to 94.31)
60-64 years	18.24 (13.63 to 23.74)	14.99 (10.03 to 22.40)	57.97 (46.86 to 72.73)	79.60 (64.20 to 99.56)
65-69 years	23.37 (17.67 to 30.46)	15.81 (11.19 to 22.24)	57.89 (45.44 to 74.80)	77.40 (61.49 to 98.58)
70-74 years	30.45 (21.76 to 40.98)	17.79 (13.49 to 23.78)	56.37 (44.50 to 73.31)	72.21 (57.81 to 92.36)
75-79 years	40.77 (27.30 to 57.27)	18.81 (14.18 to 24.65)	53.12 (41.26 to 68.29)	68.75 (54.40 to 87.96)
80-84 years	69.48 (43.90 to 98.61)	24.69 (17.53 to 33.81)	49.39 (36.24 to 62.60)	64.74 (49.25 to 79.34)
85-89 years	114.77 (76.16 to 162.86)	39.41 (26.85 to 60.79)	44.72 (33.10 to 58.87)	61.15 (47.16 to 76.22)
90-94 years	157.96 (102.86 to 221.83)	51.15 (32.83 to 79.97)	44.82 (30.85 to 61.38)	61.49 (45.15 to 82.19)
95+ years	244.74 (149.14 to 366.89)	80.67 (49.84 to 119.07)	39.78 (27.98 to 53.54)	58.48 (43.82 to 75.72)
Southeast Asia
Both
2-4 years	6.25 (2.39 to 11.92)	3.94 (1.78 to 7.00)	0.01 (0.01 to 0.02)	0.01 (0.01 to 0.02)
5-20 years	3.37 (1.60 to 6.15)	2.06 (1.14 to 3.56)	0.22 (0.16 to 0.30)	0.23 (0.16 to 0.31)
15-21 years	2.10 (1.10 to 3.68)	1.73 (0.97 to 3.00)	0.89 (0.66 to 1.15)	0.94 (0.68 to 1.21)
15-19 years	2.74 (1.36 to 5.05)	2.72 (1.62 to 4.50)	2.11 (1.64 to 2.76)	2.27 (1.78 to 2.91)
20-24 years	4.69 (2.38 to 7.38)	4.94 (2.89 to 8.50)	3.87 (3.06 to 5.08)	4.20 (3.32 to 5.42)
25-29 years	5.60 (3.13 to 9.36)	5.87 (3.74 to 9.51)	5.84 (4.64 to 7.45)	6.38 (5.16 to 8.02)
30-34 years	6.71 (3.97 to 10.86)	6.47 (4.10 to 9.44)	7.48 (5.97 to 9.29)	8.22 (6.59 to 10.27)
35-39 years	8.50 (5.09 to 13.66)	7.47 (4.71 to 11.24)	8.64 (6.92 to 11.20)	9.46 (7.50 to 12.10)
40-44 years	8.50 (5.05 to 13.35)	6.95 (4.67 to 10.16)	9.44 (7.49 to 12.11)	10.27 (8.09 to 13.09)
45-49 years	9.73 (6.10 to 15.21)	7.94 (5.25 to 11.51)	10.13 (7.82 to 12.73)	10.98 (8.53 to 14.00)
50-54 years	11.13 (6.80 to 17.01)	8.81 (6.01 to 12.64)	10.43 (8.00 to 13.36)	11.39 (8.74 to 14.69)
55-59 years	14.44 (8.49 to 22.79)	10.80 (7.21 to 15.60)	10.18 (7.76 to 12.88)	11.28 (8.71 to 14.38)
60-64 years	18.92 (10.85 to 30.78)	13.61 (8.73 to 19.75)	9.72 (7.29 to 12.72)	10.93 (8.31 to 14.34)
65-69 years	25.66 (14.31 to 41.81)	17.37 (11.12 to 25.62)	9.08 (6.79 to 12.22)	10.38 (7.81 to 13.88)
70-74 years	38.30 (21.40 to 63.71)	25.00 (15.98 to 36.44)	8.39 (6.38 to 11.24)	9.71 (7.53 to 13.00)
75-79 years	50.30 (27.75 to 85.51)	34.10 (21.51 to 51.44)	7.59 (5.71 to 10.11)	9.02 (6.90 to 12.02)
80-84 years	60.35 (33.71 to 98.33)	43.57 (27.71 to 67.96)	6.80 (5.09 to 8.92)	8.10 (6.09 to 10.53)
85-89 years	65.29 (33.74 to 110.37)	47.79 (26.49 to 75.70)	5.99 (4.45 to 8.15)	7.03 (5.11 to 9.43)
90-94 years	85.09 (43.55 to 147.08)	62.79 (34.81 to 100.01)	5.24 (3.71 to 7.15)	6.27 (4.37 to 8.64)
95+ years	95.21 (44.46 to 175.61)	83.08 (42.11 to 145.63)	4.49 (3.00 to 6.29)	5.61 (3.78 to 7.91)
Male
2-4 years	8.25 (2.84 to 18.62)	5.29 (2.10 to 10.79)	0.01 (0.01 to 0.02)	0.01 (0.01 to 0.02)
5-20 years	4.94 (2.03 to 10.13)	2.99 (1.39 to 5.81)	0.22 (0.15 to 0.30)	0.23 (0.15 to 0.30)
15-21 years	2.11 (0.91 to 4.03)	1.69 (0.91 to 3.23)	0.86 (0.63 to 1.11)	0.92 (0.67 to 1.18)
15-19 years	3.28 (1.40 to 6.66)	3.18 (1.64 to 6.45)	2.04 (1.60 to 2.62)	2.22 (1.72 to 2.81)
20-24 years	5.55 (2.59 to 10.20)	5.64 (2.91 to 11.09)	3.73 (2.93 to 4.83)	4.08 (3.25 to 5.24)
25-29 years	7.28 (3.48 to 13.42)	7.53 (3.91 to 13.27)	5.60 (4.43 to 7.13)	6.19 (4.95 to 7.94)
30-34 years	8.56 (4.18 to 16.07)	8.24 (4.56 to 14.09)	7.18 (5.65 to 9.04)	7.97 (6.40 to 10.10)
35-39 years	11.55 (5.92 to 20.15)	10.34 (5.75 to 17.38)	8.31 (6.65 to 10.76)	9.18 (7.33 to 11.77)
40-44 years	10.65 (5.31 to 18.61)	9.09 (5.25 to 15.15)	9.12 (7.15 to 11.83)	9.97 (7.86 to 13.06)
45-49 years	11.56 (6.16 to 20.29)	10.03 (6.01 to 16.59)	9.80 (7.55 to 12.53)	10.68 (8.14 to 13.74)
50-54 years	13.46 (7.21 to 23.85)	11.12 (6.64 to 17.73)	10.05 (7.64 to 13.12)	11.02 (8.34 to 14.37)
55-59 years	16.29 (8.38 to 28.22)	13.02 (7.62 to 21.10)	9.79 (7.43 to 12.61)	10.87 (8.28 to 13.97)
60-64 years	21.45 (10.32 to 38.57)	16.62 (9.45 to 28.47)	9.35 (6.98 to 12.41)	10.51 (7.76 to 13.94)
65-69 years	28.41 (14.47 to 53.02)	21.17 (11.88 to 35.28)	8.77 (6.51 to 11.88)	10.01 (7.39 to 13.41)
70-74 years	38.76 (17.58 to 73.85)	29.05 (15.35 to 47.19)	8.14 (6.13 to 10.92)	9.43 (7.27 to 12.74)
75-79 years	50.25 (24.60 to 88.78)	38.20 (20.91 to 64.65)	7.45 (5.54 to 10.21)	8.80 (6.62 to 11.91)
80-84 years	66.81 (32.18 to 121.12)	52.56 (29.81 to 95.30)	6.77 (5.04 to 8.94)	7.91 (5.96 to 10.48)
85-89 years	67.64 (30.50 to 121.26)	54.35 (30.00 to 95.20)	6.06 (4.41 to 8.08)	6.88 (5.08 to 9.09)
90-94 years	95.54 (45.09 to 183.10)	73.18 (36.33 to 123.13)	5.49 (3.84 to 7.57)	6.05 (4.23 to 8.37)
95+ years	78.02 (37.30 to 143.52)	72.01 (38.96 to 124.78)	4.89 (3.22 to 6.74)	5.54 (3.69 to 7.92)
Female
2-4 years	4.15 (1.33 to 10.33)	2.51 (1.03 to 5.22)	0.01 (0.01 to 0.02)	0.01 (0.01 to 0.02)
5-20 years	1.72 (0.58 to 4.01)	1.08 (0.49 to 2.30)	0.23 (0.15 to 0.31)	0.23 (0.16 to 0.31)
15-21 years	2.09 (0.83 to 4.54)	1.77 (0.86 to 3.48)	0.91 (0.69 to 1.22)	0.96 (0.69 to 1.24)
15-19 years	2.21 (0.96 to 4.85)	2.23 (1.19 to 5.18)	2.18 (1.69 to 2.86)	2.33 (1.82 to 3.02)
20-24 years	3.86 (1.80 to 7.97)	4.21 (2.25 to 9.33)	4.01 (3.19 to 5.25)	4.33 (3.44 to 5.56)
25-29 years	4.02 (2.09 to 8.37)	4.15 (2.31 to 7.70)	6.07 (4.85 to 7.79)	6.57 (5.30 to 8.27)
30-34 years	4.92 (2.62 to 9.68)	4.64 (2.71 to 8.21)	7.78 (6.17 to 9.66)	8.48 (6.83 to 10.52)
35-39 years	5.48 (2.99 to 10.02)	4.53 (2.80 to 7.51)	8.96 (7.17 to 11.60)	9.75 (7.71 to 12.46)
40-44 years	6.40 (3.41 to 11.74)	4.79 (2.98 to 7.82)	9.75 (7.73 to 12.36)	10.57 (8.32 to 13.19)
45-49 years	8.00 (4.28 to 15.99)	5.87 (3.71 to 9.82)	10.45 (8.12 to 13.05)	11.28 (8.93 to 14.24)
50-54 years	8.95 (4.88 to 16.90)	6.56 (4.22 to 10.69)	10.79 (8.30 to 13.55)	11.76 (9.24 to 15.02)
55-59 years	12.73 (6.14 to 24.10)	8.70 (5.22 to 13.94)	10.55 (8.06 to 13.54)	11.67 (9.06 to 14.64)
60-64 years	16.58 (8.18 to 34.72)	10.86 (6.24 to 18.70)	10.05 (7.53 to 13.24)	11.32 (8.70 to 14.80)
65-69 years	23.22 (10.63 to 46.47)	14.06 (7.93 to 23.58)	9.36 (6.93 to 12.78)	10.71 (8.40 to 14.11)
70-74 years	37.92 (15.81 to 77.27)	21.62 (11.81 to 37.09)	8.60 (6.56 to 11.67)	9.95 (7.67 to 13.15)
75-79 years	50.34 (19.92 to 105.21)	30.99 (14.81 to 53.53)	7.69 (5.71 to 10.45)	9.18 (7.00 to 12.18)
80-84 years	55.86 (21.13 to 111.24)	37.57 (17.23 to 65.77)	6.83 (5.09 to 9.19)	8.22 (6.14 to 10.62)
85-89 years	63.80 (21.45 to 128.26)	44.02 (19.63 to 77.68)	5.95 (4.38 to 8.10)	7.12 (5.19 to 9.62)
90-94 years	79.99 (30.73 to 173.92)	57.48 (24.21 to 107.90)	5.11 (3.62 to 6.96)	6.38 (4.42 to 8.70)
95+ years	101.07 (37.07 to 201.11)	87.73 (38.68 to 176.20)	4.35 (2.92 to 6.09)	5.64 (3.82 to 8.03)
South Asia
Both
2-4 years	3.02 (1.40 to 5.33)	1.84 (0.98 to 3.12)	0.02 (0.01 to 0.02)	0.02 (0.01 to 0.03)
5-20 years	1.33 (0.66 to 2.33)	0.75 (0.42 to 1.20)	0.38 (0.28 to 0.50)	0.40 (0.29 to 0.52)
15-21 years	1.47 (0.86 to 2.31)	1.16 (0.76 to 1.73)	1.80 (1.34 to 2.34)	1.96 (1.45 to 2.52)
15-19 years	4.37 (2.66 to 7.20)	3.02 (1.95 to 4.55)	5.24 (4.13 to 6.65)	5.82 (4.63 to 7.32)
20-24 years	7.38 (4.71 to 10.92)	5.44 (3.76 to 7.82)	12.16 (9.72 to 15.53)	13.83 (11.23 to 17.54)
25-29 years	13.81 (8.98 to 20.80)	10.55 (7.30 to 14.37)	23.34 (18.81 to 28.91)	27.02 (21.91 to 33.18)
30-34 years	18.41 (12.43 to 26.24)	15.16 (10.46 to 20.44)	37.95 (30.48 to 48.45)	44.89 (36.38 to 57.25)
35-39 years	22.59 (16.37 to 32.01)	19.02 (13.48 to 25.21)	53.94 (42.61 to 70.64)	65.23 (51.96 to 84.60)
40-44 years	30.79 (22.05 to 44.36)	25.77 (17.74 to 34.05)	69.53 (54.69 to 89.53)	85.33 (68.01 to 109.12)
45-49 years	33.13 (23.26 to 46.54)	28.34 (19.19 to 36.91)	83.45 (64.33 to 106.74)	104.29 (81.23 to 131.66)
50-54 years	39.67 (27.21 to 56.53)	33.37 (24.40 to 45.14)	93.55 (71.13 to 120.62)	119.68 (93.76 to 153.58)
55-59 years	41.82 (29.67 to 60.30)	36.08 (25.79 to 49.38)	96.73 (73.92 to 125.34)	125.66 (95.61 to 161.26)
60-64 years	48.38 (32.83 to 71.01)	37.95 (26.56 to 52.65)	96.37 (72.70 to 129.79)	126.97 (96.58 to 168.60)
65-69 years	52.73 (35.93 to 77.77)	40.92 (28.44 to 53.87)	93.56 (70.90 to 125.86)	123.49 (95.06 to 162.20)
70-74 years	65.87 (44.25 to 98.31)	52.68 (36.71 to 73.79)	89.62 (69.24 to 116.82)	117.68 (91.53 to 155.46)
75-79 years	76.15 (49.41 to 109.99)	61.08 (43.93 to 88.39)	86.32 (66.39 to 113.64)	113.62 (87.40 to 149.42)
80-84 years	88.20 (56.45 to 132.47)	73.00 (48.77 to 105.63)	81.63 (61.99 to 108.00)	108.10 (81.44 to 140.00)
85-89 years	86.23 (54.01 to 136.11)	79.11 (51.37 to 119.88)	72.88 (55.01 to 96.25)	99.93 (74.89 to 132.27)
90-94 years	100.50 (59.76 to 156.26)	103.67 (62.50 to 160.13)	64.42 (49.30 to 84.70)	91.66 (66.56 to 122.65)
95+ years	124.61 (72.22 to 197.74)	145.09 (87.32 to 228.79)	58.91 (42.97 to 78.98)	82.68 (59.44 to 111.51)
Male
2-4 years	2.95 (0.97 to 6.59)	1.88 (0.79 to 3.93)	0.02 (0.01 to 0.02)	0.02 (0.01 to 0.02)
5-20 years	1.38 (0.52 to 2.93)	0.80 (0.39 to 1.62)	0.39 (0.28 to 0.51)	0.41 (0.30 to 0.52)
15-21 years	1.46 (0.74 to 2.66)	1.11 (0.66 to 2.05)	1.85 (1.38 to 2.44)	2.00 (1.49 to 2.58)
15-19 years	4.57 (2.14 to 9.20)	3.02 (1.73 to 5.02)	5.35 (4.23 to 6.77)	5.90 (4.64 to 7.43)
20-24 years	7.58 (4.36 to 12.70)	5.19 (3.41 to 8.33)	12.46 (9.93 to 15.95)	14.04 (11.37 to 17.90)
25-29 years	13.35 (7.93 to 22.23)	9.97 (6.48 to 15.43)	23.98 (18.84 to 29.82)	27.57 (22.02 to 34.06)
30-34 years	19.78 (11.23 to 32.65)	15.45 (10.12 to 23.29)	38.97 (31.41 to 50.43)	45.76 (37.20 to 58.73)
35-39 years	24.32 (15.19 to 40.44)	19.51 (13.00 to 28.91)	55.04 (43.47 to 72.40)	66.23 (52.64 to 88.19)
40-44 years	33.93 (20.74 to 55.96)	27.81 (18.13 to 40.85)	70.31 (54.94 to 90.92)	86.22 (67.24 to 111.61)
45-49 years	35.87 (22.58 to 56.94)	29.20 (19.23 to 40.10)	83.27 (63.37 to 107.16)	104.49 (80.72 to 134.02)
50-54 years	46.47 (28.25 to 72.07)	37.53 (25.08 to 54.44)	91.03 (68.46 to 117.79)	116.63 (88.58 to 149.16)
55-59 years	48.03 (28.48 to 80.19)	38.32 (26.08 to 58.63)	93.89 (70.48 to 123.07)	122.85 (93.39 to 157.95)
60-64 years	54.52 (31.09 to 91.82)	41.09 (27.37 to 61.60)	93.62 (70.67 to 127.33)	124.39 (95.42 to 164.44)
65-69 years	60.12 (34.54 to 109.19)	44.39 (29.01 to 66.29)	91.20 (68.86 to 122.22)	121.43 (92.34 to 161.95)
70-74 years	71.56 (39.54 to 131.89)	56.15 (34.72 to 84.26)	88.16 (67.44 to 115.72)	116.56 (90.76 to 154.29)
75-79 years	79.75 (42.23 to 140.46)	65.30 (41.36 to 108.71)	85.08 (65.28 to 111.28)	112.48 (85.85 to 148.18)
80-84 years	84.95 (42.79 to 164.42)	68.73 (41.21 to 107.42)	80.77 (61.91 to 106.43)	106.89 (81.65 to 138.90)
85-89 years	85.81 (41.56 to 175.63)	82.21 (46.53 to 147.09)	72.66 (54.00 to 96.20)	98.75 (73.72 to 130.99)
90-94 years	93.72 (42.65 to 192.60)	103.07 (56.12 to 194.18)	64.48 (49.16 to 83.75)	89.77 (66.42 to 121.68)
95+ years	116.33 (54.28 to 236.73)	153.61 (79.15 to 290.34)	59.09 (43.00 to 79.22)	81.18 (58.03 to 107.18)
Female
2-4 years	3.10 (0.97 to 6.61)	1.80 (0.79 to 3.52)	0.02 (0.01 to 0.02)	0.02 (0.01 to 0.03)
5-20 years	1.28 (0.50 to 2.60)	0.70 (0.32 to 1.26)	0.38 (0.28 to 0.49)	0.40 (0.29 to 0.51)
15-21 years	1.47 (0.76 to 2.77)	1.22 (0.73 to 1.92)	1.75 (1.31 to 2.21)	1.91 (1.41 to 2.48)
15-19 years	4.16 (2.23 to 7.89)	3.01 (1.88 to 4.70)	5.13 (4.02 to 6.59)	5.73 (4.52 to 7.17)
20-24 years	7.16 (3.89 to 13.26)	5.71 (3.60 to 8.80)	11.85 (9.55 to 15.05)	13.60 (10.90 to 17.45)
25-29 years	14.29 (7.64 to 26.51)	11.14 (6.85 to 16.54)	22.66 (18.19 to 28.41)	26.47 (21.32 to 33.26)
30-34 years	16.94 (9.89 to 28.33)	14.86 (9.96 to 21.18)	36.86 (29.88 to 46.57)	44.00 (35.11 to 56.63)
35-39 years	20.71 (13.48 to 30.66)	18.52 (12.68 to 26.37)	52.74 (41.71 to 71.54)	64.19 (51.49 to 84.14)
40-44 years	27.35 (17.54 to 41.24)	23.62 (16.26 to 33.24)	68.68 (54.52 to 88.04)	84.40 (66.81 to 108.82)
45-49 years	30.04 (19.05 to 48.50)	27.44 (17.86 to 38.16)	83.65 (65.19 to 104.77)	104.08 (81.98 to 129.74)
50-54 years	31.93 (19.87 to 49.48)	29.07 (19.59 to 40.68)	96.41 (73.90 to 124.56)	122.84 (94.15 to 160.09)
55-59 years	34.77 (21.96 to 53.71)	33.85 (21.87 to 45.77)	99.94 (77.23 to 128.66)	128.48 (97.49 to 167.36)
60-64 years	41.39 (25.56 to 66.58)	34.84 (23.10 to 49.22)	99.51 (75.06 to 132.52)	129.53 (98.59 to 169.90)
65-69 years	44.57 (27.87 to 71.88)	37.51 (25.84 to 53.59)	96.17 (73.01 to 129.87)	125.52 (96.69 to 166.38)
70-74 years	59.92 (34.53 to 107.58)	49.35 (32.74 to 75.39)	91.15 (71.19 to 119.77)	118.74 (91.99 to 156.88)
75-79 years	72.47 (39.36 to 129.41)	57.14 (37.91 to 91.29)	87.59 (67.25 to 115.59)	114.69 (87.34 to 148.78)
80-84 years	91.42 (46.83 to 165.69)	76.66 (46.04 to 126.66)	82.48 (61.74 to 109.66)	109.14 (81.86 to 143.29)
85-89 years	86.66 (38.60 to 169.79)	76.80 (43.87 to 137.75)	73.11 (55.81 to 96.90)	100.81 (74.43 to 137.39)
90-94 years	107.08 (45.91 to 221.03)	104.09 (54.97 to 196.15)	64.35 (48.73 to 85.40)	92.99 (65.97 to 128.19)
95+ years	132.80 (55.47 to 257.80)	139.61 (74.36 to 262.31)	58.74 (42.65 to 79.51)	83.64 (59.07 to 112.70)

Abbreviation: DALY, disability-adjusted life year; GBD, Global burden of disease; UI, uncertainty interval; IBD, Inflammatory bowel disease.

