Trends in asthma incidence and prevalence in 2 million children and adolescents in Catalonia, Spain, 2010-2024: a population-based cohort study

Anna Palomar-Cros; Alicia Abellan; Berta Raventós; Andrea Pistillo; Carlen Reyes; Agustina Guiliodori; Laura Granés; Juan Luís García Rivero; Katia Mc Verhamme; Elena Roel; Talita Duarte-Salles

doi:10.1136/thorax-2026-224985

Trends in asthma incidence and prevalence in 2 million children and adolescents in Catalonia, Spain, 2010-2024: a population-based cohort study

Thorax. 2026 Jun 8:thorax-2026-224985. doi: 10.1136/thorax-2026-224985. Online ahead of print.

Authors

Affiliations

¹ Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
² RTI Health Solutions Barcelona, Barcelona, Spain.
³ Department of Medical Informatics, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
⁴ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
⁵ Sardenya Primary Health Care Center, EAP Sardenya-Research Institute Sant Pau (IR Sant Pau), Barcelona, Spain.
⁶ Respiratory Department, Marqués de Valdecilla University Hospital. IDIVAL, Santander, Spain.
⁷ Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain tduarte@idiapjgol.org.

PMID: 42259635
DOI: 10.1136/thorax-2026-224985

Abstract

Background: Asthma represents a major public health concern in childhood and adolescence. However, population-based estimates of trends in its epidemiology in Spain are limited.

Methods: We conducted a population-based cohort study using primary care electronic health records in Catalonia, Spain, from 2010 to 2024. Asthma diagnoses, ascertained through Systematized Nomenclature of Medicine (SNOMED) codes, were leveraged to estimate annual incidence rates (IR) and prevalence among children aged 1-17 years. Results were stratified by sex, age and Socioeconomic Deprivation Index (SDI). Incidence rate ratios (IRR) were estimated to investigate differences in overall incidence of asthma in these sociodemographic groups. Joinpoint modelling was used to investigate time trends in incidence.

Results: We included 2 001 625 individuals (48.40% females, median age 7 years). Crude IR of asthma (2010-2024) was 687.46 (95% CI 683.09 to 691.85) per 100 000 person-years. Incidence was highest in males (IRR=1.35, 95% CI 1.33 to 1.37, vs females) until adolescence, after which the pattern reversed, youngest individuals (IRR=3.03 95% CI 2.96 to 3.11, for 1-4 versus 15-17) and in individuals living in the most deprived areas (IRR=1.14, 95% CI 1.11 to 1.16, vs least deprived SDI quintile). Incidence declined before the COVID-19 pandemic, dropped sharply during it, and then increased among children aged 5-14 years post-pandemic, while consistently decreased in children aged 1-4 years. Asthma prevalence showed an upward trend until 2019 followed by stabilisation until 2024, when its prevalence was 7.36% (7.3%-7.41%).

Conclusion: Asthma remains a major public health burden in children and adolescents, with incidence and prevalence varying by age, sex and socioeconomic status, making continuous monitoring essential to guide prevention.

Keywords: Asthma Epidemiology; Asthma in primary care; Paediatric asthma.