Global Burden of Disease of interstitial lung disease and pulmonary sarcoidosis in adolescents and young adults (1990–2019)

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Adolescents and young adults (AYAs) aged 15–39 years are frequently overlooked in global burden estimates despite their unique epidemiological and societal implications. Comprehensive global burden estimates are lacking. To address this gap, we analysed the results of the Global Burden of Disease Study (GBD) 2019, focusing on Disability-Adjusted Life Years (DALYs). Methods: Using the GBD 2019 dataset, we calculated age-standardised rate of incidence, mortality, and DALYs and their average annual percentage change from 1990–2019 across various factors, including sex, socio-demographic index (SDI), and geographic region. Decomposition analyses explored the impacts of population growth, changing age structures, and epidemiological changes on ILD incidence, DALYs, and mortality in AYAs globally and across different SDI and GBD regions. Results: In 2019, there were 2.6 million cases of ILD and pulmonary sarcoidosis in AYAs, and 3,428 deaths were attributed to these diseases. Age-standardised incidence and DALY rates significantly increased between 1990 and 2019. Females experienced higher rates than males. Standardised DALY rates decreased in high and middle–high SDI countries but increased in low, middle–low, and low-SDI countries. The primary reason was population growth, significantly impacting areas in the lower SDI quintiles. Conclusions: This study provides recent epidemiological data on the burden of ILD and pulmonary sarcoidosis in AYAs. These findings highlight the importance of targeted control measures to reduce the burden in this age group. burden adolescents and young adults incidence DALYs death trend Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Introduction Interstitial lung diseases (ILD), also known as pulmonary fibrosis, are a group of clinically recognised disorders that lead to interstitial scarring, also referred to as pulmonary fibrosis [1,2]. ILD is classified based on its aetiology and includes connective tissue disease-associated ILD (CTD-ILD), hypersensitivity pneumonitis, drug-induced ILD, post-infectious ILD, and idiopathic interstitial pneumonia. These diseases share similar clinical features but are distinguished by their unique histopathological manifestations and findings. The most common ILDs are idiopathic pulmonary fibrosis (IPF) (>30% of ILD cases), hypersensitivity pneumonitis (approximately 15% of ILD cases), and connective tissue disease (CTD) (approximately 25% of ILD cases). Other ILDs include pharmacological and post-infectious ILD (e.g., post-covid disease 2019) [3]. Approximately 14% of newly diagnosed patients with IPF have pulmonary hypertension [4], and this figure increases to approximately 86% in patients with pulmonary fibrosis awaiting lung transplantation [5,6]. The overall prevalence of ILD in the United States is approximately 200 per 100,000 people, and has increased by 19.1% over the past decade, coinciding with an ageing population [7,8]. Although nodular disease is classified as ILD, it exhibits various pulmonary symptoms, including airway obstruction [9,10], with an incidence of 126–160 per 100,000 people [11] and as high as 519 per 100,000 people in African American women [12]. Pulmonary sarcoidosis is a disorder characterised by an unexplained inflammatory granulomatous disease that affects a large proportion of the global population, ranging from 2–160 per 100,000 people, and can affect any organ in the body. While some patients with pulmonary sarcoidosis may experience spontaneous remission without significant consequences, others may experience disease progression, leading to fibrocystic structures of the lungs being distorted. This progression is associated with a 12–18% mortality rate over 5 years. Overall, the mortality rate of pulmonary