Subtype-specific age distributions also differed between UC and CD. As shown in Tables S13 and S14, age- and sex-specific DALY counts showed distinct peak patterns between the two subtypes. In East Asia, UC DALY counts peaked at older ages, at 70–74 years in males and 80–84 years in females. In contrast, CD DALY counts peaked between ages 20–24 years and 55–59 years across subregions and sexes, with the earliest peak observed at ages 20–24 years in Southeast Asian females and the latest peak at ages 55–59 years in East Asian females. Similar differences were observed for prevalent case counts. UC prevalent cases peaked later than CD prevalent cases in both Central Asia and East Asia, with UC peaking at ages 45–49 years in Central Asia and 55–59 years in East Asia; whereas, CD peaked at ages 35–39 years in Central Asia and 50–54 years in East Asia.

Table S13.

Age- and sex-specific DALY and prevalence counts for UC across the five GBD regions of Asia in 2023 (95% UI).

Location	DALY, number	Prevalence, number
Central Asia	2023	2023
Male
2-4 years	674.76 (481.22 to 966.30)	0.60 (0.35 to 0.90)
5-20 years	245.04 (179.64 to 356.19)	13.96 (9.38 to 19.61)
15-21 years	107.73 (81.85 to 150.97)	62.78 (43.01 to 90.71)
15-19 years	99.20 (74.90 to 137.83)	160.20 (112.63 to 224.63)
20-24 years	169.04 (129.79 to 219.05)	343.67 (250.15 to 452.55)
25-29 years	254.44 (197.82 to 330.33)	726.69 (519.93 to 956.38)
30-34 years	382.32 (277.95 to 530.67)	1354.08 (1001.54 to 1812.38)
35-39 years	612.55 (460.74 to 844.97)	1899.47 (1399.51 to 2638.17)
40-44 years	567.31 (422.88 to 803.42)	2083.72 (1536.84 to 2812.91)
45-49 years	648.84 (483.30 to 859.10)	2150.41 (1554.67 to 2912.66)
50-54 years	559.83 (417.49 to 756.18)	2054.22 (1496.93 to 2794.73)
55-59 years	538.45 (410.05 to 705.58)	1841.66 (1285.34 to 2505.55)
60-64 years	570.20 (442.26 to 743.00)	1559.53 (1082.25 to 2195.01)
65-69 years	395.88 (307.02 to 493.12)	945.77 (649.59 to 1320.40)
70-74 years	261.93 (206.30 to 319.84)	510.47 (366.17 to 711.35)
75-79 years	102.19 (78.31 to 129.22)	195.55 (137.79 to 272.63)
80-84 years	82.31 (64.14 to 104.26)	131.84 (94.00 to 186.60)
85-89 years	32.91 (26.02 to 42.33)	55.53 (38.49 to 79.48)
90-94 years	17.06 (12.83 to 22.64)	15.44 (10.81 to 22.03)
95+ years	6.47 (4.79 to 8.63)	3.49 (2.27 to 5.05)
Female
2-4 years	613.55 (408.24 to 828.25)	0.56 (0.31 to 0.85)
5-20 years	138.05 (100.40 to 187.96)	12.89 (8.41 to 18.08)
15-21 years	119.91 (89.50 to 160.48)	58.65 (41.34 to 83.97)
15-19 years	86.98 (65.50 to 113.14)	152.53 (107.11 to 214.76)
20-24 years	162.85 (122.51 to 212.60)	334.07 (240.15 to 445.49)
25-29 years	252.04 (181.51 to 326.56)	722.77 (537.05 to 970.45)
30-34 years	353.94 (243.63 to 489.61)	1356.93 (971.55 to 1866.14)
35-39 years	552.08 (394.73 to 755.50)	1901.45 (1392.17 to 2580.55)
40-44 years	471.48 (308.38 to 658.62)	2083.66 (1496.62 to 2808.28)
45-49 years	559.72 (388.46 to 758.28)	2174.24 (1588.71 to 2886.62)
50-54 years	533.51 (370.52 to 730.87)	2145.65 (1558.01 to 2894.12)
55-59 years	564.95 (393.78 to 781.72)	2018.14 (1412.02 to 2835.14)
60-64 years	480.80 (330.91 to 652.29)	1802.52 (1243.19 to 2521.27)
65-69 years	376.66 (285.46 to 494.28)	1147.60 (784.39 to 1584.74)
70-74 years	254.07 (188.32 to 325.68)	702.15 (486.84 to 976.59)
75-79 years	123.59 (97.17 to 155.96)	294.26 (196.53 to 416.89)
80-84 years	123.57 (95.04 to 152.63)	218.43 (150.86 to 307.54)
85-89 years	65.06 (49.42 to 84.50)	103.65 (70.04 to 147.99)
90-94 years	27.18 (20.90 to 35.57)	29.89 (21.01 to 42.41)
95+ years	3.84 (2.96 to 5.05)	8.18 (5.44 to 11.97)
East Asia
Male
2-4 years	4108.61 (2139.43 to 7227.32)	2.87 (1.39 to 4.74)
5-20 years	934.07 (484.58 to 1593.84)	85.83 (49.23 to 121.95)
15-21 years	519.17 (299.71 to 889.99)	327.11 (208.84 to 484.16)
15-19 years	329.15 (213.33 to 537.94)	765.12 (506.18 to 1039.15)
20-24 years	625.66 (417.40 to 1006.23)	1287.34 (884.89 to 1751.69)
25-29 years	1064.20 (694.43 to 1605.60)	2190.19 (1525.79 to 2934.21)
30-34 years	1627.72 (1109.35 to 2182.94)	3984.60 (2943.16 to 5479.38)
35-39 years	2206.84 (1521.90 to 3255.95)	5406.76 (3906.23 to 7602.68)
40-44 years	2072.03 (1414.55 to 2964.09)	5018.86 (3544.37 to 7197.86)
45-49 years	3338.67 (2363.62 to 4834.29)	6119.36 (4337.67 to 8661.20)
50-54 years	4576.94 (3004.51 to 6583.91)	7761.84 (5263.75 to 10849.33)
55-59 years	5696.39 (3771.36 to 8317.83)	7866.04 (5384.77 to 11118.42)
60-64 years	5300.34 (3519.79 to 8204.74)	5555.47 (3710.92 to 7983.73)
65-69 years	6045.42 (3811.45 to 9169.83)	5070.48 (3589.15 to 7430.44)
70-74 years	6941.64 (4209.55 to 10562.82)	3815.33 (2796.79 to 5610.49)
75-79 years	5651.89 (3567.71 to 8820.16)	2152.17 (1539.80 to 3076.65)
80-84 years	5556.42 (3372.81 to 8540.22)	1194.43 (850.32 to 1686.66)
85-89 years	4332.36 (2574.48 to 6040.11)	562.01 (394.99 to 783.04)
90-94 years	2193.71 (1363.93 to 3299.37)	178.72 (124.86 to 257.51)
95+ years	574.24 (327.42 to 912.12)	41.49 (27.64 to 60.22)
Female
2-4 years	3532.25 (1563.21 to 5883.95)	2.46 (1.19 to 4.02)
5-20 years	443.58 (216.12 to 799.74)	74.31 (42.16 to 105.27)
15-21 years	410.80 (202.28 to 696.53)	285.09 (175.63 to 411.95)
15-19 years	320.23 (194.58 to 474.20)	668.73 (444.51 to 917.74)
20-24 years	371.54 (232.25 to 532.58)	1147.75 (804.54 to 1561.38)
25-29 years	556.66 (338.59 to 794.41)	1986.12 (1403.80 to 2613.37)
30-34 years	847.77 (560.22 to 1219.01)	3673.12 (2718.66 to 5021.99)
35-39 years	1352.61 (876.62 to 1943.74)	5046.93 (3648.25 to 7227.04)
40-44 years	1392.50 (901.03 to 2093.51)	4601.14 (3260.98 to 6515.26)
45-49 years	1831.29 (1243.41 to 2767.20)	5688.85 (4040.63 to 7848.09)
50-54 years	2814.18 (1885.28 to 4123.49)	7252.71 (5028.14 to 10264.55)
55-59 years	3242.04 (2118.89 to 4711.29)	7622.72 (5279.54 to 10504.28)
60-64 years	3449.95 (2068.66 to 5103.09)	5421.73 (3664.40 to 7705.27)
65-69 years	3964.22 (2406.97 to 6259.39)	5032.45 (3540.77 to 7170.04)
70-74 years	5020.16 (2936.20 to 7850.10)	3987.95 (2996.95 to 5851.70)
75-79 years	4646.44 (2644.63 to 7309.34)	2361.54 (1713.25 to 3274.05)
80-84 years	5312.01 (2728.93 to 9055.54)	1423.96 (1005.19 to 1974.04)
85-89 years	4764.08 (2464.45 to 8238.92)	780.00 (547.29 to 1090.62)
90-94 years	3131.96 (1552.31 to 5667.89)	281.73 (192.56 to 412.49)
95+ years	1332.69 (629.22 to 2275.01)	74.94 (49.00 to 108.55)
High-income Asia Pacific
Male
2-4 years	14.59 (11.09 to 18.86)	0.32 (0.18 to 0.49)
5-20 years	9.85 (7.56 to 13.09)	9.44 (6.13 to 13.02)
15-21 years	13.60 (9.72 to 18.84)	52.21 (35.83 to 72.25)
15-19 years	51.49 (38.68 to 69.18)	155.99 (109.57 to 209.75)
20-24 years	103.22 (77.20 to 139.06)	398.79 (292.39 to 526.11)
25-29 years	197.96 (129.45 to 300.25)	844.18 (613.78 to 1125.58)
30-34 years	281.24 (165.01 to 440.53)	1384.23 (1036.75 to 1824.37)
35-39 years	358.06 (219.30 to 546.92)	1938.06 (1500.91 to 2619.34)
40-44 years	554.47 (370.53 to 825.52)	2815.34 (2131.71 to 3751.74)
45-49 years	688.98 (464.59 to 978.56)	3497.12 (2674.69 to 4531.78)
50-54 years	892.88 (605.79 to 1224.68)	4268.61 (3226.60 to 5501.89)
55-59 years	951.78 (651.46 to 1276.81)	4075.82 (3083.31 to 5335.38)
60-64 years	1000.90 (685.76 to 1370.65)	4096.04 (3048.90 to 5332.53)
65-69 years	1024.55 (760.17 to 1397.57)	3747.23 (2797.91 to 5057.83)
70-74 years	1316.24 (1039.53 to 1612.56)	3632.41 (2715.21 to 4915.33)
75-79 years	1173.57 (952.46 to 1433.80)	2816.39 (2048.38 to 3698.99)
80-84 years	1130.90 (909.52 to 1395.06)	1924.06 (1389.28 to 2474.03)
85-89 years	895.77 (701.94 to 1086.10)	1041.46 (763.21 to 1338.51)
90-94 years	533.45 (428.30 to 654.92)	414.00 (298.12 to 540.24)
95+ years	162.19 (124.21 to 205.64)	94.22 (68.74 to 122.88)
Female
2-4 years	1.65 (1.02 to 2.91)	0.30 (0.16 to 0.47)
5-20 years	4.36 (3.06 to 6.71)	8.65 (5.62 to 11.87)
15-21 years	15.77 (11.03 to 21.80)	47.43 (32.35 to 65.71)
15-19 years	40.16 (27.73 to 53.96)	141.00 (98.83 to 188.27)
20-24 years	99.09 (71.34 to 137.06)	359.08 (262.30 to 477.60)
25-29 years	161.66 (91.71 to 248.44)	748.93 (546.06 to 973.76)
30-34 years	218.31 (129.85 to 349.22)	1187.81 (904.50 to 1546.18)
35-39 years	307.42 (197.61 to 479.66)	1697.46 (1306.31 to 2249.66)
40-44 years	466.82 (297.30 to 740.85)	2523.98 (1916.87 to 3338.97)
45-49 years	577.39 (366.55 to 820.91)	3189.02 (2425.15 to 4152.96)
50-54 years	709.24 (464.39 to 1000.49)	3893.42 (2957.04 to 5129.39)
55-59 years	668.04 (438.18 to 1022.90)	3716.66 (2841.77 to 4909.67)
60-64 years	689.60 (440.64 to 1039.30)	3725.80 (2799.32 to 4914.25)
65-69 years	693.00 (475.05 to 1023.17)	3426.63 (2528.97 to 4626.26)
70-74 years	848.51 (618.21 to 1133.84)	3444.13 (2604.38 to 4626.83)
75-79 years	791.57 (598.07 to 1027.97)	2841.97 (2136.27 to 3669.35)
80-84 years	892.74 (623.97 to 1280.85)	2231.09 (1620.36 to 2822.69)
85-89 years	1040.63 (691.49 to 1693.38)	1511.14 (1122.39 to 1966.76)
90-94 years	796.84 (507.52 to 1277.78)	878.37 (630.50 to 1202.93)
95+ years	490.17 (298.52 to 733.47)	329.95 (241.99 to 438.69)
Southeast Asia
Male
2-4 years	1469.52 (577.58 to 3016.14)	1.76 (0.79 to 3.03)
5-20 years	857.60 (389.49 to 1694.42)	37.28 (20.32 to 55.27)
15-21 years	408.28 (200.12 to 830.95)	154.19 (91.49 to 231.32)
15-19 years	697.35 (315.13 to 1475.84)	368.68 (242.26 to 512.74)
20-24 years	1270.29 (598.88 to 2379.68)	684.65 (475.38 to 935.84)
25-29 years	1768.41 (819.31 to 3372.99)	1089.25 (767.76 to 1433.85)
30-34 years	2042.81 (1045.04 to 3540.90)	1488.36 (1128.27 to 1982.64)
35-39 years	2227.37 (1112.19 to 3958.10)	1746.78 (1315.10 to 2449.51)
40-44 years	1869.08 (1026.56 to 3273.46)	1883.64 (1357.47 to 2603.92)
45-49 years	1878.44 (1043.33 to 3148.06)	1864.04 (1316.56 to 2525.95)
50-54 years	1919.43 (1139.44 to 3100.88)	1753.58 (1259.03 to 2364.26)
55-59 years	2037.44 (1160.04 to 3317.37)	1505.68 (1075.76 to 2071.21)
60-64 years	2016.94 (1054.32 to 3654.17)	1204.20 (802.07 to 1684.99)
65-69 years	2068.13 (1151.08 to 3445.30)	852.22 (581.80 to 1188.86)
70-74 years	1872.10 (979.79 to 3086.98)	518.21 (374.92 to 742.73)
75-79 years	1374.65 (744.99 to 2351.09)	271.69 (188.54 to 381.30)
80-84 years	1010.99 (567.86 to 1824.42)	127.72 (90.07 to 178.46)
85-89 years	496.03 (265.13 to 877.12)	52.07 (35.54 to 76.03)
90-94 years	275.63 (129.80 to 475.62)	18.31 (11.81 to 26.65)
95+ years	93.41 (48.33 to 162.30)	5.93 (3.71 to 9.33)
Female
2-4 years	657.48 (269.01 to 1367.22)	1.60 (0.69 to 2.86)
5-20 years	263.00 (109.96 to 567.46)	34.07 (18.77 to 50.69)
15-21 years	408.56 (176.01 to 779.30)	143.38 (86.07 to 220.06)
15-19 years	447.13 (211.31 to 990.61)	343.19 (227.99 to 492.55)
20-24 years	805.70 (366.29 to 1794.78)	645.15 (445.21 to 902.67)
25-29 years	837.48 (407.91 to 1644.47)	1028.91 (736.82 to 1360.82)
30-34 years	1013.67 (536.59 to 1908.82)	1413.98 (1062.23 to 1848.01)
35-39 years	874.93 (503.42 to 1440.54)	1683.34 (1297.91 to 2347.73)
40-44 years	950.81 (572.89 to 1625.46)	1849.15 (1349.15 to 2546.73)
45-49 years	1056.39 (625.23 to 1765.95)	1857.46 (1317.75 to 2454.21)
50-54 years	1192.84 (710.49 to 1997.49)	1806.20 (1342.05 to 2436.43)
55-59 years	1376.88 (775.10 to 2219.88)	1608.49 (1169.38 to 2202.42)
60-64 years	1541.43 (845.72 to 2673.18)	1332.02 (915.73 to 1847.69)
65-69 years	1567.82 (830.67 to 2674.31)	980.81 (683.92 to 1389.43)
70-74 years	1611.30 (813.48 to 2757.42)	616.24 (444.65 to 878.20)
75-79 years	1506.14 (697.45 to 2584.66)	353.24 (245.74 to 495.78)
80-84 years	1104.97 (464.76 to 1920.33)	187.51 (130.24 to 260.36)
85-89 years	681.03 (270.07 to 1240.88)	88.23 (59.07 to 127.72)
90-94 years	429.14 (173.43 to 783.62)	35.53 (21.99 to 53.34)
95+ years	281.02 (114.50 to 560.01)	13.60 (8.32 to 20.70)
South Asia
Male
2-4 years	1469.35 (596.92 to 3056.41)	8.53 (4.70 to 13.02)
5-20 years	611.84 (272.87 to 1236.33)	215.94 (140.92 to 293.74)
15-21 years	779.46 (429.54 to 1464.70)	1123.97 (776.01 to 1573.94)
15-19 years	2040.57 (1039.17 to 3809.40)	3411.01 (2380.33 to 4577.87)
20-24 years	3126.51 (1910.05 to 5008.64)	7947.10 (5687.61 to 10629.46)
25-29 years	5798.97 (3679.22 to 9248.99)	15084.96 (10888.46 to 20107.34)
30-34 years	8579.80 (5355.50 to 13222.55)	24366.93 (17973.42 to 32597.80)
35-39 years	10438.57 (6832.72 to 15850.30)	34238.83 (25404.22 to 48307.33)
40-44 years	13407.11 (8445.70 to 20783.63)	40256.29 (28897.46 to 55600.90)
45-49 years	12010.63 (7931.63 to 17270.66)	41851.12 (29738.20 to 56489.73)
50-54 years	13496.50 (8584.19 to 19731.38)	39864.45 (28483.91 to 53790.25)
55-59 years	11329.43 (7703.87 to 17097.23)	34761.74 (24422.79 to 46895.88)
60-64 years	10380.52 (6762.08 to 16024.61)	29663.83 (20657.17 to 41865.63)
65-69 years	8922.29 (5559.11 to 13310.32)	22783.59 (15891.85 to 32372.88)
70-74 years	8175.47 (4782.21 to 12627.66)	15566.60 (11323.67 to 21920.61)
75-79 years	5944.35 (3715.34 to 9701.44)	9396.42 (6617.92 to 12665.30)
80-84 years	3517.92 (2083.86 to 5639.37)	4799.91 (3417.65 to 6605.49)
85-89 years	1750.51 (965.83 to 3136.80)	1824.72 (1244.06 to 2537.11)
90-94 years	652.91 (338.16 to 1257.72)	484.50 (337.47 to 673.86)
95+ years	222.42 (115.34 to 416.40)	99.01 (64.46 to 141.48)
Female
2-4 years	1286.79 (560.86 to 2592.18)	7.49 (3.95 to 11.53)
5-20 years	437.40 (198.62 to 868.05)	184.15 (117.31 to 258.28)
15-21 years	756.21 (405.64 to 1276.24)	926.99 (611.73 to 1315.12)
15-19 years	1598.08 (939.35 to 2743.66)	2836.14 (2016.82 to 4051.99)
20-24 years	3116.82 (1893.40 to 5277.11)	6758.65 (4893.05 to 9151.90)
25-29 years	5724.51 (3308.38 to 8942.16)	12989.78 (9430.93 to 17487.09)
30-34 years	7650.69 (4667.17 to 11276.44)	20808.69 (15061.45 to 28222.88)
35-39 years	8627.72 (5623.66 to 12189.10)	29214.21 (21458.63 to 40650.89)
40-44 years	10046.67 (6578.24 to 14481.05)	34550.26 (25138.11 to 47059.70)
45-49 years	9789.32 (6000.04 to 14357.56)	36693.99 (26417.18 to 48759.10)
50-54 years	8959.32 (5786.03 to 12746.45)	37729.86 (27201.06 to 51126.67)
55-59 years	9183.38 (5723.48 to 12700.41)	33794.87 (24066.57 to 47249.54)
60-64 years	8087.49 (5063.01 to 11728.76)	29096.98 (19856.36 to 41014.69)
65-69 years	7029.27 (4752.99 to 10148.68)	22386.84 (15485.03 to 31733.95)
70-74 years	7067.23 (4508.52 to 11567.26)	15473.37 (11298.07 to 21758.98)
75-79 years	5404.37 (3384.81 to 8662.96)	9575.68 (6536.10 to 13088.10)
80-84 years	4428.48 (2543.06 to 7712.20)	5335.93 (3750.63 to 7663.58)
85-89 years	2089.65 (1153.71 to 3783.52)	2329.80 (1615.44 to 3320.23)
90-94 years	901.46 (461.90 to 1764.18)	665.84 (455.15 to 984.12)
95+ years	302.97 (159.34 to 574.94)	147.58 (96.57 to 212.55)

Abbreviation: DALY, disability-adjusted life year; GBD, Global burden of disease; UC, ulcerative colitis; UI, uncertainty interval.

