Epidemiology and burden of asthma in Saudi Arabia: A national secondary data analysis from the Global Asthma Network survey

OBJECTIVES: Asthma represents a significant public health challenge in Saudi Arabia, with prevalence rates among the highest in the Eastern Mediterranean Region. This study aimed to analyze the epidemiological burden, regional variations, and risk factors associated with asthma across different age groups in Saudi Arabia using nationally representative data from the Global Asthma Network (GAN) Phase I survey. METHODS: We conducted a secondary analysis of data from the GAN Phase I national cross-sectional survey (2019–2020), which included 15,910 participants (3817 children aged 6–7 years, 4138 adolescents aged 13–14 years, and 7955 adults aged ≥18 years) from 277 schools and community centers across all 20 administrative regions of Saudi Arabia. Asthma prevalence was determined using standardized International Study of Asthma and Allergies in Childhood-derived questionnaires. Data from the Saudi Health Interview Survey (2013) and systematic reviews were incorporated for trend analysis. The Chi-square tests and multivariable logistic regression were employed to identify risk factors, with significance set at P < 0.05 and odds ratios reported with 95% confidence intervals (CIs). RESULTS: Current wheeze prevalence was 10.4% (95% CI: 9.4–11.4) among children, 13.3% (95% CI: 12.2–14.4) among adolescents, and 14.2% (95% CI: 13.4–15.0) among adults. Physician-diagnosed asthma prevalence was 13.8% in children and 15.7% in adolescents. Males showed higher prevalence than females in pediatric groups (11.5% vs. 9.6% in children, P = 0.038; 16.1% vs. 10.4% in adolescents, P < 0.001). Among adults, females had higher rates (15.8% vs. 12.6%, P = 0.002). Severe asthma affected 5.2% of children and 5.6% of adolescents. Regional analysis revealed significant geographic variation ( P < 0.001), with the highest prevalence in Al-Hofuf (33.7%), Rabigh (31.5%), and Jazan (30.9%), and lowest in Abha (9.0%). Significant risk factors included antibiotic use in the first year of life (adjusted odds ratio [aOR]: 1.8, 95% CI: 1.4–2.3), history of pneumonia (aOR: 6.3, 95% CI: 4.2–9.5), frequent paracetamol use (aOR: 2.5, 95% CI: 1.9–3.3), tobacco exposure (aOR: 2.7, 95% CI: 2.1–3.5), and moisture exposure (aOR: 2.2, 95% CI: 1.7–2.9). Only 53% of children and 32.4% of adolescents had written asthma action plans. CONCLUSIONS: Saudi Arabia exhibits high asthma prevalence comparable to developed nations, with substantial regional heterogeneity and suboptimal disease management. These findings support prioritization of asthma control programs within Saudi Vision 2030’s noncommunicable disease reduction framework, particularly targeting high-burden regions and improving guideline-based care delivery.