sarcoidosis is approximately 7% at 5 years, with over 60% of deaths attributed to lung involvement [13]. Due to the diagnostic complexity of pulmonary sarcoidosis, the financial burden and stress on patients increase the challenges faced by individuals with this disease [14,15]. The burden of ILD and pulmonary sarcoidosis is unevenly distributed across age groups, with adolescents and young adults (AYAs) categorised as individuals aged 15–39 years, facing unique challenges. Although the prevalence of ILD and pulmonary sarcoidosis may be lower in adolescents than in older adults, their impact on the loss of healthy life expectancy is disproportionately high [16,17]. Using data from the Global Burden of Disease (GBD) Study 2019, this study investigated the global impact of ILD and pulmonary sarcoidosis on AYAs between 1990 and 2019. These diseases affect respiratory function, cause various symptoms, and seriously impact lung health. This study aimed to investigate the progression of these diseases in this age group, providing valuable insights into international patterns and differences in geography, age, and sex. This analysis is essential for developing focused public health interventions and improving the well-being of AYAs. Materials and methods Data source The Institute for Health Metrics and Evaluation conducted a GBD study that provides a systematic scientific assessment of the prevalence, incidence, and mortality of diseases and injuries. The GBD 2019 study offers a comprehensive epidemiological assessment of the burden of 369 diseases and injuries across 204 countries and territories. Our study focused on patients with ILD and pulmonary sarcoidosis with an age onset of 15–39 years, using data from the Global Health Data Exchange (GHD) at https://ghdx.healthdata.org. Age-, sex-, and region-specific incidence, DALY, and mortality rates for ILD and pulmonary nodular disease in the 15–39-year age group were obtained from the GHD. Patient informed consent was not required to access the use of GHDx data. D efinition Interstitial lung disease (ILD) and pulmonary sarcoidosis are long-term respiratory conditions that impact lung function and oxygen absorption as a result of scarring and inflammation. The ICD-10 codes for these conditions are D86 to D86.2 and D86.9, and J84 to J84.9, respectively. In contrast, the ICD-9 codes range from 135 to 135.9 and 515 to 516.9. It is important to note that this classification specifically does not include lung disorders caused by external factors, drug-induced interstitial lung issues, systemic or rheumatic diseases, or any other conditions leading to ILD. Statistical analyses Age-standardised rates and their corresponding 95% confidence intervals (CIs) were calculated using the world standard population, as shown in the GBD Study 2019 [18]. Age-standardised rates for each indicator in the population aged 15–39 years were calculated using direct standardisation based on the world population [19]. The rates are expressed per 100,000 people. To assess the trends in the incidence, DALYs, and mortality associated with ILD and pulmonary sarcoidosis in AYAs, we calculated the mean annual percentage changes and corresponding 95% CIs using joint-point regression [20]. Comparisons were made based on sex and socio-demographic indices (SDI) divided into five groups. Detailed information on SDI is available in the Supplementary Material. Least-squares regression and generalised additive models were used to explore potential linear or non-linear associations between SDI and age-standardised incidence rate(ASIR), age-standardised mortality rates(ASMR), and age-standardised DALY rate. Pearson's correlation analyses were used to determine the strength and direction of the relationships between the covariates. Decomposition analyses were used to calculate the impact of population growth, age-structural changes, and epidemiological changes on the burden of ILD and pulmonary