Table S14.

Age- and sex-specific DALY and prevalence counts for CD across the five GBD regions of Asia in 2023 (95% UI).

Location	DALY, number	Prevalence, number
Central Asia	2023	2023
Male
2-4 years	60.59 (32.11 to 102.62)	0.56 (0.30 to 0.87)
5-20 years	24.25 (14.46 to 39.81)	13.00 (8.43 to 18.68)
15-21 years	20.27 (13.97 to 28.43)	57.36 (38.47 to 80.86)
15-19 years	32.22 (21.82 to 46.36)	138.41 (98.62 to 190.92)
20-24 years	87.95 (62.96 to 120.74)	273.54 (195.20 to 380.97)
25-29 years	125.32 (85.90 to 177.86)	513.00 (370.78 to 697.93)
30-34 years	244.71 (179.87 to 332.12)	799.03 (584.96 to 1080.07)
35-39 years	297.96 (208.21 to 416.36)	892.07 (646.11 to 1233.65)
40-44 years	262.26 (173.14 to 366.70)	792.66 (572.80 to 1050.84)
45-49 years	298.90 (219.07 to 407.36)	704.32 (506.79 to 950.36)
50-54 years	213.71 (146.49 to 293.79)	619.73 (444.49 to 864.79)
55-59 years	228.74 (165.14 to 307.88)	538.41 (388.99 to 737.10)
60-64 years	245.30 (179.00 to 327.91)	456.28 (319.16 to 616.68)
65-69 years	138.28 (99.84 to 182.93)	273.90 (192.21 to 376.52)
70-74 years	112.96 (81.04 to 152.81)	147.85 (102.47 to 197.86)
75-79 years	46.37 (32.26 to 64.73)	56.42 (38.25 to 78.29)
80-84 years	30.19 (20.22 to 42.39)	37.77 (25.97 to 55.38)
85-89 years	15.86 (11.28 to 21.32)	15.79 (10.90 to 22.36)
90-94 years	6.27 (4.18 to 8.88)	4.39 (2.98 to 6.34)
95+ years	1.14 (0.72 to 1.68)	0.98 (0.64 to 1.48)
Female
2-4 years	45.38 (26.05 to 70.81)	0.53 (0.28 to 0.83)
5-20 years	21.83 (13.08 to 34.52)	12.54 (8.04 to 18.24)
15-21 years	46.24 (30.38 to 66.19)	56.89 (38.11 to 81.36)
15-19 years	50.49 (35.41 to 67.76)	143.11 (100.20 to 192.81)
20-24 years	88.83 (62.77 to 125.61)	298.07 (209.36 to 408.13)
25-29 years	160.97 (110.56 to 222.35)	593.61 (413.65 to 798.60)
30-34 years	231.62 (149.13 to 320.02)	964.19 (671.95 to 1305.88)
35-39 years	253.29 (165.26 to 344.66)	1097.99 (777.59 to 1541.57)
40-44 years	231.31 (150.79 to 323.77)	987.38 (694.97 to 1344.77)
45-49 years	232.57 (161.94 to 322.68)	904.62 (657.97 to 1237.27)
50-54 years	216.69 (145.66 to 315.95)	838.25 (581.12 to 1225.56)
55-59 years	206.34 (133.87 to 301.97)	774.57 (546.22 to 1100.94)
60-64 years	191.11 (128.48 to 258.61)	701.40 (479.73 to 971.67)
65-69 years	153.04 (110.35 to 201.63)	447.63 (306.53 to 617.46)
70-74 years	86.73 (58.13 to 124.13)	277.06 (176.99 to 385.93)
75-79 years	40.18 (28.40 to 54.96)	115.44 (78.12 to 163.17)
80-84 years	29.18 (20.78 to 37.93)	83.02 (58.00 to 118.07)
85-89 years	14.62 (10.25 to 19.74)	38.61 (27.02 to 52.34)
90-94 years	5.11 (3.58 to 7.18)	11.14 (7.50 to 16.00)
95+ years	1.09 (0.72 to 1.56)	3.02 (1.95 to 4.61)
East Asia
Male
2-4 years	122.85 (44.43 to 250.16)	2.55 (1.21 to 4.12)
5-20 years	66.67 (31.99 to 137.94)	75.62 (46.51 to 111.09)
15-21 years	163.98 (84.83 to 282.00)	285.62 (181.81 to 401.49)
15-19 years	214.03 (131.28 to 319.89)	670.85 (465.92 to 951.95)
20-24 years	407.85 (249.21 to 645.21)	1159.31 (801.20 to 1622.49)
25-29 years	620.11 (408.10 to 917.28)	1925.56 (1335.81 to 2783.60)
30-34 years	797.28 (508.61 to 1175.20)	2946.29 (1992.09 to 4144.13)
35-39 years	803.66 (514.70 to 1130.78)	3167.19 (2215.13 to 4439.90)
40-44 years	645.05 (416.80 to 952.64)	2461.71 (1713.86 to 3445.73)
45-49 years	753.50 (492.75 to 1081.63)	2717.82 (1901.03 to 3886.24)
50-54 years	967.19 (596.58 to 1382.43)	3252.87 (2260.85 to 4584.04)
55-59 years	828.83 (534.75 to 1172.29)	3126.57 (2172.83 to 4295.62)
60-64 years	663.61 (437.22 to 1000.24)	2118.92 (1449.51 to 2833.06)
65-69 years	724.62 (444.72 to 1111.57)	1879.96 (1333.37 to 2517.06)
70-74 years	569.44 (340.32 to 868.57)	1427.41 (989.53 to 2027.41)
75-79 years	371.73 (213.02 to 587.07)	830.68 (585.39 to 1179.65)
80-84 years	222.17 (124.37 to 341.60)	477.81 (334.20 to 679.34)
85-89 years	131.52 (73.53 to 208.67)	230.19 (160.10 to 326.12)
90-94 years	52.10 (27.36 to 90.02)	75.73 (52.05 to 110.75)
95+ years	20.46 (9.97 to 39.24)	17.54 (11.91 to 26.20)
Female
2-4 years	52.15 (18.09 to 111.45)	2.40 (1.19 to 3.88)
5-20 years	19.78 (12.14 to 32.19)	73.59 (47.93 to 107.24)
15-21 years	80.59 (51.81 to 122.79)	285.32 (187.72 to 398.77)
15-19 years	144.90 (97.05 to 211.98)	678.82 (473.13 to 940.01)
20-24 years	253.91 (161.96 to 374.98)	1201.43 (847.31 to 1656.75)
25-29 years	455.18 (290.95 to 646.62)	2065.58 (1464.31 to 2937.92)
30-34 years	686.50 (422.09 to 997.51)	3328.11 (2287.17 to 4673.89)
35-39 years	748.17 (470.85 to 1073.60)	3747.55 (2634.42 to 5197.23)
40-44 years	610.77 (397.64 to 901.70)	2917.84 (2048.69 to 3988.13)
45-49 years	646.59 (405.88 to 960.73)	3271.66 (2321.23 to 4694.43)
50-54 years	819.01 (531.35 to 1185.39)	3907.73 (2823.08 to 5496.78)
55-59 years	837.90 (547.28 to 1189.71)	3872.35 (2736.00 to 5406.90)
60-64 years	561.86 (363.24 to 835.45)	2620.13 (1762.33 to 3560.10)
65-69 years	548.10 (373.08 to 792.79)	2329.64 (1614.62 to 3084.21)
70-74 years	476.73 (317.32 to 686.82)	1826.45 (1258.47 to 2545.41)
75-79 years	295.09 (183.96 to 445.41)	1091.41 (767.95 to 1537.30)
80-84 years	209.58 (132.11 to 314.80)	664.33 (466.92 to 933.88)
85-89 years	164.00 (97.51 to 269.25)	367.83 (261.39 to 511.00)
90-94 years	82.02 (41.88 to 148.92)	135.28 (93.41 to 195.75)
95+ years	48.39 (21.02 to 87.18)	36.30 (24.28 to 57.12)
High-income Asia Pacific
Male
2-4 years	5.99 (4.30 to 7.91)	0.32 (0.18 to 0.49)
5-20 years	4.43 (3.24 to 6.14)	10.19 (7.07 to 14.10)
15-21 years	15.53 (11.36 to 21.38)	60.25 (43.63 to 81.38)
15-19 years	45.14 (32.27 to 62.47)	182.40 (134.23 to 244.99)
20-24 years	130.98 (79.68 to 218.49)	465.22 (337.27 to 637.28)
25-29 years	244.53 (152.98 to 397.32)	917.63 (649.35 to 1275.66)
30-34 years	292.76 (176.85 to 451.49)	1219.43 (869.50 to 1704.40)
35-39 years	308.99 (198.87 to 463.54)	1207.45 (860.22 to 1664.66)
40-44 years	336.47 (219.64 to 486.74)	1380.18 (990.52 to 1890.58)
45-49 years	411.63 (283.94 to 568.22)	1421.94 (1048.42 to 1944.51)
50-54 years	472.44 (322.59 to 635.97)	1563.05 (1167.81 to 2151.69)
55-59 years	399.77 (275.54 to 583.85)	1327.59 (966.61 to 1806.66)
60-64 years	356.54 (239.90 to 527.75)	1206.15 (838.29 to 1621.10)
65-69 years	331.90 (234.58 to 450.42)	955.71 (695.17 to 1259.92)
70-74 years	306.80 (223.43 to 417.31)	774.02 (539.32 to 1023.43)
75-79 years	231.10 (165.57 to 310.49)	545.63 (388.53 to 747.58)
80-84 years	180.35 (126.39 to 236.76)	341.86 (238.89 to 487.15)
85-89 years	130.10 (88.98 to 173.44)	170.55 (121.80 to 239.97)
90-94 years	58.13 (39.28 to 80.39)	64.74 (43.21 to 94.18)
95+ years	24.41 (16.83 to 34.02)	14.38 (9.43 to 21.30)
Female
2-4 years	1.74 (1.14 to 2.54)	0.28 (0.16 to 0.44)
5-20 years	5.48 (4.09 to 7.42)	8.29 (5.55 to 11.54)
15-21 years	9.92 (6.66 to 14.57)	45.76 (31.95 to 61.93)
15-19 years	28.17 (19.20 to 40.74)	132.22 (95.21 to 180.43)
20-24 years	69.51 (46.19 to 101.63)	326.21 (235.27 to 436.11)
25-29 years	129.88 (71.70 to 214.31)	638.38 (460.41 to 871.46)
30-34 years	169.68 (97.76 to 281.05)	858.05 (611.81 to 1186.91)
35-39 years	184.64 (115.37 to 304.68)	930.47 (674.02 to 1298.70)
40-44 years	220.75 (131.53 to 344.71)	1128.05 (792.78 to 1520.74)
45-49 years	253.45 (160.67 to 391.47)	1257.53 (935.08 to 1706.15)
50-54 years	284.05 (170.08 to 433.02)	1434.09 (1077.16 to 1942.24)
55-59 years	231.35 (136.80 to 349.95)	1263.11 (945.34 to 1657.20)
60-64 years	232.27 (139.85 to 387.22)	1168.07 (846.18 to 1500.58)
65-69 years	205.51 (127.38 to 331.08)	971.01 (697.66 to 1291.59)
70-74 years	216.75 (143.45 to 308.92)	879.48 (608.14 to 1153.56)
75-79 years	171.90 (117.56 to 246.64)	679.95 (485.48 to 921.91)
80-84 years	149.46 (99.95 to 212.31)	501.78 (354.24 to 710.78)
85-89 years	139.82 (97.46 to 206.26)	320.28 (231.22 to 442.88)
90-94 years	84.58 (54.70 to 122.35)	181.23 (120.23 to 259.44)
95+ years	57.89 (35.43 to 86.69)	67.37 (44.96 to 98.52)
Southeast Asia
Male
2-4 years	11.64 (1.85 to 48.53)	1.51 (0.67 to 2.52)
5-20 years	33.77 (10.20 to 101.07)	31.02 (18.34 to 47.33)
15-21 years	104.18 (42.56 to 267.82)	123.53 (75.09 to 176.45)
15-19 years	238.22 (99.43 to 601.96)	282.59 (190.43 to 402.76)
20-24 years	359.96 (156.35 to 832.75)	494.17 (342.42 to 705.83)
25-29 years	415.71 (202.12 to 928.66)	705.47 (482.46 to 1023.73)
30-34 years	310.75 (173.61 to 570.27)	790.70 (539.64 to 1120.48)
35-39 years	559.53 (265.04 to 1098.71)	727.01 (511.16 to 1015.84)
40-44 years	439.10 (221.78 to 823.78)	646.91 (456.37 to 894.98)
45-49 years	409.85 (201.22 to 825.32)	572.03 (396.53 to 804.18)
50-54 years	363.36 (183.01 to 697.99)	507.05 (357.66 to 705.39)
55-59 years	272.02 (132.92 to 555.78)	422.16 (298.37 to 584.51)
60-64 years	413.87 (184.00 to 818.08)	333.36 (225.81 to 450.56)
65-69 years	224.34 (102.09 to 475.15)	232.17 (154.50 to 317.50)
70-74 years	168.11 (77.79 to 348.12)	143.83 (97.34 to 201.30)
75-79 years	148.15 (64.00 to 315.59)	79.27 (54.27 to 114.39)
80-84 years	97.31 (39.88 to 236.51)	39.16 (26.59 to 56.73)
85-89 years	47.76 (19.20 to 106.03)	16.77 (11.41 to 23.51)
90-94 years	19.52 (7.60 to 47.80)	6.09 (3.95 to 8.86)
95+ years	9.91 (3.65 to 21.87)	2.02 (1.29 to 3.05)
Female
2-4 years	3.67 (0.98 to 9.92)	1.51 (0.67 to 2.57)
5-20 years	41.66 (14.97 to 97.40)	31.78 (19.37 to 47.92)
15-21 years	98.44 (40.42 to 230.46)	131.71 (81.91 to 184.32)
15-19 years	174.35 (80.28 to 424.40)	308.64 (209.60 to 450.76)
20-24 years	360.34 (167.69 to 852.46)	556.36 (382.51 to 793.39)
25-29 years	322.78 (175.98 to 656.36)	810.82 (544.85 to 1159.58)
30-34 years	269.44 (158.80 to 463.16)	931.33 (630.49 to 1334.00)
35-39 years	316.92 (171.20 to 578.11)	884.27 (616.03 to 1237.84)
40-44 years	252.90 (151.34 to 444.60)	808.26 (579.54 to 1110.87)
45-49 years	288.98 (162.56 to 525.35)	728.28 (519.74 to 1002.75)
50-54 years	189.55 (114.00 to 321.82)	670.70 (475.90 to 946.69)
55-59 years	255.11 (130.55 to 463.50)	579.83 (406.56 to 807.74)
60-64 years	191.44 (109.41 to 330.58)	474.27 (326.02 to 631.37)
65-69 years	171.25 (91.90 to 325.30)	343.91 (233.33 to 461.87)
70-74 years	204.48 (96.45 to 394.72)	219.43 (149.35 to 295.25)
75-79 years	126.57 (57.77 to 254.51)	130.61 (90.21 to 185.48)
80-84 years	81.57 (35.10 to 160.12)	72.20 (49.85 to 99.80)
85-89 years	83.70 (32.39 to 175.96)	35.42 (23.53 to 50.70)
90-94 years	24.38 (8.94 to 49.36)	14.78 (9.44 to 22.54)
95+ years	18.49 (6.11 to 42.83)	5.67 (3.55 to 8.83)
South Asia
Male
2-4 years	96.96 (19.90 to 259.12)	6.46 (3.20 to 10.08)
5-20 years	116.30 (47.89 to 252.53)	155.47 (100.59 to 226.61)
15-21 years	255.34 (139.85 to 421.12)	752.23 (507.92 to 1033.99)
15-19 years	759.60 (408.38 to 1458.12)	2062.34 (1464.51 to 2856.62)
20-24 years	1410.58 (845.46 to 2348.17)	4339.23 (3053.91 to 6017.72)
25-29 years	2339.32 (1378.31 to 4132.85)	7412.57 (5321.04 to 10267.03)
30-34 years	3202.81 (1853.04 to 5197.27)	10528.93 (7444.88 to 14666.63)
35-39 years	3404.45 (2045.19 to 5398.87)	12765.78 (9109.19 to 17507.41)
40-44 years	3892.70 (2222.15 to 6358.61)	13377.81 (9609.13 to 17534.77)
45-49 years	3339.30 (1940.43 to 5281.01)	13082.99 (9568.16 to 18005.97)
50-54 years	3234.45 (1942.66 to 5007.74)	12128.79 (8968.72 to 16569.51)
55-59 years	2765.72 (1618.16 to 4210.33)	10430.42 (7679.71 to 14270.44)
60-64 years	2334.41 (1336.63 to 3834.68)	8823.68 (6064.94 to 11868.14)
65-69 years	1827.73 (1066.52 to 3042.25)	6621.22 (4713.64 to 8869.29)
70-74 years	1486.20 (868.75 to 2426.98)	4489.66 (3065.39 to 5937.71)
75-79 years	1071.99 (596.85 to 1951.61)	2689.92 (1822.07 to 3678.08)
80-84 years	436.14 (251.99 to 766.03)	1349.89 (948.84 to 1892.46)
85-89 years	189.91 (99.37 to 376.77)	506.05 (356.28 to 692.22)
90-94 years	55.90 (28.11 to 112.95)	132.80 (92.51 to 192.15)
95+ years	15.67 (7.08 to 32.11)	26.81 (18.02 to 39.95)
Female
2-4 years	94.27 (21.91 to 267.87)	6.30 (3.09 to 10.39)
5-20 years	149.42 (63.28 to 353.68)	151.56 (97.67 to 216.70)
15-21 years	308.20 (167.97 to 511.11)	735.10 (502.74 to 1028.96)
15-19 years	1011.72 (554.78 to 1611.88)	2126.31 (1482.73 to 2992.49)
20-24 years	1706.04 (959.81 to 2765.66)	4736.81 (3321.21 to 6588.58)
25-29 years	3262.34 (1848.92 to 5161.73)	8370.13 (6071.19 to 11541.69)
30-34 years	3392.45 (2041.94 to 5339.66)	11896.38 (8446.04 to 16444.81)
35-39 years	3987.28 (2562.84 to 6312.84)	14517.10 (10434.23 to 20753.45)
40-44 years	3933.79 (2585.17 to 6217.18)	15394.70 (11236.82 to 20951.59)
45-49 years	3947.69 (2386.11 to 6157.09)	15411.32 (11490.97 to 20927.19)
50-54 years	3597.46 (2323.44 to 5404.90)	15324.72 (10965.86 to 21872.25)
55-59 years	3259.43 (2041.69 to 5053.38)	13428.54 (9499.26 to 18902.49)
60-64 years	2801.04 (1748.41 to 4238.51)	11388.67 (7660.99 to 15633.87)
65-69 years	2210.53 (1369.02 to 3610.14)	8532.36 (5912.75 to 11517.39)
70-74 years	1800.15 (1115.16 to 3131.24)	5862.03 (3916.76 to 7933.35)
75-79 years	1168.31 (712.79 to 2026.56)	3616.87 (2450.97 to 4957.60)
80-84 years	718.35 (383.73 to 1185.09)	1991.31 (1403.39 to 2767.09)
85-89 years	339.73 (171.60 to 636.22)	859.08 (603.91 to 1257.36)
90-94 years	117.23 (58.65 to 234.89)	244.23 (163.50 to 385.63)
95+ years	33.11 (15.71 to 66.38)	53.78 (34.72 to 88.00)

Abbreviation: CD, Crohn’s disease; DALY, disability-adjusted life year; GBD, Global burden of disease; UI, uncertainty interval.