sarcoidosis in young sex-specific populations, with a special focus on global, SDI, and GBD regions [21]. All statistical analyses and graphical representations were generated using R version 4.2.1. The R program V.3.6.3 was used for derivative analyses and plotting, with the significance level set at P < 0.05. Results Global distribution of ILD and pulmonary sarcoidosis in AYAs in 2019 In 2019, there were 2.6 million (95% CI: 1.5–4.4) cases of ILD and pulmonary sarcoidosis in AYAs, with 3,428 (2,759–4,266) deaths from these conditions in this age group. The global age-standardised incidence, DALY, and mortality rates per 100,000 population were 87.58 (95% CI: 51.66–140.35), 8.02 (95% CI: 6.45–9.96), and 0.11 (95% CI: 0.09–0.14), respectively. When grouped based on SDI, low-index countries had the highest age-standardised prevalence rates (100.28, 95% CI: 58.28–162.21), while middle-index countries had the lowest age-standardised prevalence rates (72.64, 95% CI: 42.27–117.46). Similarly, age-standardised DALY rates were highest in low- and middle-index countries (10.64, 95% CI: 7.84–14.57) and lowest in high- and middle-index countries (6.01, 95% CI: 4.76–7.46). ASMR were also highest in low- and middle-index countries (0.16, 95% CI: 0.11–0.23) and lowest in high- and middle-index countries (0.08, 95% CI: 0.06–0.09). Oceania and Andean Latin America showed the greatest burden of ILD and pulmonary sarcoidosis among AYAs, with Belize having the highest age-standardised incidence, DALY, and mortality rates (Tables 1–6, Appendix Tables 1–12). Countries in Andean Latin America and Oceania DALYs were concentrated in the highest quintile. Eastern and Central Europe, as well as Oceania and Andean Latin America, were in the highest quintile (Fig. 2). Age-standardised incidence rates were higher for women (87.77) than for men (86.77), while age-standardised DALY and mortality rates were higher for men (8.76% and 0.13%, respectively) than for women (7.26 and 0.10, respectively). Table 1.ASIR of interstitial lung disease and pulmonary sarcoidosis in adolescents and young adults in 1990 and 2019 for all locations, with AAPC from 2009 and 2019 location Numbers in 1990 Numbers in 2019 Age-standardized rates in 1990 (95% CI) Age standardized rates in 2019 (95% CI) AAPC, % (95% CI) P Global 1746787.83 (1016491.09,2837214.13) 2636440.02 (1556551.44,4221375.39) 83.56 ( 48.79,135.72) 87.58 ( 51.66,140.35) 0.18 ( 0.07, 0.28) 0.001 High SDI 337700.61 ( 197203.24, 549884.24) 354191.55 ( 214997.59, 553860.74) 100.52 ( 58.59,163.77) 97.65 ( 59.03,152.65) -0.07 (-0.18, 0.03) 0.153 High-middle SDI 459067.28 ( 268523.26, 746674.73) 488396.59 ( 288670.17, 782859.18) 94.80 ( 55.45,154.21) 84.91 ( 49.93,136.31) -0.37 (-0.45,-0.28) 0 Middle SDI 436550.35 ( 249229.39, 715759.10) 701436.91 ( 409141.71,1132569.94) 62.84 ( 36.08,103.01) 72.64 ( 42.27,117.46) 0.51 ( 0.43, 0.58) 0 Low-middle SDI 349601.77 ( 203062.60, 564305.94) 682706.64 ( 399423.20,1099344.97) 86.31 ( 50.48,139.28) 96.51 ( 56.62,155.47) 0.39 ( 0.34, 0.45) 0 Low SDI 163209.94 ( 94207.09, 262156.17) 408354.84 ( 235546.37, 660187.70) 92.52 ( 53.79,148.53) 100.28 ( 58.28,162.21) 0.29 ( 0.25, 0.32) 0 Andean Latin America 10429.40 ( 6080.51, 16668.23) 23243.18 ( 14026.66, 36672.80) 74.97 ( 44.04,119.84) 91.92 ( 55.50,145.08) 0.68 ( 0.58, 0.79) 0 Australasia 6050.27 ( 3491.86, 9907.45) 7063.00 ( 4082.02, 11402.57) 72.53 ( 41.79,118.77) 68.52 ( 39.46,110.74) -0.19 (-0.21,-0.18) 0 Caribbean 6931.01 ( 3907.90, 11386.36) 10147.41 ( 5836.49, 16625.93) 50.55 ( 28.68, 83.18) 56.16 ( 32.30, 92.13) 0.36 ( 0.34, 0.38) 0 Central Asia 30285.68 ( 17894.31, 48163.35) 44829.73 ( 26549.70, 72091.28) 111.97 ( 66.41,178.72) 114.96 ( 67.99,185.41) 0.10 ( 0.01, 0.18) 0.025 Central Europe 91333.54 ( 54076.35, 147551.33) 84815.45 ( 51887.02, 131948.02) 186.60 (110.11,301.00) 206.01 (125.54,320.17) 0.38 ( 0.23, 0.53) 0 Central Latin America 39504.96 ( 22435.50, 65610.59) 55635.46 ( 32728.57, 89975.06) 64.27 ( 36.74,106.99) 55.66 ( 32.76, 90.00) -0.51 (-0.59,-0.44) 0 Central Sub-Saharan Africa 17470.91 ( 10005.80, 28356.54) 47150.76 ( 27019.82, 75988.40) 91.76 ( 52.95,149.22) 98.90 ( 57.09,159.33) 0.26 ( 0.20, 0.33) 0 East Asia 230600.81 ( 128599.91, 390031.47) 177996.75 ( 102520.65, 290334.57) 42.66 ( 23.88, 72.02) 31.06 ( 17.75, 50.95) -1.08 (-1.23,-0.93) 0 Eastern Europe 191545.19 ( 113401.51, 307410.91) 172448.72 ( 101544.74, 279064.78) 206.31 (121.70,331.37) 213.54 (124.93,345.27) 0.14 ( 0.03, 0.24) 0.011 Eastern Sub-Saharan Africa 54630.25 ( 31306.52, 88352.68) 136856.04 ( 78123.24, 222034.23) 85.93 ( 49.64,139.19) 90.38 ( 51.99,146.81) 0.19 ( 0.15, 0.23) 0 High-income Asia Pacific 64406.64 ( 36702.16, 105710.30) 48847.00 ( 28468.58, 79573.66) 95.05 ( 54.17,155.71) 87.25 ( 50.67,141.59) -0.27 (-0.36,-0.19) 0 High-income North America 216476.57 ( 127378.30, 354553.40) 207387.43 ( 126862.56, 320047.92) 178.29 (104.63,292.25) 162.04 ( 99.00,249.89) -0.28 (-0.51,-0.04) 0.019 North Africa and Middle East 154924.19 ( 89554.54, 250027.41) 371160.19 ( 216896.22, 598227.08) 125.06 ( 72.68,202.16) 139.90 ( 81.63,225.50) 0.40 ( 0.35, 0.44) 0 Oceania 3438.97 ( 2028.18, 5428.26) 8394.88 ( 5061.16, 13122.92) 140.70 ( 83.24,221.86) 159.78 ( 96.45,249.48) 0.43 ( 0.37, 0.49) 0 South Asia 402470.95 ( 235352.92, 644912.56) 875442.72 ( 513231.16,1399739.95) 100.73 ( 59.22,161.36) 117.76 ( 69.18,188.27) 0.55 ( 0.52, 0.57) 0 Southeast Asia 46873.88 ( 25798.39, 78268.18) 74671.86 ( 41503.44, 124712.34) 25.27 ( 13.99, 42.30) 27.09 ( 15.04, 45.22) 0.25 ( 0.22, 0.27) 0 Southern Latin America 11826.41 ( 6788.14, 19217.05) 15944.41 ( 9139.85, 25860.65) 63.33 ( 36.40,102.91) 61.31 ( 35.08, 99.49) -0.06 (-0.23, 0.11) 0.496 Southern Sub-Saharan Africa 30933.22 ( 18043.88, 49307.09) 52062.44 ( 30335.71, 83701.20) 153.76 ( 90.25,245.43) 153.61 ( 89.46,247.43) 0.03 (-0.07, 0.13) 0.517 Tropical Latin America 46386.23 ( 26754.12, 76111.38) 27969.82 ( 16317.03, 44843.58) 77.25 ( 44.74,127.00) 30.05 ( 17.46, 48.15) -3.21 (-3.35,-3.07) 0 Western Europe 27170.58 ( 15305.03, 44457.71) 25788.86 ( 14696.73, 42169.02) 18.44 ( 10.37, 30.20) 18.37 ( 10.41, 30.05) 0.04 (-0.03, 0.10) 0.274 Western Sub-Saharan Africa 63098.18 ( 36135.66, 102132.21) 168583.91 ( 96959.18, 271469.11) 96.54 ( 55.68,156.52) 102.78 ( 59.52,165.71) 0.23 ( 0.19, 0.27) 0 NOTE:ASIR,age-standardised incidence rate;APPC,average annual percentage change; Table 2. Age-standardised DALY rates of interstitial lung disease and pulmonary sarcoidosis in adolescents and young adults in 1990 and 2019 for all locations, with AAPC from 2009 and 2019 location Numbers in 1990 Numbers in 2019 Age-standardized rates in 1990 (95% CI) Age standardized rates in 2019 (95% CI) AAPC, % (95% CI) P Global 158654.11 (127975.23,203108.40) 241150.69 (193974.44,299613.84) 7.56 ( 6.10, 9.68) 8.02 ( 6.45, 9.96) 0.23 ( 0.05, 0.41) 0.011 High SDI 33589.50 ( 27527.65, 43736.70) 34417.50 ( 28584.36, 42643.37) 10.02 ( 8.21,13.08) 9.60 ( 7.97,11.88) -0.15 (-0.24,-0.05) 0.003 High-middle SDI 31653.87 ( 25331.06, 39702.06) 33632.19 ( 26695.51, 41830.91) 6.54 ( 5.23, 8.20) 6.01 ( 4.76, 7.46) -0.28 (-0.44,-0.11) 0.001 Middle SDI 39931.68 ( 32027.70, 53341.55) 64930.84 ( 52958.60, 79867.70) 5.70 ( 4.57, 7.60) 6.75 ( 5.51, 8.31) 0.59 ( 0.29, 0.89) 0 Low-middle SDI 39370.82 ( 27321.23, 58199.55) 75052.95 ( 55355.05,102675.31) 9.78 ( 6.78,14.47) 10.64 ( 7.84,14.57) 0.34 ( 0.07, 0.60) 0.012 Low SDI 13992.45 ( 8404.12, 21315.25) 32888.13 ( 23171.58, 44247.43) 8.04 ( 4.85,12.23) 8.17 ( 5.77,10.96) 0.09 (-0.08, 0.25) 0.312 Andean Latin America 3935.11 ( 2474.65, 6070.42) 6550.46 ( 4451.49, 9114.89) 26.88 (17.00,41.42) 25.69 (17.46,35.75) -0.08 (-0.36, 0.20) 0.574 Australasia 297.58 ( 193.70, 452.85) 662.88 ( 372.67, 1033.25) 3.56 ( 2.32, 5.41) 6.39 ( 3.58,10.00) 2.04 ( 1.63, 2.46) 0 Caribbean 916.31 ( 705.59, 1220.42) 1886.90 ( 1304.23, 2663.15) 6.67 ( 5.14, 8.85) 10.43 ( 7.21,14.72) 