Decomposition of changes in disability-adjusted life-years and prevalence

Figure 5a shows the sex-specific decomposition of changes in DALYs due to IBD across the five GBD regions and 34 Asian countries from 1990 to 2023. Considerable heterogeneity was observed between countries and sexes [Tables S15 and S16]. Among males, DALYs decreased in Armenia, Georgia, and Kyrgyzstan, whereas the Maldives showed the largest relative increase, driven primarily by population growth. Large increases were also observed in India and Pakistan, where population aging and population growth contributed substantially despite negative epidemiological effects. Among females, DALYs decreased in the same three countries, whereas Mauritius showed the largest relative increase, followed by India and Pakistan. Unlike most countries, the increase in Mauritius was driven mainly by epidemiological change, with additional contributions from population aging. Overall, population aging and population growth contributed positively to DALY increases, whereas epidemiological change generally contributed negatively. Figure 5b shows broadly similar patterns for prevalence in both sexes [Tables S17 and S18]. Prevalence generally increased across countries, with the Maldives showing the largest relative increase in both males and females. Population aging and population growth were the primary contributors to prevalence increases, whereas epidemiological effects were smaller and more heterogeneous across countries. Georgia was the only country that showed a decrease in prevalence in both sexes.

Figure 5.

Decomposition analysis of the percentage change in the number of (a) DALYs and (b) prevalence due to IBD between 1990 and 2023 in Asia, stratified by sex. Abbreviation: DALYs = Disability-adjusted life years; IBD = Inflammatory bowel disease

Table S15.

Decomposition of effects on DALY due to IBD among males across the five GBD regions and 34 Asian countries, 1990-2023 (95% CIs).

Location	Overall change	Aging effect	Population growth effect	Epidemiological effect
Central Asia	1613.93 (835.81 to 2419.28)	1838.89 (1578.60 to 2094.70)	1836.53 (1702.89 to 1977.29)	-2061.50 (-2851.06 to -1237.51)
Armenia	-187.42 (-233.42 to -141.13)	133.54 (118.94 to 150.08)	-79.54 (-88.93 to -69.56)	-241.42 (-290.92 to -196.08)
Azerbaijan	335.40 (198.18 to 459.90)	184.14 (-2631230000000.00 to 224.44)	178.98 (155.98 to 227736000000.00)	-27.71 (-162.85 to 2403490000000.00)
Georgia	-557.57 (-651.36 to -457.02)	159.42 (136.00 to 184.14)	-301.47 (-326.57 to -276.34)	-415.52 (-507.39 to -319.70)
Kazakhstan	222.07 (-18.57 to 453.44)	558.53 (493.81 to 633.38)	100.48 (49.04 to 159.23)	-436.94 (-673.81 to -195.75)
Kyrgyzstan	-374.72 (-469.70 to -278.24)	125.52 (100.04 to 156.45)	231.62 (203.07 to 262.39)	-731.87 (-845.21 to -619.73)
Mongolia	47.65 (-83.46 to 163.62)	63.42 (19.24 to 106.34)	95.19 (73.95 to 119.70)	-110.96 (-226.05 to -9.74)
Tajikistan	603.36 (414.38 to 778.52)	131.65 (68.99 to 204.48)	356.34 (307.14 to 407.90)	115.37 (-82.76 to 296.69)
Turkmenistan	236.77 (155.28 to 321.83)	79.48 (30.81 to 121.46)	113.09 (96.18 to 131.53)	44.20 (-48.82 to 140.92)
Uzbekistan	1288.38 (967.27 to 1609.15)	356.62 (214.58 to 497.70)	793.07 (708.31 to 882.47)	138.69 (-187.43 to 469.62)
East Asia	5890.25 (-11347.89 to 23291.03)	29836.31 (21170.62 to 38781.18)	7122.84 (5467.65 to 8978.91)	-31068.90 (-48807.37 to -13373.40)
China	5069.63 (-11745.29 to 22960.90)	28265.27 (20184.71 to 37058.45)	5701.50 (4101.21 to 7425.61)	-28897.13 (-45048.67 to -11637.62)
Democratic People’s Republic of Korea	157.32 (-180.60 to 483.66)	314.18 (157.47 to 468.36)	136.51 (102.44 to 174.49)	-293.36 (-621.26 to 22.57)
Taiwan	663.29 (455.57 to 853.84)	1256.17 (1178.23 to 1333.24)	64.74 (55.37 to 74.38)	-657.62 (-829.50 to -500.67)
High-income Asia Pacific	4720.15 (3372.21 to 6116.21)	6932.72 (6439.56 to 7415.88)	31.04 (-169.93 to 228.77)	-2243.61 (-3741.19 to -788.98)
Brunei Darussalam	15.18 (10.33 to 19.85)	11.31 (9.71 to 12.95)	8.75 (7.70 to 9.80)	-4.88 (-9.57 to -0.49)
Japan	3780.46 (3033.42 to 4593.36)	4492.66 (4162.92 to 4841.17)	-555.96 (-715.71 to -408.60)	-156.23 (-936.93 to 631.62)
Republic of Korea	874.74 (-59.61 to 1877.31)	3988.11 (3280.98 to 4682.09)	638.62 (514.19 to 784.95)	-3751.98 (-4962.03 to -2470.85)
Singapore	49.76 (41.09 to 58.62)	45.48 (42.60 to 48.78)	57.12 (53.99 to 60.45)	-52.84 (-61.90 to -43.67)
South Asia	66519.15 (44999.20 to 89579.35)	50129.41 (44285.32 to 56671.02)	47208.59 (42361.44 to 52341.35)	-30818.85 (-53522.29 to -6017.37)
Bangladesh	6530.57 (2746.66 to 10130.08)	9045.06 (7576.30 to 10403.34)	3223.58 (2671.03 to 3789.10)	-5738.06 (-9922.40 to -1929.72)
Bhutan	28.59 (9.81 to 47.87)	43.70 (35.74 to 53.98)	28.34 (23.50 to 34.09)	-43.45 (-66.80 to -21.05)
India	47368.04 (32537.58 to 62760.88)	37316.72 (32758.47 to 41993.28)	34156.82 (30565.82 to 38208.64)	-24105.50 (-41928.17 to -6286.96)
Nepal	1148.38 (501.69 to 1733.44)	1071.98 (892.41 to 1242.16)	719.83 (601.95 to 846.19)	-643.43 (-1379.28 to 8.19)
Pakistan	11443.58 (6789.36 to 16199.76)	3917.82 (2882.21 to 5081.23)	8718.66 (7396.62 to 10105.61)	-1192.90 (-6155.11 to 3400.35)
Southeast Asia	12531.70 (6424.78 to 18056.13)	8102.35 (6210.81 to 10025.89)	7354.96 (6407.59 to 8301.38)	-2925.61 (-9325.63 to 3099.82)
Cambodia	171.88 (6.88 to 343.40)	131.65 (68.56 to 192.46)	170.56 (136.34 to 212.25)	-130.33 (-296.90 to 28.04)
Indonesia	4876.96 (1238.80 to 8438.97)	3438.64 (2331.75 to 4606.95)	3397.17 (2860.99 to 3977.01)	-1958.85 (-5559.96 to 1614.82)
Lao People’s Democratic Republic	78.50 (33.02 to 126.26)	33.72 (17.30 to 49.87)	75.74 (63.49 to 89.33)	-30.97 (-80.94 to 20.20)
Malaysia	975.08 (531.04 to 1420.98)	701.75 (566.70 to 853.66)	759.64 (652.65 to 872.18)	-486.30 (-946.72 to -41.73)
Maldives	16.19 (12.47 to 20.12)	5.97 (4.17 to 7.79)	11.62 (10.10 to 13.05)	-1.40 (-5.21 to 2.22)
Mauritius	56.16 (49.23 to 62.66)	32.41 (30.23 to 34.93)	3.08 (1.86 to 4.35)	20.68 (14.33 to 26.40)
Myanmar	1481.75 (0.98 to 2975.99)	1035.19 (675.55 to 1422.98)	547.26 (391.01 to 745.40)	-100.71 (-1598.26 to 1464.78)
Philippines	1707.35 (1015.89 to 2389.23)	599.68 (385.71 to 815.19)	1346.83 (1179.05 to 1525.13)	-239.16 (-972.56 to 468.00)
Seychelles	1.36 (0.52 to 2.25)	1.60 (1.33 to 1.92)	1.15 (0.98 to 1.32)	-1.40 (-2.29 to -0.45)
Sri Lanka	94.60 (52.21 to 137.89)	102.61 (86.92 to 118.53)	27.93 (16.91 to 39.39)	-35.94 (-79.74 to 8.25)
Thailand	1171.34 (890.66 to 1442.37)	704.95 (600.13 to 812.79)	154.83 (124.31 to 187.79)	311.56 (45.04 to 553.99)
Timor-Leste	18.70 (2.88 to 33.02)	7.73 (2.78 to 12.74)	18.20 (14.69 to 21.79)	-7.23 (-23.32 to 7.15)
Viet Nam	1870.34 (1099.21 to 2636.42)	1145.02 (860.05 to 1397.08)	794.57 (673.62 to 919.36)	-69.25 (-807.66 to 638.77)

Abbreviation: CI, Confidence intervals; DALY, disability-adjusted life year; GBD, Global burden of disease; IBD, Inflammatory bowel disease.

Table S16.

Decomposition of effects on DALY due to IBD among females across the five GBD regions and 34 Asian countries, 1990-2023 (95% CIs).

Location	Overall change	Aging effect	Population growth effect	Epidemiological effect
Central Asia	1198.89 (412.01 to 2010.87)	1333.75 (1088.94 to 1576.86)	1627.45 (1509.96 to 1764.56)	-1762.31 (-2602.43 to -875.68)
Armenia	-32.69 (-81.20 to 10.61)	117.10 (101.38 to 132.74)	-66.65 (-75.79 to -57.04)	-83.14 (-127.23 to -39.07)
Azerbaijan	269.70 (154.08 to 381.19)	179.18 (145.33 to 211.50)	125.62 (108.24 to 143.16)	-35.10 (-142.56 to 69.40)
Georgia	-575.23 (-673.54 to -469.39)	154.59 (131.07 to 182.17)	-286.06 (-313.95 to -260.66)	-443.76 (-537.97 to -342.27)
Kazakhstan	294.33 (49.54 to 526.50)	348.07 (291.18 to 406.35)	108.96 (64.07 to 155.54)	-162.69 (-416.16 to 67.00)
Kyrgyzstan	-106.46 (-182.45 to -28.96)	78.47 (57.75 to 99.11)	162.83 (145.14 to 183.58)	-347.76 (-425.99 to -269.21)
Mongolia	67.81 (-21.42 to 149.37)	64.09 (31.88 to 98.97)	90.78 (74.73 to 108.87)	-87.06 (-169.55 to -16.04)
Tajikistan	376.33 (252.41 to 493.84)	76.41 (29.19 to 119.80)	245.14 (212.61 to 281.24)	54.78 (-70.71 to 172.38)
Turkmenistan	219.84 (145.52 to 299.09)	42.05 (-8.57 to 88.31)	83.33 (68.15 to 99.05)	94.46 (-3.44 to 196.10)
Uzbekistan	685.25 (282.02 to 1076.24)	418.75 (252.85 to 579.88)	941.54 (840.24 to 1041.04)	-675.04 (-1056.05 to -230.97)
East Asia	-20024.89 (-42292.34 to 3849.68)	32014.84 (19899.59 to 43366.45)	9238.70 (7233.30 to 11459.26)	-61278.43 (-82262.85 to -37006.20)
China	-20206.02 (-42732.14 to 4821.67)	30098.00 (18166.82 to 41393.90)	7774.72 (5873.06 to 9860.84)	-58078.74 (-80067.53 to -33517.23)
Democratic People’s Republic of Korea	88.78 (-280.58 to 467.83)	378.02 (202.00 to 559.83)	54.54 (24.34 to 86.35)	-343.77 (-710.93 to 38.05)
Taiwan	92.34 (-82.50 to 277.88)	1701.14 (1572.52 to 1826.30)	240.29 (226.10 to 254.64)	-1849.09 (-2058.72 to -1653.03)
High-income Asia Pacific	705.10 (-827.83 to 2219.65)	8053.78 (7066.22 to 9048.60)	261.02 (73.98 to 449.93)	-7609.70 (-9527.99 to -5765.74)
Brunei Darussalam	19.24 (12.13 to 26.79)	18.62 (16.09 to 21.49)	14.07 (12.33 to 16.10)	-13.45 (-21.47 to -5.78)
Japan	995.10 (275.95 to 1789.82)	4711.14 (4254.99 to 5170.00)	-321.63 (-446.79 to -197.00)	-3394.41 (-4206.16 to -2500.18)
Republic of Korea	-332.96 (-1397.50 to 701.89)	5118.10 (3791.98 to 6525.90)	708.20 (556.63 to 879.76)	-6159.26 (-8256.18 to -4072.67)
Singapore	23.71 (14.84 to 32.51)	38.85 (36.01 to 42.19)	58.53 (55.05 to 62.20)	-73.67 (-83.64 to -64.28)
South Asia	72320.17 (55608.60 to 89766.31)	47157.95 (42313.52 to 52747.40)	43076.31 (38930.22 to 47430.06)	-17914.09 (-36236.80 to 294.79)
Bangladesh	10360.49 (6196.46 to 13937.05)	9054.67 (7713.36 to 10384.69)	4234.97 (3619.72 to 4940.27)	-2929.14 (-7283.26 to 938.07)
Bhutan	24.39 (11.71 to 37.30)	28.31 (23.04 to 34.72)	20.42 (16.60 to 24.57)	-24.33 (-40.16 to -8.33)
India	51720.77 (38445.26 to 64645.86)	34966.73 (31148.08 to 38784.04)	30829.96 (27742.84 to 34155.40)	-14075.91 (-27716.43 to -257.57)
Nepal	789.34 (349.07 to 1246.09)	975.44 (829.24 to 1140.81)	781.80 (678.48 to 896.30)	-967.90 (-1523.15 to -403.94)
Pakistan	9425.16 (6901.20 to 11916.81)	3530.84 (2808.34 to 4323.45)	6748.89 (5955.67 to 7654.86)	-854.57 (-3436.69 to 1705.21)
Southeast Asia	8024.87 (3874.62 to 12204.81)	7925.43 (6365.82 to 9476.89)	5198.42 (4510.50 to 5852.22)	-5098.98 (-9937.30 to -376.59)
Cambodia	187.06 (60.66 to 305.91)	136.69 (94.60 to 181.21)	117.52 (94.87 to 145.58)	-67.15 (-198.77 to 52.43)
Indonesia	4159.72 (1238.27 to 6998.52)	4719.81 (3646.62 to 5854.18)	2791.26 (2336.55 to 3356.39)	-3351.35 (-6600.57 to 86.70)
Lao People’s Democratic Republic	50.17 (32.41 to 68.15)	22.39 (17.00 to 28.14)	32.37 (27.98 to 37.36)	-4.59 (-23.42 to 15.20)
Malaysia	680.21 (345.87 to 1007.19)	600.87 (466.31 to 719.89)	567.47 (474.83 to 653.78)	-488.14 (-867.72 to -111.78)
Maldives	4.33 (3.27 to 5.39)	3.34 (2.71 to 4.01)	2.53 (2.24 to 2.84)	-1.55 (-2.80 to -0.33)
Mauritius	71.06 (63.44 to 78.53)	27.30 (24.96 to 29.65)	4.20 (3.11 to 5.26)	39.56 (33.97 to 44.98)
Myanmar	145.35 (-233.91 to 548.43)	321.28 (195.78 to 452.48)	268.97 (209.49 to 341.17)	-444.90 (-875.04 to -20.87)
Philippines	949.86 (594.71 to 1289.23)	482.54 (361.40 to 595.11)	749.86 (668.29 to 836.95)	-282.54 (-678.78 to 93.66)
Seychelles	0.45 (-0.12 to 1.02)	0.86 (0.70 to 1.04)	0.55 (0.45 to 0.65)	-0.96 (-1.57 to -0.32)
Sri Lanka	159.01 (112.69 to 206.62)	138.25 (120.31 to 159.22)	53.00 (41.66 to 63.76)	-32.24 (-78.31 to 14.22)
Thailand	811.67 (636.01 to 1004.79)	569.78 (487.36 to 664.35)	148.57 (128.89 to 173.05)	93.31 (-83.40 to 273.80)
Timor-Leste	18.36 (8.27 to 29.02)	9.97 (6.07 to 13.81)	14.02 (11.72 to 16.66)	-5.63 (-16.32 to 5.12)
Viet Nam	780.55 (317.34 to 1244.91)	625.00 (438.82 to 797.91)	449.24 (376.50 to 525.88)	-293.68 (-747.21 to 151.59)

Abbreviation: CI, Confidence intervals; DALY, disability-adjusted life year; GBD, Global burden of disease; IBD, Inflammatory bowel disease.

Table S17.

Decomposition of effects on Prevalence due to IBD among males across the five GBD regions and 34 Asian countries, 1990-2023 (95% CIs).