1.55 ( 1.27, 1.84) 0 Central Asia 3952.13 ( 2644.55, 5308.40) 4873.89 ( 3490.19, 6501.98) 14.49 ( 9.71,19.43) 12.51 ( 8.97,16.69) -0.47 (-0.67,-0.26) 0 Central Europe 4984.32 ( 3553.67, 6585.68) 3272.38 ( 2446.87, 4361.61) 10.29 ( 7.31,13.61) 8.18 ( 6.11,10.85) -0.79 (-0.90,-0.68) 0 Central Latin America 6158.96 ( 5011.27, 8408.77) 13701.68 ( 8793.11, 18241.30) 9.74 ( 7.95,13.22) 13.64 ( 8.75,18.17) 1.25 ( 1.12, 1.38) 0 Central Sub-Saharan Africa 1194.45 ( 446.77, 2284.90) 2900.34 ( 1442.05, 5198.72) 6.35 ( 2.36,12.16) 6.12 ( 3.03,10.93) -0.14 (-0.21,-0.07) 0 East Asia 16366.55 ( 11910.93, 24114.47) 13455.89 ( 10297.28, 17678.21) 2.99 ( 2.18, 4.41) 2.39 ( 1.83, 3.15) -0.71 (-0.87,-0.55) 0 Eastern Europe 7209.33 ( 5108.30, 10091.06) 5221.64 ( 3493.96, 7881.43) 7.84 ( 5.56,10.97) 6.58 ( 4.40, 9.99) -0.47 (-0.70,-0.23) 0 Eastern Sub-Saharan Africa 3781.84 ( 1480.81, 6177.54) 9069.32 ( 4674.88, 13808.41) 5.93 ( 2.32, 9.65) 5.97 ( 3.07, 9.08) 0.03 (-0.17, 0.24) 0.739 High-income Asia Pacific 5802.66 ( 3793.34, 8878.08) 4388.64 ( 3133.25, 6217.28) 8.55 ( 5.58,13.09) 7.78 ( 5.56,11.03) -0.27 (-0.42,-0.13) 0 High-income North America 19646.72 ( 15795.54, 24344.03) 16597.08 ( 13662.01, 21339.23) 16.21 (13.03,20.11) 13.05 (10.73,16.77) -0.75 (-0.88,-0.63) 0 North Africa and Middle East 8784.19 ( 6028.41, 13306.81) 20859.22 ( 15448.59, 29636.67) 6.92 ( 4.76,10.49) 7.90 ( 5.85,11.23) 0.45 ( 0.37, 0.54) 0 Oceania 1136.35 ( 700.86, 1886.74) 2480.44 ( 1480.43, 4146.49) 44.72 (27.76,73.82) 46.43 (27.82,77.53) 0.11 ( 0.02, 0.20) 0.014 South Asia 48118.28 ( 31496.76, 72747.34) 96270.30 ( 68721.06,134250.86) 12.14 ( 7.94,18.34) 12.98 ( 9.26,18.10) 0.26 (-0.07, 0.58) 0.118 Southeast Asia 4896.87 ( 3323.52, 8515.28) 8196.02 ( 5907.85, 12585.55) 2.60 ( 1.77, 4.49) 2.98 ( 2.15, 4.58) 0.47 ( 0.34, 0.61) 0 Southern Latin America 2196.23 ( 1580.35, 3004.18) 3182.43 ( 2159.12, 4359.04) 11.72 ( 8.44,16.02) 12.29 ( 8.32,16.86) 0.18 (-0.18, 0.55) 0.315 Southern Sub-Saharan Africa 2768.84 ( 1659.95, 3810.56) 3333.17 ( 2192.57, 5277.35) 14.17 ( 8.49,19.45) 9.76 ( 6.43,15.44) -1.30 (-1.86,-0.74) 0 Tropical Latin America 6308.99 ( 4850.56, 7965.17) 9010.50 ( 6544.58, 11158.63) 10.34 ( 7.94,13.06) 9.78 ( 7.09,12.12) -0.20 (-0.50, 0.09) 0.177 Western Europe 7921.11 ( 6135.35, 11330.21) 9544.40 ( 6528.51, 11869.75) 5.38 ( 4.17, 7.70) 6.84 ( 4.65, 8.50) 0.82 ( 0.70, 0.94) 0 Western Sub-Saharan Africa 2277.31 ( 1336.40, 3373.62) 5693.10 ( 3779.46, 8199.86) 3.51 ( 2.06, 5.19) 3.49 ( 2.32, 5.01) -0.03 (-0.15, 0.09) 0.632 NOTE:APPC,average annual percentage change; Table 3. ASMR of interstitial lung disease and pulmonary sarcoidosis in adolescents and young adults in 1990 and 2019 for all locations, with AAPC from 2009 and 2019 location Numbers in 1990 Numbers in 2019 Age-standardized rates in 1990 (95% CI) Age standardized rates in 2019 (95% CI) AAPC, % (95% CI) P Global 2200.13 (1774.10,2824.35) 3428.03 (2759.44,4266.19) 0.11 (0.09,0.14) 0.11 (0.09,0.14) 0.30 ( 0.08, 0.52) 0.008 High SDI 451.03 ( 379.29, 598.72) 467.36 ( 387.81, 578.83) 0.13 (0.11,0.18) 0.13 (0.11,0.16) -0.14 (-0.32, 0.04) 0.129 High-middle SDI 406.92 ( 328.42, 493.29) 443.35 ( 348.14, 521.62) 0.08 (0.07,0.10) 0.08 (0.06,0.09) -0.23 (-0.44,-0.02) 0.035 Middle SDI 557.21 ( 451.95, 757.72) 932.24 ( 754.67,1149.34) 0.08 (0.07,0.11) 0.10 (0.08,0.12) 0.64 ( 0.28, 1.00) 0 Low-middle SDI 586.10 ( 386.42, 907.18) 1126.03 ( 804.44,1606.54) 0.15 (0.10,0.23) 0.16 (0.11,0.23) 0.31 (-0.01, 0.65) 0.061 Low SDI 197.16 ( 106.71, 315.15) 455.67 ( 302.09, 634.95) 0.12 (0.06,0.18) 0.12 (0.08,0.16) 0.03 (-0.18, 0.25) 0.76 Andean Latin America 62.71 ( 38.66, 98.14) 104.82 ( 69.72, 147.55) 0.44 (0.27,0.68) 0.41 (0.27,0.58) -0.11 (-0.40, 0.18) 0.453 Australasia 3.58 ( 2.16, 6.08) 9.75 ( 4.97, 15.74) 0.04 (0.03,0.07) 0.09 (0.05,0.15) 2.77 ( 2.42, 3.13) 0 Caribbean 13.82 ( 10.46, 18.89) 29.86 ( 19.98, 43.09) 0.10 (0.08,0.14) 0.17 (0.11,0.24) 1.68 ( 1.36, 1.99) 0 Central Asia 