Location	Overall change	Aging effect	Population growth effect	Epidemiological effect
Central Asia	10673.92 (8669.90 to 12637.27)	6572.43 (6104.67 to 6986.02)	3730.11 (3451.41 to 4033.08)	371.37 (-1524.11 to 2233.82)
Armenia	192.47 (97.62 to 290.19)	357.02 (323.07 to 393.14)	-197.58 (-222.62 to -172.17)	33.03 (-63.78 to 129.09)
Azerbaijan	1492.48 (1232.52 to 1750.11)	866.52 (-2472760762116.17 to 949.07)	535.18 (480.02 to 206258829048.75)	90.78 (-131.20 to 2266081243346.65)
Georgia	-260.26 (-403.71 to -122.12)	325.47 (290.82 to 362.64)	-610.06 (-655.69 to -568.93)	24.33 (-122.39 to 166.68)
Kazakhstan	1462.41 (1009.33 to 1956.32)	1207.91 (1076.58 to 1352.79)	184.68 (82.47 to 290.56)	69.81 (-398.05 to 543.84)
Kyrgyzstan	805.49 (673.76 to 934.11)	344.31 (307.55 to 386.37)	327.05 (293.43 to 363.06)	134.12 (12.12 to 246.98)
Mongolia	395.93 (327.72 to 458.31)	252.41 (227.08 to 276.99)	150.97 (134.14 to 168.94)	-7.46 (-68.33 to 47.31)
Tajikistan	1170.77 (1020.99 to 1320.05)	495.92 (450.23 to 539.45)	597.12 (550.92 to 643.54)	77.74 (-60.42 to 217.03)
Turkmenistan	695.09 (590.97 to 804.38)	431.81 (395.64 to 473.95)	208.75 (180.04 to 238.75)	54.54 (-43.98 to 147.11)
Uzbekistan	4719.54 (4031.57 to 5433.00)	2636.77 (2404.09 to 2896.77)	1873.59 (1705.95 to 2063.56)	209.19 (-383.15 to 790.67)
East Asia	55744.32 (47577.23 to 63309.26)	23735.85 (21538.74 to 25968.57)	5615.52 (4307.32 to 6882.52)	26392.95 (19563.00 to 32815.66)
China	55087.24 (48075.97 to 61924.99)	23129.36 (20935.28 to 25113.79)	4566.24 (3291.10 to 5895.60)	27391.64 (21563.24 to 33492.03)
Democratic People’s Republic of Korea	268.71 (169.65 to 369.45)	327.54 (295.77 to 356.67)	100.00 (77.53 to 125.85)	-158.83 (-259.10 to -62.29)
Taiwan	388.38 (267.84 to 520.28)	326.45 (293.80 to 357.53)	30.60 (25.80 to 35.58)	31.33 (-79.05 to 152.98)
High-income Asia Pacific	23705.43 (20003.20 to 27276.19)	12419.51 (11393.87 to 13416.19)	88.11 (-482.82 to 633.24)	11197.80 (7686.90 to 14656.47)
Brunei Darussalam	18.16 (15.95 to 20.34)	8.34 (7.66 to 9.03)	8.40 (7.74 to 9.13)	1.42 (-0.60 to 3.38)
Japan	8697.24 (6562.40 to 10981.73)	7265.88 (6516.50 to 8035.92)	-1509.32 (-1910.89 to -1093.48)	2940.68 (920.29 to 5192.97)
Republic of Korea	14814.69 (13085.73 to 16588.30)	6596.49 (6024.74 to 7177.70)	1742.24 (1448.47 to 2064.95)	6475.96 (4972.59 to 7975.13)
Singapore	175.34 (156.52 to 197.16)	47.19 (42.71 to 52.07)	92.30 (86.47 to 98.08)	35.84 (19.97 to 52.94)
South Asia	282745.96 (243427.17 to 319981.97)	117452.60 (108910.29 to 126160.45)	107179.23 (98757.09 to 116031.70)	58114.13 (25308.70 to 89500.61)
Bangladesh	29464.51 (25826.78 to 33108.87)	15952.77 (14701.48 to 17268.46)	5927.17 (5133.57 to 6866.24)	7584.57 (4520.89 to 10644.91)
Bhutan	112.76 (95.09 to 131.71)	84.01 (75.31 to 94.48)	50.65 (42.91 to 59.65)	-21.90 (-40.79 to -3.46)
India	224417.62 (195464.65 to 253500.50)	91818.40 (83334.23 to 100070.63)	84653.80 (77187.12 to 92320.81)	47945.41 (22759.10 to 74487.32)
Nepal	4211.52 (3589.15 to 4854.70)	1855.75 (1690.36 to 2041.86)	1234.67 (1085.68 to 1404.84)	1121.09 (559.83 to 1673.91)
Pakistan	24539.56 (21215.46 to 28026.28)	8731.96 (7582.64 to 9972.49)	13893.45 (12756.17 to 15214.97)	1914.14 (-969.06 to 4987.55)
Southeast Asia	12266.08 (10397.97 to 14059.03)	6178.31 (5740.24 to 6633.45)	4223.83 (3943.74 to 4546.23)	1863.94 (196.45 to 3422.57)
Cambodia	256.28 (222.11 to 291.28)	136.37 (122.88 to 151.07)	93.38 (80.81 to 106.12)	26.53 (-6.52 to 56.28)
Indonesia	4850.32 (4073.75 to 5527.87)	2490.49 (2271.45 to 2722.71)	1633.85 (1479.21 to 1809.28)	725.98 (24.11 to 1345.75)
Lao People’s Democratic Republic	121.23 (102.17 to 137.78)	49.48 (43.87 to 54.98)	53.10 (48.10 to 58.38)	18.65 (2.92 to 32.62)
Malaysia	1105.95 (985.35 to 1220.30)	369.32 (339.57 to 400.74)	474.40 (440.89 to 508.92)	262.22 (170.95 to 356.31)
Maldives	22.75 (20.68 to 25.12)	8.55 (7.78 to 9.31)	9.35 (8.75 to 10.01)	4.85 (3.45 to 6.39)
Mauritius	21.46 (16.72 to 25.96)	14.18 (12.75 to 15.87)	2.02 (1.16 to 2.91)	5.26 (0.61 to 9.45)
Myanmar	665.04 (536.31 to 793.84)	394.01 (350.42 to 439.33)	148.97 (110.27 to 188.83)	122.06 (-4.34 to 246.72)
Philippines	1366.68 (1160.96 to 1571.26)	627.22 (572.48 to 689.56)	761.34 (707.58 to 821.60)	-21.88 (-221.75 to 159.55)
Seychelles	2.64 (2.27 to 3.00)	1.21 (1.09 to 1.34)	0.89 (0.79 to 0.99)	0.55 (0.21 to 0.87)
Sri Lanka	497.76 (406.58 to 582.63)	233.41 (200.12 to 265.73)	79.95 (53.69 to 108.40)	184.40 (94.61 to 269.35)
Thailand	1081.23 (872.43 to 1285.97)	748.44 (679.86 to 820.97)	206.57 (170.93 to 248.36)	126.22 (-71.15 to 306.56)
Timor-Leste	17.65 (15.16 to 20.40)	5.43 (4.80 to 6.06)	9.10 (8.33 to 9.87)	3.13 (0.75 to 5.76)
Viet Nam	2243.86 (1937.60 to 2567.92)	1179.95 (1074.34 to 1292.87)	648.79 (579.96 to 720.37)	415.12 (154.02 to 686.79)

Abbreviation: CI, Confidence intervals; GBD, Global burden of disease; IBD, Inflammatory bowel disease.

Table S18.

Decomposition of effects on Prevalence due to IBD among females across the five GBD regions and 34 Asian countries, 1990-2023 (95% CIs).

Location	Overall change	Aging effect	Population growth effect	Epidemiological effect
Central Asia	11730.65 (9696.04 to 13987.61)	7190.45 (6687.64 to 7725.63)	4076.86 (3756.63 to 4403.74)	463.34 (-1543.99 to 2586.14)
Armenia	339.07 (229.85 to 448.53)	450.57 (412.56 to 494.92)	-206.53 (-233.58 to -178.67)	95.03 (-18.16 to 201.63)
Azerbaijan	1636.47 (1311.25 to 1962.61)	975.59 (879.81 to 1070.12)	553.91 (488.10 to 625.28)	106.97 (-185.06 to 390.50)
Georgia	-378.53 (-590.78 to -175.15)	399.18 (353.87 to 447.34)	-800.36 (-860.71 to -739.80)	22.64 (-196.90 to 227.42)
Kazakhstan	1765.84 (1172.95 to 2414.08)	1340.45 (1186.03 to 1499.13)	279.75 (160.89 to 398.53)	145.64 (-466.97 to 795.21)
Kyrgyzstan	895.57 (719.69 to 1050.15)	364.58 (320.82 to 411.79)	359.55 (318.39 to 400.03)	171.44 (12.68 to 320.31)
Mongolia	448.25 (383.29 to 514.85)	283.82 (258.26 to 312.70)	178.11 (158.43 to 197.48)	-13.69 (-75.16 to 42.88)
Tajikistan	1069.96 (884.69 to 1247.69)	514.34 (463.49 to 573.55)	600.96 (546.17 to 653.57)	-45.34 (-230.09 to 128.08)
Turkmenistan	650.14 (533.51 to 762.51)	424.65 (386.58 to 469.65)	175.26 (148.38 to 203.71)	50.23 (-56.50 to 154.41)
Uzbekistan	5303.88 (4388.48 to 6161.55)	2935.53 (2666.08 to 3226.13)	2021.13 (1810.41 to 2237.61)	347.23 (-403.30 to 1061.44)
East Asia	57600.77 (50365.01 to 64956.34)	25641.45 (23476.50 to 28007.30)	7555.43 (6133.84 to 8819.75)	24403.89 (18312.33 to 30553.65)
China	56961.64 (49605.41 to 64601.39)	25037.82 (22795.27 to 27339.60)	6460.33 (5126.05 to 7792.84)	25463.50 (19095.56 to 31647.76)
Democratic People’s Republic of Korea	202.74 (80.11 to 326.00)	311.28 (281.23 to 345.08)	45.20 (22.49 to 70.07)	-153.73 (-279.10 to -35.88)
Taiwan	436.38 (320.27 to 547.77)	329.34 (295.72 to 364.27)	106.96 (100.04 to 114.58)	0.08 (-103.43 to 98.83)
High-income Asia Pacific	20918.01 (17541.25 to 24297.40)	10917.73 (10088.15 to 11722.33)	746.83 (215.33 to 1302.24)	9253.46 (5786.78 to 12503.65)
Brunei Darussalam	18.01 (15.86 to 20.19)	8.40 (7.67 to 9.11)	8.50 (7.89 to 9.13)	1.11 (-1.00 to 3.01)
Japan	8949.28 (6748.31 to 11158.57)	6606.72 (5999.53 to 7292.04)	-1015.40 (-1430.17 to -586.21)	3357.96 (1079.18 to 5512.99)
Republic of Korea	11716.86 (10170.83 to 13218.31)	5444.24 (5021.77 to 5955.35)	1549.64 (1293.10 to 1826.97)	4722.97 (3338.88 to 6042.88)
Singapore	233.87 (208.35 to 260.97)	52.41 (47.03 to 58.01)	145.52 (136.54 to 154.13)	35.94 (13.18 to 59.46)
South Asia	293319.14 (256560.39 to 330137.70)	128209.11 (119644.05 to 137753.43)	111745.88 (103062.56 to 120215.80)	53364.15 (22538.86 to 84156.13)
Bangladesh	30796.26 (27233.24 to 34834.19)	16805.66 (15489.91 to 18243.29)	7578.70 (6748.82 to 8432.74)	6411.90 (3349.81 to 9560.62)
Bhutan	100.04 (84.41 to 115.29)	66.70 (58.90 to 75.60)	43.31 (37.18 to 50.75)	-9.97 (-26.37 to 4.72)
India	235783.61 (208258.14 to 266018.33)	101585.45 (93040.65 to 110308.45)	88081.30 (80949.83 to 95571.66)	46116.87 (21957.99 to 71182.68)
Nepal	4699.54 (4119.62 to 5354.70)	2304.96 (2112.63 to 2504.87)	1680.26 (1509.07 to 1846.83)	714.32 (179.05 to 1291.89)
Pakistan	21939.69 (18761.63 to 25094.26)	9031.67 (7850.87 to 10289.40)	13123.20 (11891.05 to 14342.30)	-215.18 (-2984.37 to 2652.26)
Southeast Asia	13016.18 (11221.98 to 14961.59)	6620.57 (6208.10 to 7088.24)	4647.28 (4351.90 to 4978.12)	1748.33 (145.09 to 3492.25)
Cambodia	272.84 (225.26 to 318.65)	133.97 (118.10 to 150.85)	102.40 (88.60 to 117.09)	36.47 (-7.65 to 75.95)
Indonesia	4825.29 (4140.91 to 5609.27)	2505.66 (2301.78 to 2718.59)	1642.65 (1471.74 to 1838.26)	676.99 (37.60 to 1386.90)
Lao People’s Democratic Republic	116.28 (97.32 to 134.54)	47.07 (41.96 to 52.56)	52.11 (46.89 to 57.61)	17.10 (0.36 to 33.00)
Malaysia	997.18 (886.84 to 1117.90)	342.89 (314.24 to 373.54)	435.72 (404.72 to 467.03)	218.57 (125.74 to 311.36)
Maldives	12.33 (10.88 to 13.80)	5.57 (5.09 to 6.02)	4.31 (3.94 to 4.67)	2.45 (1.38 to 3.50)
Mauritius	23.75 (18.40 to 28.82)	16.02 (14.50 to 17.56)	3.83 (2.89 to 4.85)	3.90 (-1.33 to 8.82)
Myanmar	832.55 (657.40 to 1000.74)	466.61 (415.39 to 524.56)	243.66 (196.05 to 291.56)	122.28 (-42.82 to 275.49)
Philippines	1357.98 (1136.59 to 1562.53)	659.94 (606.02 to 718.33)	784.19 (730.91 to 840.75)	-86.15 (-283.11 to 102.96)
Seychelles	1.83 (1.47 to 2.19)	1.10 (0.99 to 1.23)	0.61 (0.53 to 0.70)	0.11 (-0.25 to 0.45)
Sri Lanka	706.34 (593.02 to 830.40)	330.03 (291.13 to 370.94)	175.47 (138.97 to 210.25)	200.83 (85.40 to 317.96)
Thailand	1447.67 (1216.71 to 1693.99)	879.39 (807.04 to 967.88)	341.01 (292.96 to 388.69)	227.27 (4.64 to 462.86)
Timor-Leste	16.96 (14.39 to 19.54)	5.50 (4.85 to 6.14)	9.45 (8.68 to 10.28)	2.01 (-0.38 to 4.42)
Viet Nam	2391.27 (2069.92 to 2733.95)	1292.32 (1192.63 to 1403.18)	706.45 (626.47 to 787.64)	392.50 (82.26 to 705.51)

Abbreviation: CI, Confidence intervals; GBD, Global burden of disease; IBD, Inflammatory bowel disease.

In the overall decomposition analysis, DALYs increased across all five Asian subregions [Figure S1a and Table S19], while prevalence increased across all subregions [Figure S1b and Table S20]. South Asia showed the largest increase in prevalence, followed by East Asia and high-income Asia Pacific. Population growth was the dominant contributor in Central Asia, South Asia, and Southeast Asia, whereas epidemiological change was the dominant contributor in East Asia and high-income Asia Pacific. At the country level, the Maldives showed the largest relative increase in DALYs among males and in prevalence among both sexes, whereas Mauritius showed the largest relative increase in DALYs among females. In contrast, Georgia consistently showed reductions in both DALYs and prevalence across both sexes. Additional decomposition analyses stratified by the periods 1990-2019 and 2019-2023 are presented in Figures S2-S3 and Tables S21-S24.

Table S19.

Decomposition of effects on DALYs due to IBD across the five GBD regions and 34 Asian countries, 1990-2023 (95% CIs).

Location	Overall change	Aging effect	Population growth effect	Epidemiological effect
Central Asia	13984.17 (435.30 to 27890.68)	6995.39 (-2145.67 to 23402.46)	35210.36 (4331.26 to 67478.09)	-28359.65 (-53093.97 to -3625.33)
Armenia	-1266.55 (-3060.69 to -135.80)	771.21 (-616.67 to 2159.09)	-233.12 (-411.86 to -31.91)	-1819.27 (-2892.53 to -406.42)
Azerbaijan	3090.94 (173.27 to 5797.39)	730.78 (-434.93 to 2626.31)	2843.62 (198.39 to 5436.67)	-537.68 (-1277.45 to 61.23)
Georgia	-7204.54 (-14403.30 to -1365.06)	628.36 (-1278.85 to 2326.38)	-2798.41 (-5265.51 to -606.03)	-4741.00 (-8499.32 to -1596.57)
Kazakhstan	2844.64 (-159.11 to 7036.74)	1253.47 (-3341.72 to 6808.05)	4734.62 (646.56 to 8822.68)	-3255.21 (-6374.64 to -203.77)
Kyrgyzstan	-2596.03 (-6482.21 to -339.40)	287.67 (-211.68 to 993.22)	3817.55 (372.15 to 7904.37)	-6649.89 (-14501.58 to -504.09)
Mongolia	1472.18 (113.09 to 2755.40)	355.44 (-71.66 to 1142.42)	1402.17 (195.53 to 2738.51)	-323.37 (-586.59 to -66.45)
Tajikistan	5164.95 (409.45 to 11138.18)	335.07 (-288.04 to 958.18)	5019.76 (582.99 to 10461.39)	-101.65 (-569.37 to 188.20)
Turkmenistan	2356.99 (209.15 to 4509.68)	487.50 (-45.28 to 1403.16)	2024.25 (203.74 to 4222.28)	-152.34 (-565.57 to 99.87)
Uzbekistan	10509.84 (448.24 to 20544.24)	3366.53 (-294.08 to 9181.05)	14726.30 (1578.68 to 30135.04)	-7596.59 (-16612.37 to -836.35)
East Asia	119178.10 (-169724.95 to 430177.92)	466998.21 (-124060.99 to 1058057.42)	201094.88 (79249.72 to 291040.70)	-547761.69 (-938710.34 to -156813.03)
China	94898.16 (-162924.23 to 384386.97)	440685.88 (-120315.99 to 1001687.75)	190929.68 (75968.08 to 275482.10)	-520884.19 (-892782.88 to -148985.50)
Democratic People’s Republic of Korea	4079.95 (-421.77 to 8461.40)	4534.33 (-894.11 to 9962.77)	3825.59 (1403.99 to 5540.40)	-4340.11 (-6564.24 to -1814.03)
Taiwan	4963.89 (-8989.71 to 20214.33)	18600.83 (-3288.15 to 42543.97)	4496.37 (1465.86 to 7406.68)	-17815.85 (-31471.96 to -5771.37)
High-income Asia Pacific	12816.93 (-55472.98 to 77261.45)	72810.00 (-33703.11 to 208933.16)	15338.76 (5294.73 to 21341.07)	-74488.33 (-169528.79 to -14178.94)
Brunei Darussalam	208.47 (47.99 to 355.73)	90.10 (-34.26 to 231.79)	206.32 (30.52 to 391.16)	-85.66 (-166.91 to -4.39)
Japan	17704.97 (-23942.29 to 56946.94)	45898.77 (-17034.27 to 138976.12)	2833.77 (908.20 to 4252.02)	-31546.47 (-85931.17 to 2119.34)
Republic of Korea	-2957.81 (-36821.49 to 23664.60)	46503.98 (-17856.65 to 111800.08)	15396.03 (5346.88 to 22987.38)	-64526.99 (-123445.24 to -16585.43)
Singapore	405.68 (-22.27 to 813.46)	382.39 (-394.29 to 1029.92)	738.68 (250.57 to 1168.30)	-723.37 (-1165.99 to -223.34)
South Asia	865443.63 (273094.96 to 1469887.81)	260495.14 (62852.69 to 492210.99)	894987.97 (149309.36 to 1717222.55)	-283991.72 (-555109.04 to -12874.40)
Bangladesh	94722.85 (25288.33 to 164491.74)	40283.14 (6597.41 to 86336.99)	110047.41 (14071.76 to 229906.58)	-55440.52 (-132654.02 to 4619.16)
Bhutan	257.63 (35.24 to 442.51)	242.05 (33.53 to 400.98)	234.93 (28.75 to 470.76)	-215.88 (-458.19 to 11.82)
India	608211.66 (204738.63 to 1035523.55)	204661.89 (53679.66 to 383465.02)	623843.50 (103002.88 to 1169041.00)	-208374.30 (-403424.74 to -13323.85)
Nepal	12463.98 (4070.58 to 18648.46)	6445.57 (1562.91 to 11364.27)	16955.68 (2958.05 to 32649.25)	-11007.78 (-23554.82 to -399.85)
Pakistan	142206.83 (32667.98 to 281175.03)	9825.72 (1984.73 to 17666.72)	149053.83 (30938.38 to 299110.15)	-18931.83 (-37608.54 to -255.13)
Southeast Asia	130967.15 (43555.15 to 207433.16)	64634.88 (-9590.00 to 138859.76)	123766.90 (38597.54 to 209682.96)	-56229.55 (-104540.52 to -18589.80)
Cambodia	2905.80 (710.92 to 4600.61)	1121.17 (182.44 to 2012.91)	2663.16 (779.29 to 4963.27)	-860.09 (-2152.31 to 1.64)
Indonesia	63121.20 (19219.35 to 102136.05)	36010.59 (-653.10 to 79782.05)	66438.22 (22327.75 to 110548.68)	-38900.73 (-80739.64 to -10673.24)
Lao People’s Democratic Republic	889.02 (247.36 to 1748.78)	192.84 (7.70 to 377.97)	863.96 (246.76 to 1703.95)	-155.89 (-331.24 to 12.65)
Malaysia	10361.21 (3579.66 to 14865.68)	5277.08 (137.23 to 10416.93)	12130.09 (4371.33 to 19888.86)	-7087.78 (-13348.60 to -826.96)
Maldives	150.83 (42.28 to 253.70)	32.48 (2.48 to 61.75)	119.39 (36.34 to 209.91)	-0.69 (-29.41 to 24.50)
Mauritius	767.82 (214.20 to 1238.08)	230.95 (-80.40 to 541.50)	127.46 (49.40 to 205.52)	394.95 (132.03 to 590.81)
Myanmar	11163.65 (1783.86 to 24729.34)	2685.75 (-876.21 to 7220.97)	12180.93 (1355.34 to 27861.02)	-3731.92 (-7656.32 to -568.09)
Philippines	17049.84 (3616.97 to 30218.45)	4379.73 (-7.17 to 10686.98)	17550.84 (4994.74 to 33248.19)	-5012.86 (-9403.85 to -1167.29)
Seychelles	10.11 (1.50 to 19.69)	7.57 (-2.03 to 21.67)	17.25 (3.69 to 27.64)	-14.84 (-26.64 to -3.10)
Sri Lanka	1460.98 (133.63 to 2567.21)	886.03 (-497.30 to 2269.36)	1084.13 (344.54 to 1935.35)	-514.69 (-729.85 to -215.49)
Thailand	11212.44 (3593.08 to 18598.97)	4919.60 (-3327.46 to 13166.65)	2612.50 (964.25 to 4260.74)	3601.43 (729.44 to 7380.58)
Timor-Leste	274.81 (91.29 to 422.60)	76.94 (-18.58 to 172.45)	254.75 (72.86 to 450.87)	-50.82 (-98.84 to -11.66)
Viet Nam	16559.59 (4956.20 to 25542.70)	6962.55 (-696.77 to 14619.24)	12283.35 (4787.88 to 19442.16)	-2524.09 (-5918.84 to -504.82)

Abbreviation: CI, Confidence intervals; DALY, disability-adjusted life year; GBD, Global burden of disease; IBD, Inflammatory bowel disease.

Table S20.

Decomposition of effects on Prevalence due to IBD across the five GBD regions and 34 Asian countries, 1990-2023 (95% CIs).

Location	Overall change	Aging effect	Population growth effect	Epidemiological effect
Central Asia	116905.79 (3676.94 to 229037.43)	17956.56 (-6373.90 to 60004.84)	92455.23 (4675.44 to 188510.08)	5945.39 (-6064.40 to 25137.82)
Armenia	1569.80 (-1817.50 to 5900.02)	1494.66 (-2631.56 to 6435.30)	-691.14 (-1327.65 to -54.63)	753.71 (-36.42 to 2024.27)
Azerbaijan	15756.33 (505.05 to 30716.70)	2632.02 (-1773.46 to 9615.16)	11279.15 (486.21 to 22718.47)	1699.69 (3.89 to 3683.11)
Georgia	-5402.29 (-13145.90 to 302.15)	931.39 (-3269.78 to 4723.02)	-6811.36 (-12940.22 to -682.50)	586.37 (96.22 to 1076.52)
Kazakhstan	14065.20 (445.41 to 28410.24)	2281.66 (-8901.50 to 15313.15)	11206.87 (725.25 to 21688.50)	939.29 (-3073.48 to 6608.04)
Kyrgyzstan	10027.08 (183.96 to 19495.61)	724.52 (-255.38 to 2198.18)	7665.04 (334.51 to 15915.12)	1450.22 (104.84 to 2795.60)
Mongolia	4303.68 (126.64 to 9618.69)	667.23 (-175.31 to 2176.23)	3265.02 (130.18 to 8041.01)	370.66 (-4.32 to 1030.97)
Tajikistan	14070.89 (189.50 to 30296.82)	1054.55 (-250.75 to 2359.86)	12536.25 (427.63 to 28318.96)	361.45 (12.63 to 710.27)
Turkmenistan	7548.43 (286.24 to 14678.12)	1270.54 (44.77 to 3558.97)	5340.69 (213.41 to 11781.03)	870.95 (28.06 to 1857.72)
Uzbekistan	54522.15 (1116.71 to 107490.47)	9982.22 (76.97 to 25604.43)	41734.12 (1645.85 to 89669.80)	2587.26 (-4470.17 to 12838.05)
East Asia	569096.00 (52679.25 to 1048337.58)	59552.30 (-344554.17 to 465312.84)	173973.36 (9539.28 to 334348.12)	340986.40 (16184.72 to 652845.37)
China	563105.81 (101905.04 to 1036275.04)	57566.71 (-340163.10 to 455296.29)	168895.08 (15889.28 to 324018.42)	342628.25 (29205.83 to 656050.68)
Democratic People’s Republic of Korea	2008.70 (260.00 to 4682.52)	664.68 (-1853.65 to 3440.99)	3202.11 (187.05 to 7589.04)	-1898.36 (-4371.44 to -171.95)
Taiwan	3570.27 (34.04 to 9528.01)	1298.23 (-3833.33 to 7423.59)	1885.28 (154.02 to 3689.66)	359.45 (80.97 to 794.23)
High-income Asia Pacific	206519.01 (9380.32 to 472831.40)	50907.53 (-141030.60 to 248013.09)	39067.50 (8223.38 to 69911.62)	115700.87 (28469.90 to 202931.83)
Brunei Darussalam	206.09 (11.86 to 397.67)	30.57 (-31.71 to 120.28)	153.44 (6.17 to 364.13)	20.76 (2.63 to 38.89)
Japan	78265.73 (-47281.54 to 198129.56)	35297.17 (-65281.75 to 135876.09)	7291.71 (2172.23 to 12411.18)	32835.13 (10460.17 to 55002.92)
Republic of Korea	126850.71 (26155.52 to 273894.58)	22830.94 (-85376.70 to 137735.05)	33542.10 (2873.21 to 64211.00)	70458.17 (7829.64 to 133086.71)
Singapore	2058.06 (263.00 to 3883.95)	98.81 (-1155.89 to 1334.29)	1443.95 (91.33 to 3041.37)	530.72 (53.66 to 1060.30)
South Asia	3552776.63 (335686.84 to 6752179.03)	548050.47 (106093.61 to 1177080.14)	2193873.86 (139480.00 to 4450438.95)	802008.60 (69033.52 to 1534983.68)
Bangladesh	378978.24 (20445.27 to 727355.34)	68849.68 (3860.22 to 145604.07)	201961.13 (9231.38 to 447800.27)	103089.49 (7353.67 to 202013.93)
Bhutan	1139.34 (109.68 to 2419.91)	353.50 (70.64 to 658.37)	485.93 (22.35 to 1198.60)	287.14 (16.68 to 680.48)
India	2782018.37 (290952.74 to 5289579.65)	463535.43 (79301.63 to 1011525.15)	1669679.79 (111349.02 to 3315159.60)	657050.98 (55848.98 to 1258252.97)
Nepal	56566.92 (4000.71 to 107293.24)	10236.69 (1808.38 to 22054.28)	33564.87 (1548.22 to 72989.73)	11673.41 (644.12 to 23206.03)
Pakistan	311964.67 (20778.95 to 681580.73)	18126.93 (1121.45 to 35132.40)	274308.99 (17867.81 to 589873.60)	25216.27 (1789.69 to 57926.31)
Southeast Asia	143077.74 (10292.70 to 272600.26)	25066.68 (-6572.17 to 76910.73)	96860.12 (4925.83 to 217399.59)	19519.68 (1545.27 to 39986.83)
Cambodia	3236.73 (172.07 to 7041.10)	564.85 (40.53 to 1089.17)	2202.70 (104.47 to 5315.01)	434.94 (27.07 to 1040.95)
Indonesia	52775.02 (3172.77 to 105027.59)	11431.36 (401.51 to 30280.75)	38641.35 (1764.68 to 86848.21)	4027.46 (522.53 to 7532.40)
Lao People’s Democratic Republic	1505.55 (54.21 to 3617.87)	224.91 (-7.24 to 492.67)	1029.62 (47.46 to 2505.51)	258.99 (13.99 to 619.69)
Malaysia	12752.91 (409.68 to 27301.18)	1498.73 (14.42 to 3750.01)	8638.16 (306.47 to 20402.15)	2669.55 (88.80 to 6167.27)
Maldives	216.94 (4.37 to 531.34)	39.66 (-1.14 to 99.31)	138.32 (4.28 to 338.20)	39.32 (1.23 to 93.83)
Mauritius	219.22 (28.48 to 435.31)	55.05 (-137.10 to 297.37)	104.91 (5.71 to 228.46)	61.53 (5.77 to 125.72)
Myanmar	8878.12 (510.60 to 17620.35)	1112.17 (-439.82 to 3488.50)	5673.09 (256.13 to 13311.64)	2009.02 (116.26 to 4598.92)
Philippines	16705.28 (887.83 to 33794.84)	2612.96 (97.37 to 6963.84)	15434.41 (787.87 to 35521.13)	-1475.81 (-2803.47 to -148.15)
Seychelles	23.40 (1.44 to 45.27)	3.86 (-3.90 to 15.37)	15.99 (0.98 to 34.70)	3.51 (0.36 to 7.44)
Sri Lanka	6689.41 (887.82 to 12195.22)	891.06 (-2665.63 to 4843.17)	3427.54 (210.51 to 7428.05)	2222.92 (174.13 to 4711.17)
Thailand	11029.22 (1736.16 to 26134.13)	2680.70 (-10978.82 to 13671.96)	4634.55 (333.87 to 9374.05)	4445.68 (467.43 to 8482.43)
Timor-Leste	233.71 (15.85 to 542.06)	10.59 (-19.76 to 45.34)	191.81 (8.02 to 481.54)	31.39 (1.73 to 80.42)
Viet Nam	24944.58 (858.68 to 48108.85)	4262.69 (-716.31 to 12790.47)	15326.28 (646.10 to 34165.88)	5276.57 (235.86 to 11487.48)

Abbreviation: CI, Confidence intervals; GBD, Global burden of disease; IBD, Inflammatory bowel disease.

Table S21.

Decomposition of effects on DALYs due to IBD across the five GBD regions and 34 Asian countries, 1990-2019 (95% CIs).

Location	Overall change	Aging effect	Population growth effect	Epidemiological effect
Central Asia	12997.93 (1457.17 to 24796.50)	7453.39 (-26.23 to 19197.10)	29364.77 (3779.29 to 56631.42)	-23820.23 (-46741.43 to -2565.48)
Armenia	-643.04 (-2214.31 to 266.61)	787.30 (-507.94 to 2077.18)	-248.55 (-439.63 to -57.48)	-1181.78 (-1782.57 to -410.55)
Azerbaijan	2748.60 (317.14 to 5180.05)	653.41 (-119.79 to 2027.50)	2557.65 (235.77 to 4879.53)	-462.46 (-994.43 to 69.51)
Georgia	-6688.73 (-12557.20 to -685.36)	732.63 (-697.76 to 2163.02)	-2679.16 (-4730.77 to -341.49)	-4742.19 (-7917.75 to -851.83)
Kazakhstan	5400.04 (1332.13 to 10309.51)	1523.00 (-1785.37 to 5849.70)	3197.75 (467.85 to 5927.66)	679.29 (66.02 to 1292.56)
Kyrgyzstan	-2983.63 (-7015.31 to -380.29)	325.55 (-153.08 to 804.18)	3068.87 (266.41 to 6440.77)	-6378.05 (-14073.35 to -525.94)
Mongolia	1063.74 (31.67 to 2095.82)	360.20 (-25.48 to 880.91)	1113.89 (148.73 to 2235.84)	-410.35 (-729.11 to -91.59)
Tajikistan	2956.78 (220.26 to 6785.77)	361.77 (-194.71 to 918.25)	3793.69 (450.31 to 8005.50)	-1198.67 (-2362.01 to -35.34)
Turkmenistan	2027.66 (207.87 to 3847.45)	445.95 (-8.41 to 1094.36)	1733.61 (180.38 to 3672.32)	-151.90 (-516.50 to 35.90)
Uzbekistan	9202.96 (399.33 to 18006.58)	3397.41 (-294.45 to 7452.20)	12721.79 (1383.84 to 26504.43)	-6916.24 (-15039.01 to -690.06)
East Asia	91873.95 (-180524.36 to 363226.30)	389912.91 (-130856.56 to 950922.26)	172689.60 (65590.22 to 242812.10)	-470728.56 (-827344.44 to -142694.72)
China	83503.04 (-126838.98 to 293845.05)	367428.56 (-89771.81 to 824628.93)	163327.85 (61250.79 to 233220.33)	-447253.37 (-759578.81 to -134927.93)
Democratic People’s Republic of Korea	5084.66 (567.31 to 10161.85)	4021.54 (-572.98 to 9914.70)	3753.93 (1410.34 to 5464.33)	-2690.82 (-4139.98 to -1008.29)
Taiwan	3973.60 (-7556.38 to 19285.02)	16379.13 (-1742.40 to 42230.54)	4476.98 (1442.28 to 7730.11)	-16882.51 (-30675.63 to -5695.80)
High-income Asia Pacific	-4138.16 (-58407.30 to 36433.75)	59698.29 (-27298.22 to 169637.48)	15684.09 (5331.17 to 21879.55)	-79520.54 (-175092.83 to -15363.12)
Brunei Darussalam	167.55 (56.22 to 268.80)	68.25 (-10.51 to 174.29)	182.40 (45.49 to 360.09)	-83.11 (-158.33 to -7.89)
Japan	3310.90 (-27116.82 to 28746.98)	37733.14 (-13970.74 to 106460.43)	3500.07 (1135.71 to 5062.79)	-37922.31 (-93721.87 to -4864.67)
Republic of Korea	-6610.69 (-35016.68 to 13646.20)	38546.33 (-20288.47 to 90885.28)	15058.89 (4794.78 to 23579.08)	-60215.91 (-113747.07 to -15575.38)
Singapore	93.15 (-64.32 to 250.62)	265.55 (-162.21 to 693.30)	657.48 (219.95 to 1102.49)	-829.88 (-1251.40 to -290.97)
South Asia	733188.33 (244447.08 to 1221929.58)	213962.93 (52093.59 to 397617.92)	783773.71 (130086.00 to 1505613.31)	-264548.32 (-565395.49 to 969.39)
Bangladesh	82278.17 (23661.56 to 140894.77)	35193.93 (5665.78 to 77577.05)	93634.80 (12097.11 to 195090.55)	-46550.56 (-120362.60 to 5898.67)
Bhutan	242.54 (81.60 to 378.62)	206.28 (63.80 to 320.22)	236.46 (28.02 to 463.10)	-200.19 (-446.22 to 13.72)
India	522643.45 (178762.25 to 864208.59)	166139.33 (44352.35 to 305269.21)	552395.77 (88957.20 to 1038216.58)	-195891.65 (-400740.34 to -4067.56)
Nepal	10170.56 (3480.80 to 15206.92)	5209.66 (929.39 to 9009.00)	15300.20 (2560.03 to 31001.63)	-10339.30 (-22608.92 to -220.88)
Pakistan	112176.12 (29544.16 to 219465.27)	7940.59 (1183.66 to 16808.84)	124294.84 (26539.42 to 247960.73)	-20059.32 (-46702.24 to 1821.08)
Southeast Asia	121182.52 (42413.67 to 189856.70)	55534.43 (-4387.43 to 115399.79)	109777.53 (34264.23 to 187978.91)	-44129.43 (-80755.78 to -16188.60)
Cambodia	2365.71 (389.52 to 4022.55)	962.87 (121.72 to 1761.17)	2292.59 (659.97 to 4252.53)	-889.76 (-2409.05 to 86.67)
Indonesia	56636.85 (18033.43 to 86806.14)	29716.74 (1346.50 to 64154.06)	57698.84 (19416.49 to 95981.19)	-30778.73 (-57561.26 to -6892.87)
Lao People’s Democratic Republic	788.69 (209.22 to 1523.92)	160.13 (7.15 to 345.64)	765.19 (219.84 to 1509.11)	-136.63 (-330.83 to 36.47)
Malaysia	10521.12 (3817.99 to 15784.33)	4409.05 (272.16 to 8971.55)	11335.28 (3576.48 to 19094.07)	-5223.21 (-9873.50 to -867.32)
Maldives	142.63 (38.07 to 239.45)	28.91 (0.07 to 57.77)	103.16 (33.57 to 181.34)	10.56 (-11.98 to 35.36)
Mauritius	880.98 (235.51 to 1389.20)	223.95 (-80.01 to 527.91)	140.67 (54.97 to 225.24)	516.36 (168.78 to 776.70)
Myanmar	10002.68 (1317.06 to 23428.17)	2515.28 (-154.49 to 6089.16)	10707.27 (1171.83 to 24699.41)	-3219.87 (-7008.63 to -553.06)
Philippines	14557.14 (4714.25 to 25995.75)	3670.37 (24.06 to 8046.86)	15570.08 (5450.61 to 29598.72)	-4683.32 (-10467.27 to -751.02)
Seychelles	6.44 (1.47 to 12.41)	6.28 (-0.45 to 16.20)	15.19 (5.21 to 24.44)	-15.03 (-25.77 to -5.41)
Sri Lanka	1254.94 (312.75 to 2361.91)	688.54 (-636.58 to 1817.34)	942.62 (255.97 to 1699.55)	-376.22 (-549.75 to -175.56)
Thailand	10206.68 (2893.62 to 16068.35)	4170.48 (-2618.52 to 10931.35)	2520.88 (842.43 to 4199.33)	3515.33 (772.59 to 7150.14)
Timor-Leste	196.06 (56.14 to 308.07)	54.87 (-24.02 to 133.76)	207.04 (53.35 to 376.91)	-65.85 (-135.75 to -16.37)
Viet Nam	15913.76 (5106.65 to 23317.89)	6405.96 (318.11 to 12493.82)	10946.29 (4155.38 to 17438.46)	-1438.50 (-3956.10 to -32.89)

Abbreviation: CI, Confidence intervals; DALY, disability-adjusted life year; GBD, Global burden of disease; IBD, Inflammatory bowel disease.

Table S24.

Decomposition of effects on Prevalence due to IBD across the five GBD regions and 34 Asian countries, 2019-2023 (95% CIs).

Location	Overall change	Aging effect	Population growth effect	Epidemiological effect
Central Asia	17551.12 (-160.90 to 35263.15)	-2109.61 (-19197.65 to 13848.36)	18000.39 (861.16 to 36077.64)	1660.34 (-55.96 to 4401.22)
Armenia	206.79 (-543.74 to 1111.10)	86.91 (-728.05 to 944.44)	-9.04 (-17.21 to -0.46)	128.92 (4.95 to 248.31)
Azerbaijan	1501.53 (-64.94 to 3665.40)	323.11 (-1569.17 to 2660.14)	1198.56 (50.38 to 2346.74)	-20.15 (-268.84 to 202.09)
Georgia	-294.60 (-842.32 to 160.01)	-58.67 (-543.62 to 518.33)	-379.66 (-727.17 to -49.27)	143.72 (14.23 to 309.78)
Kazakhstan	4145.60 (44.83 to 8246.37)	-545.81 (-4216.50 to 2831.30)	4373.92 (271.42 to 8476.42)	317.49 (25.64 to 609.34)
Kyrgyzstan	1582.62 (-50.93 to 3216.18)	-100.57 (-1411.69 to 1249.54)	1618.68 (62.30 to 3335.85)	64.52 (-175.56 to 391.76)
Mongolia	524.38 (28.88 to 1059.32)	-203.39 (-1101.64 to 485.15)	689.40 (24.80 to 1495.17)	38.38 (-2.25 to 100.43)
Tajikistan	2238.09 (-5.08 to 4481.27)	-311.55 (-1749.50 to 931.36)	2351.45 (65.05 to 5288.31)	198.19 (3.06 to 420.38)
Turkmenistan	941.00 (17.92 to 1864.09)	39.90 (-662.41 to 804.78)	822.63 (32.99 to 1963.54)	78.48 (7.60 to 165.40)
Uzbekistan	6815.47 (81.24 to 13549.70)	-1036.11 (-7611.43 to 4660.73)	6605.64 (220.64 to 13987.45)	1245.94 (13.44 to 2705.98)
East Asia	21915.10 (-106473.61 to 136500.50)	-8088.57 (-143442.85 to 94784.14)	27729.39 (3145.04 to 52313.73)	2274.29 (-8385.52 to 10179.83)
China	22228.85 (-92055.69 to 113085.38)	-8305.76 (-133985.24 to 77598.74)	27878.96 (3181.40 to 52576.51)	2655.65 (-4955.66 to 10140.95)
Democratic People’s Republic of Korea	431.92 (-70.36 to 1276.43)	70.08 (-862.36 to 1030.70)	146.71 (10.04 to 296.10)	215.12 (23.75 to 509.50)
Taiwan	-578.88 (-2434.73 to 552.61)	-15.16 (-1241.71 to 1066.04)	-77.54 (-146.92 to -8.17)	-486.18 (-1075.90 to 23.43)
High-income Asia Pacific	2850.51 (-58476.95 to 44725.99)	5637.41 (-41939.64 to 39256.21)	-3859.42 (-6618.14 to -1100.70)	1072.52 (-11780.37 to 11682.71)
Brunei Darussalam	19.01 (1.34 to 51.19)	4.51 (-25.26 to 36.77)	14.64 (0.65 to 32.33)	-0.14 (-3.21 to 2.64)
Japan	706.20 (-19044.41 to 18973.79)	4239.25 (-12798.35 to 20136.24)	-2740.84 (-4372.03 to -902.11)	-792.22 (-1965.93 to 381.27)
Republic of Korea	2183.48 (-26928.16 to 36529.64)	2379.58 (-19591.53 to 30552.28)	-934.64 (-1761.21 to -108.07)	738.54 (-5947.79 to 7184.39)
Singapore	-39.99 (-449.45 to 329.61)	-55.45 (-501.58 to 355.38)	18.31 (1.45 to 35.16)	-2.84 (-41.57 to 24.17)
South Asia	852605.88 (99302.38 to 1605909.39)	117543.38 (13245.54 to 284836.94)	281513.66 (20737.90 to 553693.99)	453548.85 (49909.33 to 857188.37)
Bangladesh	102379.96 (7943.08 to 196816.83)	10522.98 (708.42 to 20337.54)	36069.26 (1687.95 to 76668.89)	55787.72 (5546.71 to 106028.73)
Bhutan	139.72 (11.47 to 356.96)	57.88 (-26.27 to 184.90)	-11.99 (-26.29 to -0.68)	93.83 (9.49 to 178.04)
India	650183.90 (84757.05 to 1215610.76)	108492.85 (13102.80 to 264478.85)	192107.63 (15155.47 to 369059.79)	349583.42 (41480.32 to 657686.51)
Nepal	11855.93 (1175.20 to 22536.66)	2168.83 (139.90 to 5366.34)	3221.05 (174.64 to 6808.95)	6466.06 (484.23 to 12447.89)
Pakistan	89470.86 (6015.41 to 201625.29)	2323.07 (-3947.24 to 10026.74)	43801.47 (2849.29 to 104794.67)	43346.32 (2582.90 to 97425.70)
Southeast Asia	21396.82 (2571.78 to 40221.86)	2676.81 (-9661.65 to 16671.26)	11993.08 (665.11 to 25542.58)	6726.93 (901.69 to 12552.17)
Cambodia	660.84 (48.09 to 1407.78)	47.11 (-28.81 to 153.52)	291.18 (14.11 to 682.46)	322.55 (18.33 to 753.17)
Indonesia	11357.27 (687.37 to 22027.18)	1744.37 (-2751.99 to 7731.36)	5393.65 (265.78 to 11544.43)	4219.25 (167.84 to 9685.30)
Lao People’s Democratic Republic	258.13 (9.99 to 553.17)	18.16 (-36.79 to 91.93)	125.89 (5.28 to 306.03)	114.09 (5.41 to 283.90)
Malaysia	-3297.93 (-9419.88 to 105.04)	145.28 (-275.52 to 669.04)	954.28 (41.31 to 2194.25)	-4397.49 (-11263.42 to -42.50)
Maldives	47.68 (0.39 to 109.52)	6.27 (-0.75 to 13.29)	28.40 (0.74 to 69.88)	13.01 (0.40 to 31.52)
Mauritius	25.94 (6.04 to 50.14)	5.52 (-13.43 to 24.89)	-2.50 (-4.92 to -0.16)	22.93 (3.01 to 42.84)
Myanmar	1832.99 (112.48 to 3588.85)	46.59 (-611.80 to 736.14)	759.95 (36.63 to 1722.37)	1026.45 (60.44 to 2478.28)
Philippines	2740.52 (175.61 to 5305.43)	455.95 (0.14 to 1271.43)	1624.26 (83.05 to 3623.94)	660.31 (54.77 to 1460.53)
Seychelles	3.84 (0.35 to 7.96)	0.09 (-3.99 to 4.25)	1.69 (0.10 to 3.51)	2.06 (0.19 to 3.95)
Sri Lanka	1273.61 (353.89 to 2193.32)	121.42 (-249.11 to 491.96)	452.14 (33.15 to 899.67)	700.05 (72.96 to 1327.13)
Thailand	1995.71 (-372.50 to 5427.93)	176.41 (-2832.97 to 2942.65)	22.26 (1.17 to 42.58)	1797.04 (152.67 to 3292.68)
Timor-Leste	54.41 (2.76 to 137.53)	7.94 (-0.88 to 20.28)	29.39 (1.33 to 71.48)	17.08 (0.71 to 44.17)
Viet Nam	4156.67 (384.77 to 7928.56)	-236.58 (-4006.13 to 3251.16)	1998.55 (113.61 to 4260.49)	2394.69 (225.93 to 4644.54)

Abbreviation: CI, Confidence intervals; GBD, Global burden of disease; IBD, Inflammatory bowel disease.