59.32 ( 37.62, 81.46) 72.92 ( 50.06, 99.99) 0.22 (0.14,0.30) 0.19 (0.13,0.26) -0.51 (-0.74,-0.28) 0 Central Europe 61.72 ( 42.54, 80.44) 33.94 ( 25.36, 42.11) 0.13 (0.09,0.17) 0.08 (0.06,0.11) -1.36 (-1.53,-1.19) 0 Central Latin America 93.17 ( 74.95, 130.13) 219.49 ( 135.75, 296.61) 0.15 (0.12,0.21) 0.22 (0.14,0.30) 1.40 ( 1.26, 1.55) 0 Central Sub-Saharan Africa 15.75 ( 4.05, 33.92) 37.00 ( 14.20, 74.72) 0.09 (0.02,0.18) 0.08 (0.03,0.16) -0.31 (-0.40,-0.22) 0 East Asia 203.77 ( 147.41, 324.19) 182.34 ( 135.70, 246.94) 0.04 (0.03,0.06) 0.03 (0.02,0.04) -0.43 (-0.67,-0.19) 0 Eastern Europe 73.80 ( 51.31, 103.46) 44.72 ( 31.73, 74.20) 0.08 (0.06,0.11) 0.06 (0.04,0.09) -1.08 (-1.62,-0.54) 0 Eastern Sub-Saharan Africa 49.42 ( 13.86, 86.73) 117.56 ( 49.64, 189.80) 0.08 (0.02,0.14) 0.08 (0.03,0.13) -0.04 (-0.29, 0.20) 0.724 High-income Asia Pacific 62.08 ( 42.34, 102.15) 45.30 ( 35.43, 68.14) 0.09 (0.06,0.15) 0.08 (0.06,0.12) -0.41 (-0.57,-0.25) 0 High-income North America 276.07 ( 217.08, 341.82) 226.53 ( 186.67, 305.08) 0.23 (0.18,0.28) 0.18 (0.15,0.24) -0.84 (-1.02,-0.67) 0 North Africa and Middle East 106.40 ( 68.98, 179.59) 260.09 ( 189.03, 394.71) 0.08 (0.06,0.14) 0.10 (0.07,0.15) 0.49 ( 0.29, 0.70) 0 Oceania 17.02 ( 10.09, 28.98) 36.52 ( 20.54, 64.47) 0.68 (0.41,1.15) 0.69 (0.39,1.22) 0.01 (-0.08, 0.10) 0.796 South Asia 732.31 ( 453.86,1157.17) 1454.17 (1012.07,2114.61) 0.19 (0.12,0.30) 0.20 (0.14,0.29) 0.19 (-0.21, 0.59) 0.345 Southeast Asia 69.50 ( 45.48, 126.81) 119.59 ( 83.92, 193.01) 0.04 (0.02,0.07) 0.04 (0.03,0.07) 0.51 ( 0.36, 0.66) 0 Southern Latin America 33.82 ( 23.65, 47.21) 49.27 ( 32.29, 68.47) 0.18 (0.13,0.25) 0.19 (0.12,0.26) 0.19 (-0.21, 0.60) 0.35 Southern Sub-Saharan Africa 39.78 ( 21.85, 56.21) 44.43 ( 27.00, 77.50) 0.21 (0.11,0.29) 0.13 (0.08,0.23) -1.62 (-2.31,-0.92) 0 Tropical Latin America 94.28 ( 70.10, 119.51) 147.96 ( 106.00, 184.75) 0.16 (0.12,0.20) 0.16 (0.11,0.20) 0.07 (-0.24, 0.38) 0.67 Western Europe 109.75 ( 85.30, 163.25) 139.51 ( 89.08, 168.97) 0.07 (0.06,0.11) 0.10 (0.06,0.12) 0.95 ( 0.76, 1.14) 0 Western Sub-Saharan Africa 22.07 ( 10.58, 33.55) 52.24 ( 32.51, 73.87) 0.03 (0.02,0.05) 0.03 (0.02,0.05) -0.23 (-0.43,-0.03) 0.024 NOTE:;ASMR,age-standardised mortality rates ;APPC,average annual percentage change; Discussion In this study, we collected data on the incidence, mortality, and DALYs in AYAs from 204 countries and territories between 1990 and 2019, focusing on ILD and publicly available information on pulmonary sarcoidosis. The findings of this study contribute to our understanding of ILD and pulmonary sarcoidosis patterns in AYAs. Consistent with a previous study [22], an increasing trend in the global age-standardised incidence and DALY rates was observed in AYAs. Additionally, age-standardised incidence rates were highest in countries with low SDIs. This trend is associated with factors such as increased industrial activity, air pollution, tobacco smoke, automobile traffic, and higher levels of occupational exposure in these densely populated areas [23,24]. Furthermore, age-standardised DALY and mortality rates among AYAs were highest in low SDI countries. Several factors contribute to this: 1) The diagnosis of ILD or pulmonary sarcoidosis imposes a significant financial burden on individuals, particularly affecting low-income populations [25]. 2) Rising treatment costs over time exacerbate financial pressures. Individuals with low incomes or living in low-income areas frequently face challenges accessing necessary medications and medical services [26]. Owing to advances in healthcare and public health, the global DALYs is expected to decrease. However, our findings show that standardised DALY rates decreased in high and middle–high SDI countries but increased in low, middle–low, and low-SDI countries. These inter-regional differences were evident. Low-SDI countries could benefit from observing and adopting best practices by high-SDI countries