Table S22.

Decomposition of effects on Prevalence due to IBD across the five GBD regions and 34 Asian countries, 1990-2019 (95% CIs).

Location	Overall change	Aging effect	Population growth effect	Epidemiological effect
Central Asia	98806.06 (3837.84 to 193774.29)	18884.75 (1085.75 to 48860.73)	75375.36 (3955.68 to 155664.76)	4545.96 (-6142.49 to 20983.96)
Armenia	1350.44 (-1273.76 to 4279.42)	1386.85 (-1906.59 to 4700.30)	-675.85 (-1299.43 to -52.27)	639.44 (-42.32 to 1847.46)
Azerbaijan	14109.35 (569.99 to 27648.71)	2330.81 (-394.89 to 7272.85)	10117.30 (456.66 to 20878.02)	1661.24 (-5.60 to 3483.45)
Georgia	-4998.99 (-12303.58 to 487.90)	1010.67 (-2618.13 to 4022.78)	-6426.80 (-12175.19 to -678.40)	417.14 (88.53 to 745.75)
Kazakhstan	10282.23 (400.58 to 20163.87)	2637.30 (-4691.54 to 11936.25)	6968.94 (464.86 to 13632.37)	675.99 (-3130.14 to 5889.56)
Kyrgyzstan	8257.16 (234.90 to 16517.19)	770.47 (-183.16 to 1722.12)	6165.31 (287.68 to 13065.28)	1321.38 (128.39 to 2514.37)
Mongolia	3778.53 (97.76 to 7632.91)	786.01 (-4.13 to 1696.81)	2661.32 (104.33 to 6070.50)	331.19 (-2.43 to 891.41)
Tajikistan	11714.16 (194.59 to 26380.93)	1208.86 (-181.48 to 2736.17)	10308.87 (366.37 to 23536.92)	196.42 (9.70 to 402.23)
Turkmenistan	6541.18 (268.32 to 12814.03)	1193.51 (60.62 to 2743.38)	4567.15 (185.75 to 10134.60)	780.51 (21.95 to 1697.23)
Uzbekistan	47488.12 (1035.47 to 97954.86)	10204.29 (211.89 to 23773.25)	35585.81 (1436.30 to 77512.82)	1698.03 (-4786.50 to 10485.10)
East Asia	552596.96 (79064.67 to 1026129.24)	63235.83 (-242110.05 to 388395.89)	153171.28 (12469.50 to 305431.66)	336189.85 (23173.52 to 654137.70)
China	546861.19 (77849.83 to 1015872.54)	61379.77 (-238611.81 to 380292.69)	148094.17 (12141.47 to 294893.39)	337387.24 (23249.93 to 656838.25)
Democratic People’s Republic of Korea	1536.51 (300.55 to 3362.68)	587.53 (-1001.28 to 2417.47)	3009.07 (169.54 to 6510.42)	-2060.09 (-4430.64 to -176.40)
Taiwan	4121.84 (815.10 to 8895.47)	1305.28 (-2842.92 to 6119.66)	1998.26 (147.86 to 4026.04)	818.30 (67.62 to 1902.18)
High-income Asia Pacific	202825.39 (48405.29 to 392943.26)	45258.76 (-154617.40 to 194039.59)	42074.01 (4168.89 to 76058.89)	115492.62 (12470.06 to 206090.49)
Brunei Darussalam	185.75 (4.90 to 366.12)	26.55 (-12.19 to 90.21)	139.31 (4.00 to 338.79)	19.90 (1.16 to 39.52)
Japan	74717.82 (-33833.82 to 184997.31)	31999.31 (-57534.84 to 119897.62)	9657.11 (2659.24 to 16654.97)	33061.40 (9576.01 to 59188.24)
Republic of Korea	124647.74 (20766.12 to 234273.18)	20148.80 (-65892.19 to 113817.76)	34135.91 (2471.30 to 67739.52)	70363.03 (5773.98 to 134952.07)
Singapore	2113.46 (189.50 to 4037.43)	142.52 (-784.47 to 1095.54)	1440.92 (75.18 to 3130.71)	530.02 (41.48 to 1078.98)
South Asia	2691327.05 (236384.46 to 5146269.64)	411741.50 (91328.80 to 849713.69)	1831662.60 (109145.58 to 3812795.59)	447922.95 (33550.54 to 958254.02)
Bangladesh	271520.35 (12502.19 to 544699.56)	52669.34 (2633.11 to 111871.46)	159638.90 (6751.39 to 363172.75)	59212.11 (3117.69 to 136024.18)
Bhutan	986.85 (85.73 to 2026.71)	294.56 (55.60 to 534.21)	478.85 (20.14 to 1109.95)	213.43 (10.00 to 527.58)
India	2140082.29 (206195.69 to 4073968.89)	344062.06 (67610.22 to 723450.85)	1412216.22 (87573.22 to 2884733.87)	383804.01 (26966.76 to 803265.87)
Nepal	43619.04 (2874.56 to 101004.99)	7834.67 (1306.70 to 14362.64)	29094.46 (1254.35 to 71289.43)	6689.92 (313.51 to 17184.81)
Pakistan	228181.32 (8643.52 to 505971.52)	14510.54 (98.28 to 32682.88)	219892.27 (8507.68 to 477146.26)	-6221.49 (-14844.40 to 37.55)
Southeast Asia	120049.66 (4103.57 to 232378.41)	21841.02 (-983.94 to 61252.33)	84336.90 (3207.35 to 192355.04)	13871.74 (581.25 to 29876.09)
Cambodia	2541.65 (123.98 to 5633.32)	490.45 (24.10 to 956.80)	1864.81 (85.68 to 4529.15)	186.39 (14.20 to 446.58)
Indonesia	42742.91 (2485.39 to 83269.68)	9531.90 (655.26 to 22664.53)	32593.55 (1465.99 to 74470.47)	617.45 (-669.07 to 1871.52)
Lao People’s Democratic Republic	1255.39 (44.21 to 3053.88)	198.16 (-6.63 to 478.90)	889.28 (41.26 to 2178.35)	167.95 (9.59 to 396.64)
Malaysia	16104.36 (418.22 to 36607.48)	1484.22 (-37.03 to 3497.36)	8917.11 (295.38 to 21440.46)	5703.03 (159.86 to 14174.69)
Maldives	169.62 (3.98 to 421.82)	31.56 (-0.63 to 83.54)	110.19 (3.65 to 271.39)	27.87 (0.96 to 66.91)
Mauritius	195.55 (20.54 to 385.18)	49.08 (-123.51 to 258.73)	104.76 (5.18 to 254.61)	41.71 (3.36 to 96.22)
Myanmar	6961.29 (398.11 to 13868.44)	1022.92 (-15.72 to 2822.60)	4816.49 (214.41 to 11366.19)	1121.88 (68.90 to 2427.88)
Philippines	13831.04 (712.22 to 28622.52)	2137.36 (98.06 to 5577.48)	13569.92 (685.07 to 31456.34)	-1876.24 (-3652.40 to -174.33)
Seychelles	19.51 (1.10 to 37.92)	3.60 (-0.50 to 11.01)	14.09 (0.85 to 31.28)	1.83 (0.19 to 4.16)
Sri Lanka	5267.91 (533.92 to 10001.91)	731.58 (-2374.68 to 4287.05)	2925.79 (150.12 to 7098.86)	1610.54 (101.43 to 3933.98)
Thailand	9765.23 (1557.30 to 21551.44)	2368.66 (-8326.91 to 14374.54)	4451.65 (275.19 to 9325.63)	2944.92 (241.21 to 6042.92)
Timor-Leste	179.39 (11.12 to 404.53)	4.32 (-33.88 to 42.84)	158.18 (6.16 to 396.64)	16.89 (0.95 to 42.27)
Viet Nam	20708.87 (1237.45 to 40341.85)	4163.42 (331.69 to 9954.74)	13193.25 (698.66 to 30061.70)	3352.19 (207.10 to 7684.84)

Abbreviation: CI, Confidence intervals; GBD, Global burden of disease; IBD, Inflammatory bowel disease.

Table S23.

Decomposition of effects on DALYs due to IBD across the five GBD regions and 34 Asian countries, 2019-2023 (95% CIs).

Location	Overall change	Aging effect	Population growth effect	Epidemiological effect
Central Asia	848.17 (-1334.71 to 4020.93)	-509.18 (-5652.05 to 4667.51)	5881.98 (715.78 to 11048.18)	-4524.63 (-7854.63 to -1194.64)
Armenia	-638.14 (-1119.13 to -158.21)	39.99 (-172.65 to 263.26)	-2.57 (-4.53 to -0.61)	-675.56 (-1249.31 to -186.95)
Azerbaijan	288.12 (-41.10 to 617.34)	84.50 (-346.74 to 655.99)	283.74 (26.40 to 541.08)	-80.12 (-423.87 to 195.88)
Georgia	-222.32 (-365.94 to -80.04)	-25.34 (-161.03 to 127.90)	-104.19 (-185.25 to -23.14)	-92.79 (-217.01 to 31.43)
Kazakhstan	-2667.16 (-4582.27 to -890.74)	-186.35 (-1580.00 to 1241.44)	1878.47 (290.72 to 3466.22)	-4359.28 (-7757.58 to -960.98)
Kyrgyzstan	438.96 (40.88 to 837.03)	-25.94 (-351.31 to 313.42)	426.48 (38.80 to 959.92)	38.42 (11.49 to 65.35)
Mongolia	370.50 (81.42 to 670.87)	-45.66 (-370.91 to 222.68)	267.37 (31.82 to 516.69)	148.79 (38.35 to 259.23)
Tajikistan	2296.39 (189.19 to 4403.59)	-107.04 (-580.19 to 310.90)	845.57 (88.84 to 1793.21)	1557.86 (152.19 to 3225.56)
Turkmenistan	331.76 (1.28 to 702.91)	24.52 (-220.91 to 308.10)	296.20 (29.84 to 589.52)	11.04 (-71.57 to 95.75)
Uzbekistan	1293.28 (-43.09 to 3742.99)	-194.80 (-2073.59 to 1519.33)	1992.04 (189.71 to 3897.69)	-503.95 (-1586.27 to 301.42)
East Asia	28457.46 (-52913.11 to 131749.67)	53949.85 (-30874.63 to 139567.17)	21789.26 (8498.53 to 33307.35)	-47281.66 (-91590.77 to -12384.23)
China	27228.33 (-51889.61 to 128056.69)	50728.27 (-29918.98 to 131874.79)	21222.47 (8357.40 to 32333.61)	-44722.41 (-89212.30 to -10684.84)
Democratic People’s Republic of Korea	-1064.84 (-1758.73 to -379.53)	753.15 (-356.79 to 1863.09)	194.25 (63.06 to 286.68)	-2012.25 (-3359.33 to -677.80)
Taiwan	1307.75 (-213.57 to 2829.07)	1746.68 (-450.43 to 4251.36)	-152.88 (-273.19 to -45.41)	-286.04 (-1819.34 to 732.34)
High-income Asia Pacific	17798.60 (-5230.51 to 42687.47)	5861.15 (-6192.11 to 18658.02)	-1128.23 (-1592.53 to -334.13)	13065.68 (667.87 to 25817.65)
Brunei Darussalam	43.21 (1.74 to 84.68)	21.85 (-15.03 to 58.72)	17.31 (5.46 to 29.78)	4.05 (-1.41 to 11.36)
Japan	13875.17 (-449.61 to 30686.81)	3811.79 (-2821.62 to 12902.45)	-892.74 (-1379.22 to -372.94)	10956.12 (2294.14 to 20023.14)
Republic of Korea	3983.70 (-5348.25 to 13239.16)	2974.81 (-3798.23 to 9747.84)	-250.59 (-355.21 to -85.76)	1259.48 (-1417.44 to 5260.13)
Singapore	304.55 (46.26 to 562.84)	54.32 (-101.42 to 200.97)	5.90 (2.05 to 9.09)	244.33 (71.31 to 389.60)
South Asia	138303.06 (28647.88 to 256307.77)	51127.92 (6932.66 to 101277.99)	99814.46 (21019.54 to 181674.81)	-12639.32 (-63714.27 to 47688.10)
Bangladesh	12611.87 (1626.78 to 28143.77)	5256.81 (1276.03 to 9385.97)	16270.39 (2676.65 to 31281.06)	-8915.33 (-16585.78 to -2325.90)
Bhutan	18.57 (-26.76 to 63.89)	41.63 (-8.71 to 91.96)	-5.02 (-9.42 to -1.44)	-18.04 (-24.78 to -6.61)
India	97487.64 (23660.31 to 171314.96)	42845.69 (5735.55 to 84896.01)	62066.25 (13158.34 to 110974.16)	-7424.31 (-44204.98 to 36272.70)
Nepal	2222.90 (589.77 to 3728.14)	1293.49 (90.06 to 2496.92)	1313.89 (313.33 to 2464.86)	-384.47 (-618.98 to -149.97)
Pakistan	27771.60 (3123.82 to 66395.59)	1679.27 (-1261.99 to 5237.06)	22678.62 (5075.80 to 48731.67)	3413.71 (-5892.84 to 17727.82)
Southeast Asia	10989.70 (1617.42 to 21125.21)	9832.72 (-6087.23 to 25752.68)	14195.52 (4838.92 to 23607.29)	-13038.54 (-22304.20 to -3772.88)
Cambodia	558.53 (111.93 to 1098.86)	181.73 (-26.66 to 390.11)	324.16 (108.84 to 544.49)	52.64 (-256.54 to 485.52)
Indonesia	6911.23 (1185.92 to 12749.69)	6486.37 (-2356.49 to 16443.77)	8544.80 (3124.46 to 13965.15)	-8119.94 (-15588.55 to -2287.58)
Lao People’s Democratic Republic	112.23 (28.39 to 203.28)	34.95 (-17.07 to 120.26)	94.98 (27.82 to 169.36)	-17.71 (-103.02 to 50.99)
Malaysia	-201.72 (-2887.13 to 2957.64)	1026.72 (-143.24 to 2220.92)	987.26 (383.04 to 1555.22)	-2215.70 (-4696.47 to 265.08)
Maldives	8.55 (-4.10 to 21.20)	2.92 (-10.02 to 16.51)	23.34 (7.71 to 39.91)	-17.71 (-30.64 to -4.78)
Mauritius	-127.62 (-212.77 to -42.19)	54.86 (-11.39 to 143.68)	-4.49 (-6.78 to -1.63)	-177.99 (-270.31 to -60.95)
Myanmar	1132.07 (299.52 to 1989.06)	44.02 (-1169.03 to 1204.91)	1493.76 (176.83 to 3439.26)	-405.71 (-1047.08 to 56.18)
Philippines	2360.57 (498.45 to 4222.70)	780.48 (-35.31 to 1875.50)	1798.98 (469.87 to 3173.61)	-218.89 (-868.30 to 471.77)
Seychelles	3.54 (0.44 to 7.31)	0.88 (-2.22 to 4.49)	1.50 (0.54 to 2.41)	1.17 (0.59 to 1.75)
Sri Lanka	200.53 (-23.04 to 600.56)	216.38 (-55.43 to 615.60)	133.06 (48.03 to 218.08)	-148.91 (-314.47 to -38.08)
Thailand	926.84 (-676.94 to 2530.62)	947.13 (-910.66 to 2804.92)	14.57 (3.40 to 22.63)	-34.86 (-396.46 to 322.52)
Timor-Leste	84.80 (28.14 to 154.03)	22.99 (-2.14 to 55.56)	37.06 (12.33 to 62.33)	24.75 (3.95 to 56.70)
Viet Nam	808.05 (-330.63 to 2744.37)	593.51 (-1779.13 to 3277.68)	1558.53 (593.68 to 2414.05)	-1344.00 (-2323.53 to -364.47)

Abbreviation: CI, Confidence intervals; DALY, disability-adjusted life year; GBD, Global burden of disease; IBD, Inflammatory bowel disease.

DISCUSSION

Key finding

This study assessed the burden of IBD across 34 Asian countries, from 1990 to 2023, using GBD 2023 estimates. Between 1990 and 2023, ASDR generally declined across all five Asian subregions, with the steepest decline observed in East Asia, whereas ASPR increased across all subregions. UC burden was highest in South Asia, whereas CD burden was highest in Central Asia, and UC prevalent cases peaked at older ages than CD in Central Asia and East Asia. Bangladesh was a notable outlier, with the highest national ASDR for overall IBD and the highest UC-specific ASDR in 2023. Age- and sex-specific analyses showed that DALY rates increased substantially with age across Asia, whereas prevalence peaked among individuals aged 40–65 years. South and East Asia had the greatest DALY burden in older populations. In East Asia, females aged 95 years and older had higher DALY rates than males and had higher prevalence rates. Joinpoint regression analyses, summarized using AAPC and segment-specific APC estimates, showed substantial heterogeneity in temporal trends across countries and subregions. ASPRs generally increased whereas ASDRs declined across most settings. Exceptions included Mauritius and Thailand, where ASDRs increased despite modest ASPR increases, and the Democratic People’s Republic of Korea and the Philippines, where ASPR AAPCs were negative. Decomposition analyses indicated that population growth and population aging were the main contributors to increasing prevalence and DALYs across most countries, whereas epidemiological change contributed positively to DALYs only in Mauritius and Thailand. Georgia consistently showed reductions in both DALYs and prevalence.

Comparison of previous studies

Previous GBD-based studies and regional meta-analyses have reported an increasing burden of IBD in Asia,[23] but most were based on earlier estimation cycles,[7] shorter observation periods, 6 or less detailed assessments of within-Asia heterogeneity by subregion,[23] subtype,[24] age, and sex.[25] The present study extends previous evidence by using GBD 2023 estimates across 34 Asian countries, evaluating overall IBD as well as UC and CD separately, and incorporating decomposition analyses within a unified analytical framework. These approaches allowed a more detailed assessment of regional and demographic heterogeneity than has been available in previous Asia-focused studies.

As each GBD cycle incorporates newly available data sources, updated systematic reviews, and methodological refinements within the disease-modelling framework, historical estimates may be revised across successive releases.[26,27] Consequently, burden estimates for the same country and year can differ between GBD cycles, reflecting changes in data inputs and model specification rather than true epidemiological change alone. Therefore, comparisons with findings from previous GBD releases should be interpreted cautiously.

An additional advantage of GBD 2023 is the extension of estimates through 2023 that enabled assessment of short-term trend changes before and during/post-COVID-19 pandemic that could not be fully evaluated using earlier GBD releases. Using β coefficients, we observed heterogeneous changes in UC and CD trends across regions before and during/post-COVID-19. However, these findings should be interpreted cautiously because the COVID-19 pandemic may have affected health-care utilization, endoscopy access, specialist referral, follow-up, and mortality reporting, thereby influencing disease ascertainment and burden estimation during 2020–2023.[28,29] Differences between GBD cycles likely reflect updated data inputs and methodological refinements rather than a distinct COVID-19 adjustment.

Plausible underlying mechanisms

Population growth was the main contributor to ASPR increases in Central Asia, South Asia, and Southeast Asia, whereas epidemiological change contributed most in East Asia and high-income Asia Pacific.[26] The concentration of prevalent burden in middle-to-older adulthood likely reflects the chronic nature of IBD and prolonged survival after diagnosis.[25] The epidemiological change component should be interpreted as residual change not explained by population growth or aging and may reflect variation in disease risk, diagnostic ascertainment, coding practices, health-care access, or model inputs.[26,27] In higher-resource settings, this pattern may partly reflect earlier diagnosis, improved survival, and better long-term disease control.[30] However, in settings with limited endoscopy access or sparse epidemiological data, declining ASDRs may also reflect under-ascertainment, modelled severity distributions, or data limitations rather than direct improvements in patient-level disability.[31]

The decline in ASDR observed even in settings with minimal access to biologic therapy, such as Kyrgyzstan and Tajikistan, suggests that improved treatment alone cannot fully explain these trends and may partly reflect disability-weight specification and model-based estimation in data-sparse settings.[2,32] Bangladesh was a notable outlier, with the highest national ASDR for overall IBD and the highest UC-specific ASDR in 2023.[26] Although this may indicate substantial UC-related disability burden, it may also reflect limited case ascertainment, mortality inputs, or model assumptions and should therefore be interpreted cautiously. Declining ASPR in the Democratic People’s Republic of Korea should be interpreted cautiously because estimates may be more strongly influenced by sparse source data and model-based estimation within the GBD framework.[33] In contrast, declining ASPR in the Philippines may reflect variation in specialist access, endoscopy availability, and geographic heterogeneity in disease ascertainment.[34] Georgia’s reductions in both DALYs and prevalence should likewise be interpreted descriptively, given the limited primary data available, and may reflect differences in demographic change, data availability, or model inputs rather than a true decline in disease burden.

The oldest-age female predominance observed in East Asia should be interpreted cautiously because the UIs were wide.[25] This pattern may reflect longer female life expectancy, resulting in greater survival of frail individuals into the oldest age groups, as well as cohort effects related to historical differences in diagnostic practices and health-care access. Post-menopausal hormonal influences, sex-specific frailty, comorbidity burden, and patterns of health-care utilization may also contribute. Given the wide UIs and the limitations of GBD-based estimates in the oldest age groups, this finding should be regarded as hypothesis-generating rather than a definitive female-specific risk pattern.[35,36]

Clinical and policy implications

The growing burden and marked heterogeneity of IBD across Asia support policy responses stratified by burden pattern and health-system capacity.[12] First, countries with high ASPR, such as the Republic of Korea,[37] require long-term chronic disease management rather than case detection alone. Policy priorities include sustainable access to maintenance therapy,[30] biosimilar uptake, reduction of regional disparities in specialist access,[31] registry-based monitoring, and incorporation of patient-reported outcomes into routine care.[30] As ASPR is increasing even where ASDRs are declining,[12] these systems will face a growing long-term care burden despite possible reductions in severe outcomes. Second, countries with high ASDRs or high incidence and mortality, particularly in South Asia, require different priorities.[12] South Asia had the highest overall prevalence burden, whereas Bangladesh had the highest national ASDR and the highest UC-specific ASDR in 2023. In these settings, policy should focus on earlier diagnosis,[31] basic endoscopy and histopathology capacity, essential IBD medication availability, referral pathways, and affordable long-term follow-up, because expanding advanced therapies alone would be insufficient if diagnostic delay and basic care gaps remain unresolved.[6] Financial protection should also be considered part of IBD care, because long-term disease management can impose substantial financial burdens on both patients and health systems.

In higher-resource settings, biosimilar and reimbursement policies may improve access to effective therapy,[30] but lower-resource settings should prioritize diagnostic capacity, referral systems, and essential IBD medication availability.[31] In lower-middle-income and resource-constrained settings, structural replication of high-income models is not feasible; priorities should instead centre on a minimum essential package of IBD care, simplified diagnostic and referral pathways, and sentinel surveillance at selected centres in place of comprehensive national registries.[32] For countries with unexpected trend or decomposition patterns, such as Mauritius, Thailand, the Democratic People’s Republic of Korea, and the Philippines, stronger surveillance is needed before firm policy conclusions are drawn.[12] Priorities include strengthening population-based registries,[27] improving data linkage, and standardizing separate reporting of UC and CD.[7] Workforce planning should also account for the increasing burden in older age groups.[25] Subtype-specific service planning is also needed because CD and UC differ in clinical course,[38] monitoring needs, treatment intensity, and long-term complications. Since GBD does not directly capture disease phenotype, severity or treatment patterns, these implications should be interpreted cautiously and validated using clinical registry data.[12]

Limitations

Several limitations inherent to the methodology should be acknowledged. First, data availability varied widely across countries.[12,39] In settings with limited or absent primary data, particularly in some parts of Central Asia, GBD estimates relied more heavily on meta-regression models informed by predictive covariates and past trends.[12,39] Therefore, country-specific point estimates and trend metrics, particularly for data-sparse settings in Central Asia, should be interpreted with less evidentiary weight than estimates from countries with more complete clinical, registry, claims, or mortality data.[39] Second, although endoscopy with histopathology is the clinical gold standard for IBD diagnosis, many GBD input data sources include administrative claims and hospital discharge data. In Asian settings where intestinal tuberculosis, amoebiasis, and other infectious or inflammatory mimics are prevalent, administrative coding may be vulnerable to misclassification, especially for CD.[31,40,41,42] Third, the GBD framework currently attributes IBD burden to a limited set of risk factors. Important environmental and behavioral drivers relevant to Asia are not fully represented in the current attributable burden framework that may limit interpretation of the factors underlying observed temporal trends.[7] Fourth, although GBD provides comprehensive aggregate estimates, the lack of granularity regarding disease behavior, such as stricturing or penetrating disease, disease extent, treatment exposure, and severity, limits direct alignment with current clinical risk stratification.[6,7] Fifth, unlike conditions with well-established screening programs, the quality of IBD data is highly dependent on access to specialized gastroenterology care.[12] Consequently, observed burden patterns in data-sparse or resource-constrained settings, including Bangladesh, the Democratic People’s Republic of Korea, and the Philippines, may reflect underdiagnosis, limited diagnostic capacity, sparse source data, or changes in model inputs rather than true epidemiological differences. Case ascertainment may differ substantially according to specialist access, claims infrastructure, and registry availability.[6,27] Moreover, these settings differ considerably in health-system organization, diagnostic capacity, and data availability; therefore, similar burden patterns should not be assumed to arise from the same underlying mechanisms. Sixth, DALY-based interpretation may be limited because GBD disability weights may not fully capture chronic active disease, extraintestinal manifestations, surgical morbidity, or long-term functional impairment.[35,43] If disability weights underestimate IBD-related morbidity, YLDs, and DALYs may also be underestimated; therefore, declining ASDRs should not be interpreted as direct evidence of improved patient-level disability. Seventh, decomposition findings should be interpreted as descriptive rather than causal. Although bootstrap-derived confidence intervals and period-specific sensitivity analyses were performed, formal comparisons using alternative decomposition approaches, such as Kitagawa decomposition, were not conducted. Therefore, the robustness of the findings across different decomposition frameworks could not be evaluated.[15] Eighth, the GBD regional classification used in this study does not fully align with conventional geographic definitions of Asia because Mauritius and Seychelles are included according to the official GBD regional framework. Consequently, regional estimates should be interpreted within the context of the GBD classification, and comparisons with studies using conventional geographic definitions of Asia should be made with caution. Finally, estimates for the most recent years should be interpreted cautiously because the COVID-19 pandemic may have affected health-care utilization, diagnostic access, and mortality reporting.[28,29] Cross-cycle comparisons with GBD 2021 or GBD 2017 should also be interpreted cautiously because observed differences may reflect revised inputs, correction procedures, and modelling assumptions, in addition to true epidemiological change.[12,39]

CONCLUSION

This study provides a comprehensive assessment of the burden of IBD across 34 Asian countries and five GBD-defined Asian subregions, from 1990 to 2023, using the GBD 2023 framework. IBD burden in Asia increased between 1990 and 2023, with substantial heterogeneity across countries and regions. While ASDR generally declined, ASPR increased in most settings, indicating a growing long-term disease burden. Population growth and population aging were the primary drivers of these trends, with additional variation attributable to epidemiological change in selected countries. These findings highlight the need for region-specific strategies to strengthen IBD surveillance, early diagnosis, and long-term disease management across Asia. Future research should focus on strengthening surveillance systems and improving the availability of high-quality epidemiological data across Asia.

Conflicts of interest

There are no conflicts of interest.

Supplementary materials

Available at: https://links.lww.com/SJGA/A129

Figure S1a

Decomposition analysis of the percentage change in the number of (A) DALYs and (B) prevalence due to IBD between 1990 and 2023 in Asia. Abbreviation: DALYs, disability-adjusted life years; IBD, inflammatory bowel disease

Figure S1b

Decomposition analysis of the percentage change in the number of (A) DALYs and (B) prevalence due to IBD between 1990 and 2023 in Asia. Abbreviation: DALYs, disability-adjusted life years; IBD, inflammatory bowel disease

Figure S2a

Decomposition analysis of the percentage change in the number of (A) DALYs and (B) prevalence due to IBD between 1990 and 2019 in Asia. Abbreviation: DALYs, disability-adjusted life years; IBD, inflammatory bowel disease

Figure S2b

Decomposition analysis of the percentage change in the number of (A) DALYs and (B) prevalence due to IBD between 1990 and 2019 in Asia. Abbreviation: DALYs, disability-adjusted life years; IBD, inflammatory bowel disease

Figure S3a

Decomposition analysis of the percentage change in the number of (A) DALYs and (B) prevalence due to IBD between 2019 and 2023 in Asia. Abbreviation: DALYs, disability-adjusted life years; IBD, inflammatory bowel disease

Figure S3b

Decomposition analysis of the percentage change in the number of (A) DALYs and (B) prevalence due to IBD between 2019 and 2023 in Asia. Abbreviation: DALYs, disability-adjusted life years; IBD, inflammatory bowel disease

Supplementary Material

Original Article

Global burden of inflammatory bowel disease in Asia, 1990-2023: a Global Burden of Disease Study 2023

Running title: Inflammatory bowel disease in Asia

Hayoon Jung^1,2†, Jaehee Yoon^1,3†, Jaeyu Park^1,3, Yejun Son^1,3, Tae Hyeong Kim⁴, Dong Keon Yon^1,2,3,5*

†These authors contributed equally as first authors.

*Corresponding author

Dong Keon Yon, MD, PhD, FACAAI, FAAAAI, ATSF (lead contact)

Department of Pediatrics, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, South Korea

Email: yonkkang@gmail.com

Table of Contents

1. Supplementary Methods ………………………………………………………………… 5

2. Supplementary Figures…………………………………………………………………… 8

Figure S1. Decomposition analysis of the percentage change in the number of (A) DALYs and (B) prevalence due to IBD between 1990 and 2023 in Asia. Abbreviation: DALYs, disability-adjusted life years; IBD, inflammatory bowel disease.

Figure S2. Decomposition analysis of the percentage change in the number of (A) DALYs and (B) prevalence due to IBD between 1990 and 2019 in Asia. Abbreviation: DALYs, disability-adjusted life years; IBD, inflammatory bowel disease.

Figure S3. Decomposition analysis of the percentage change in the number of (A) DALYs and (B) prevalence due to IBD between 2019 and 2023 in Asia. Abbreviation: DALYs, disability-adjusted life years; IBD, inflammatory bowel disease.

3. Supplementary Tables …………………………………………………………………. 14

Table S1. Age-standardized DALY and prevalence rates (95% UI, per 100,000 population) for UC in 1990 and 2023, with β coefficients (95% CI) for pre-COVID-19 (2015-2019) and during/post-COVID-19 (2019-2023) trends in UC across five GBD regions and 34 Asian countries

Table S2. Age-standardized DALY and prevalence rates (95% UI, per 100,000 population) in 1990 and 2023, with β coefficients (95% CI) for pre-COVID-19 (2015-2019) and during/post-COVID-19 (2019-2023) trends in CD across five GBD regions and 34 Asian countries.

Table S3. Trends in age-standardized DALY and prevalence rates of IBD across five GBD regions of Asia, 1990 to 2023 (95% UI, per 100,000 population).

Table S4. Trends in age-standardized DALY and prevalence rates of UC across five GBD regions of Asia, 1990 to 2023 (95% UI, per 100,000 population).

Table S5. Trends in age-standardized DALY and prevalence rates of CD across five GBD regions of Asia, 1990 to 2023 (95% UI, per 100,000 population).

Table S6. Joinpoint regression analysis of age-standardized DALY rates for IBD across 34 Asian countries and five regions, 1990 to 2023: APCs and AAPCs with 95% CIs.

Table S7. Joinpoint regression analysis of age-standardized Prevalence rates for IBD across 34 Asian countries and five regions, 1990 to 2023: APCs and AAPCs with 95% CIs.

Table S8. Joinpoint regression analysis of age-standardized DALY rates for UC across 34 Asian countries and five regions, 1990 to 2023: APCs and AAPCs with 95% CIs.

Table S9. Joinpoint regression analysis of age-standardized Prevalence rates for UC across 34 Asian countries and five regions, 1990 to 2023: APCs and AAPCs with 95% CIs.

Table S10. Joinpoint regression analysis of age-standardized DALY rates for CD across 34 Asian countries and five regions, 1990 to 2023: APCs and AAPCs with 95% CIs.

Table S11. Joinpoint regression analysis of age-standardized Prevalence rates for CD across 34 Asian countries and five regions, 1990 to 2023: APCs and AAPCs with 95% CIs.

Table S12. Age-specific DALY and prevalence rates of IBD by sex across the five GBD regions of Asia in 1990 and 2023 (95% UI).

Table S13. Age- and sex-specific DALY and prevalence counts for UC across the five GBD regions of Asia in 2023 (95% UI).

Table S14. Age- and sex-specific DALY and prevalence counts for CD across the five GBD regions of Asia in 2023 (95% UI).

Table S15. Decomposition of percentage changes in DALY due to IBD among males across the five GBD regions and 34 Asian countries, 1990-2023 (95% CIs).

Table S16. Decomposition of percentage changes in DALY due to IBD among females across the five GBD regions and 34 Asian countries, 1990-2023 (95% CIs).

Table S17. Decomposition of percentage changes in Prevalence due to IBD among males across the five GBD regions and 34 Asian countries, 1990-2023 (95% CIs).

Table S18. Decomposition of percentage changes in Prevalence due to IBD among females across the five GBD regions and 34 Asian countries, 1990-2023 (95% CIs).

Table S19. Decomposition of percentage changes in DALYs due to IBD across the five GBD regions and 34 Asian countries, 1990-2023 (95% CIs).

Table S20. Decomposition of percentage changes in Prevalence due to IBD across the five GBD regions and 34 Asian countries, 1990-2023 (95% CIs).

Table S21. Decomposition of effects on DALYs due to IBD across the five GBD regions and 34 Asian countries, 1990-2019 (95% CIs).

Table S22. Decomposition of effects on Prevalence due to IBD across the five GBD regions and 34 Asian countries, 1990-2019 (95% CIs).

Table S23. Decomposition of effects on DALYs due to IBD across the five GBD regions and 34 Asian countries, 2019-2023 (95% CIs).

Table S24. Decomposition of effects on Prevalence due to IBD across the five GBD regions and 34 Asian countries, 2019-2023 (95% CIs).

3. References…………………………………………………………………….…………199

Supplementary Methods

Overview

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is a large international collaborative effort involving more than 14,000 researchers and experts worldwide that quantifies morbidity and mortality across diseases, injuries, and risk factors. Key metrics used in this study include incidence, prevalence, cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs).¹ GBD 2023 was conducted in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).² Standardized modeling frameworks were applied to generate estimates stratified by location, age, sex, and calendar year for the global population. For each analytical step, between 500 and 1,000 Monte Carlo simulations were performed, and uncertainty was quantified using 95% uncertainty intervals (UIs), defined by the 2.5th and 97.5th percentiles of the simulated distributions.¹ Annualized rates of change were calculated based on the natural logarithm of prevalence, DALY, and mortality rates to assess temporal trends. Age-standardized rates were computed using the GBD 2023 global standard population to enable comparisons across populations and time periods.³

All data used in this study were obtained from publicly available GBD 2023 resources maintained by the Institute for Health Metrics and Evaluation (IHME).¹ Detailed information regarding input data sources, model development, model evaluation, uncertainty estimation, and data accessibility is available in the GBD 2023 methodological publications and through the Global Health Data Exchange (GHDx). The findings reported in this study were generated using data available from public online repositories, and the data used in these analyses can be accessed through the GBD 2023 data resources (https://ghdx.healthdata.org/gbd-2023). A completed GATHER checklist covering all 18 reporting items is provided in the Guidelines for GATHER.

Geographical locations

GBD region	Countries
Central Asia	Georgia, Kyrgyzstan, Mongolia, Armenia, Azerbaijan, Kazakhstan, Tajikistan, Uzbekistan, Turkmenistan
East Asia	Democratic People’s Republic of Korea, China, Taiwan (Province of China)
High-income Asia Pacific	Brunei Darussalam, Japan, Republic of Korea, Singapore
South Asia	Nepal, Pakistan, Bhutan, Bangladesh, India
Southeast Asia	Timor-Leste, Sri Lanka, Cambodia, Thailand, Lao People’s Democratic Republic, Malaysia, Indonesia, Maldives, Mauritius, Seychelles, Philippines, Myanmar, Viet Nam

Guidelines for GATHER

This study followed the GATHER recommendations, with transparent documentation of all analytical procedures and data sources.

Item #	Checklist item	Reported on page #
Objectives and funding
1	Define the indicator(s), populations (including age, sex, and geographic entities), and time period(s) for which estimates were made.	Introduction and Methods
2	List the funding sources for the work.	Introduction and Methods
Data Inputs
For all data inputs from multiple sources that are synthesized as part of the study:
3	Describe how the data were identified and how the data were accessed.	Methods
4	Specify the inclusion and exclusion criteria. Identify all ad-hoc exclusions.	Methods
5	Provide information on all included data sources and their main characteristics. For each data source used, report reference information or contact name/institution, population represented, data collection method, year(s) of data collection, sex and age range, diagnostic criteria or measurement method, and sample size, as relevant.	Methods
6	Identify and describe any categories of input data that have potentially important biases (e.g., based on characteristics listed in item 5).	Methods
For data inputs that contribute to the analysis but were not synthesized as part of the study:
7	Describe and give sources for any other data inputs.	Methods
For all data inputs:
8	Provide all data inputs in a file format from which data can be efficiently extracted (e.g., a spreadsheet rather than a PDF), including all relevant meta-data listed in item 5. For any data inputs that cannot be shared because of ethical or legal reasons, such as third-party ownership, provide a contact name or the name of the institution that retains the right to the data.	Methods
Data analysis
9	Provide a conceptual overview of the data analysis method. A diagram may be helpful.	Methods
10	Provide a detailed description of all steps of the analysis, including mathematical formulae. This description should cover, as relevant, data cleaning, data pre-processing, data adjustments and weighting of data sources, and mathematical or statistical model(s).	Methods
11	Describe how candidate models were evaluated and how the final model(s) were selected.	Methods
12	Provide the results of an evaluation of model performance, if done, as well as the results of any relevant sensitivity analysis.	Methods
13	Describe methods for calculating uncertainty of the estimates. State which sources of uncertainty were, and were not, accounted for in the uncertainty analysis.	Methods
14	State how analytic or statistical source code used to generate estimates can be accessed.	Methods
Results and Discussion
15	Provide published estimates in a file format from which data can be efficiently extracted.	Results and Discussion
16	Report a quantitative measure of the uncertainty of the estimates (e.g. uncertainty intervals).	Results and Discussion
17	Interpret results in light of existing evidence. If updating a previous set of estimates, describe the reasons for changes in estimates.	Results and Discussion
18	Discuss limitations of the estimates. Include a discussion of any modelling assumptions or data limitations that affect interpretation of the estimates.	Discussion

Funding Statement

This study received funding from the Ministry of Science and ICT of the Republic of Korea (RS-2026-25495984) and the Ministry of Health and Welfare (RS-2025-02220492). The funding agencies were not involved in the study design, data acquisition, analysis, interpretation, or the preparation of the manuscript. All authors had full access to the data and were solely responsible for the decision to submit the manuscript for publication.