to advocate for a more efficient allocation of healthcare resources. Our analyses showed that age-standardised morbidity in AYAs was higher in women, whereas age-standardised DALY and mortality were higher in men. Despite the higher incidence in women, men tended to have a poorer prognosis. Additionally, CTD-ILD is more common in women but tends to progress more rapidly in men, with a higher prevalence of common interstitial pneumonia [27,28]. Between 1990 and 2019, age-standardised DALY and mortality rates were negatively correlated with SDI in AYAs. Conversely, age-standardised morbidity was positively correlated with the SDI. This can be attributed to the increased accessibility of healthcare in more developed regions, leading to early detection and timely treatment [29]. Our study showed a significant increase in global morbidity among AYAs, especially in low-SDI areas, mainly due to population growth and epidemiological changes. Analyses of global mortality and DALYs among AYAs showed that epidemiological changes and population growth led to increases in mortality and DALYs. Our study was limited by a lack of primary sources, and the GBD 2019 data may have underestimated the total burden of ILD. The GBD 2019 data excluded external causes of ILD, pharmacological ILD, ILD due to systemic rheumatic diseases, and other specific types of ILD under the categories of ILD and pulmonary sarcoidosis [30]. Therefore, future GBD reports should include these subtypes to provide a more comprehensive overview of the burden of ILD. The complexity and country-specific nature of the classification of ILD and pulmonary nodular disease present challenges in identifying cases and determining data sources. Including a broader and more detailed classification of ILD in the GBD study will improve our understanding of the disease burden. Conclusion AYAs with ILD and pulmonary sarcoidosis are at a greater risk of long-term effects that may impact productivity growth and social structure than older patients. Therefore, recognising and addressing the global burden of ILD and pulmonary sarcoidosis in AYAs is critical for developing effective healthcare policies and improving the outcomes associated with these diseases. Declarations Acknowledgements Not applicable. Funding sources This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Data statement The original contributions presented in the study are included in the article/supplementary material; further inquiries can be directed to the corresponding authors. Author contributions Xiaoshuang He : Data curation, Methodology, Formal analysis, Writing – original draft, Writing – review & editing. Lu Wang : Data curation, Formal analysis. Yu Zhao : Data curation, Writing – original draft. Yuanyuan Qu: Methodology. Wenyan Xin: Resources. Lina Xu: Resources. Wanyu Li: Resources. Chao Wu : Conceptualization, Writing – original draft, Project administration. Competing Interest No parts of this manuscript are being considered for publication elsewhere. All authors have read and approved this manuscript. References Sharp, M., Mustafa, A. M., Farah, N., & Bonham, C. A. (2023). Interstitial Lung Disease and Sarcoidosis. Clinics in chest medicine , 44 (3), 575–584. https://doi.org/10.1016/j.ccm.2023.06.003 Huang H. (2024). 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An Official American Thoracic Society Clinical Practice Guideline. American journal of respiratory and critical care medicine , 201 (8), e26–e51. https://doi.org/10.1164/rccm.202002-0251ST Fidler, L. M., Gershon, A., Fisher, J. H., Stanbrook, M. B., To, T., & Balter, M. (2021). Hospitalizations in Sarcoidosis: A Cohort Study of a Universal Healthcare Population. Annals of the American Thoracic Society , 18 (11), 1786–1794. https://doi.org/10.1513/AnnalsATS.202009-1134OC Arkema, E. V., & Cozier, Y. C. (2020). Sarcoidosis epidemiology: recent estimates of incidence, prevalence and risk factors. Current opinion in pulmonary medicine , 26 (5), 527–534. https://doi.org/10.1097/MCP.0000000000000715 Belperio, J. A., Shaikh, F., Abtin, F. G., Fishbein, M. C., Weigt, S. S., Saggar, R., & Lynch, J. P., 3rd (2022). Diagnosis and Treatment of Pulmonary Sarcoidosis: A Review. JAMA , 327 (9), 856–867. https://doi.org/10.1001/jama.2022.1570 Wong, A. W., Koo, J., Ryerson, C. J., Sadatsafavi, M., & Chen, W. (2022). A systematic review on the economic burden of interstitial lung disease and the cost-effectiveness of current therapies. BMC pulmonary medicine , 22 (1), 148. https://doi.org/10.1186/s12890-022-01922-2 Harper, L. J., Love, G., Singh, R., Smith, A., Culver, D. A., & Thornton, J. D. (2021). Barriers to Care among Patients with Sarcoidosis: A Qualitative Study. Annals of the American Thoracic Society , 18 (11), 1832–1838. https://doi.org/10.1513/AnnalsATS.202011-1467OC Li, X., Cao, X., Guo, M., Xie, M., & Liu, X. (2020). Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017. BMJ (Clinical research ed.) , 368 , m234. https://doi.org/10.1136/bmj.m234 GBD 2019 Diseases and Injuries Collaborators (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet (London, England) , 396 (10258), 1204–1222. https://doi.org/10.1016/S0140-6736(20)30925-9 GBD 2019 Diseases and Injuries Collaborators (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet (London, England) , 396 (10258), 1204–1222. https://doi.org/10.1016/S0140-6736(20)30925-9 GBD 2019 Demographics Collaborators (2020). Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet (London, England) , 396 (10258), 1160–1203. https://doi.org/10.1016/S0140-6736(20)30977-6 Kim, H. J., Fay, M. P., Feuer, E. J., & Midthune, D. N. (2000). Permutation tests for joinpoint regression with applications to cancer rates. Statistics in medicine , 19 (3), 335–351. https://doi.org/10.1002/(sici)1097-0258(20000215)19:33.0.co;2-z Cheng, X., Yang, Y., Schwebel, D. C., Liu, Z., Li, L., Cheng, P., Ning, P., & Hu, G. (2020). Population ageing and mortality during 1990-2017: A global decomposition analysis. PLoS medicine , 17 (6), e1003138. https://doi.org/10.1371/journal.pmed.1003138 Ma, X., Zhu, L., Kurche, J. S., Xiao, H., Dai, H., & Wang, C. (2022). Global and regional burden of interstitial lung disease and pulmonary sarcoidosis from 1990 to 2019: results from the Global Burden of Disease study 2019. Thorax , 77 (6), 596–605. https://doi.org/10.1136/thoraxjnl-2020-216732 Sesé, L., Caliez, J., Annesi-Maesano, I., Cottin, V., Pesce, G., Didier, M., Carton, Z., Israel-Biet, D., Crestani, B., Dudoret, S. G., Cadranel, J., Wallaert, B., Tazi, A., Maître, B., Prévot, G., Marchand-Adam, S., Hirschi, S., Dury, S., Giraud, V., Gondouin, A., … COFI collaborators (2021). Low income and outcome in idiopathic pulmonary fibrosis: An association to uncover. Respiratory medicine , 183 , 106415. https://doi.org/10.1016/j.rmed.2021.106415 Rose, J. A., Planchart Ferretto, M. A., Maeda, A. H., Perez Garcia, M. F., Carmichael, N. E., Gulati, S., Rice, M. B., Goldberg, H. J., Putman, R. K., Hatabu, H., Raby, B. A., Rosas, I. O., & Hunninghake, G. M. (2023). Progressive Interstitial Lung Disease in Relatives of Patients with Pulmonary Fibrosis. American journal of respiratory and critical care medicine , 207 (2), 211–214. https://doi.org/10.1164/rccm.202208-1470LE Harper, L. J., Gerke, A. K., Wang, X. F., Ribeiro Neto, M. L., Baughman, R. P., Beyer, K., Drent, M., Judson, M. A., Maier, L. A., Serchuck, L., Singh, N., & Culver, D. A. (2020). Income and Other Contributors to Poor Outcomes in U.S. Patients with Sarcoidosis. American journal of respiratory and critical care medicine , 201 (8), 955–964. https://doi.org/10.1164/rccm.201906-1250OC Johannson, K. A., Chaudhuri, N., Adegunsoye, A., & Wolters, P. J. (2021). Treatment of fibrotic interstitial lung disease: current approaches and future directions. Lancet (London, England) , 398 (10309), 1450–1460. https://doi.org/10.1016/S0140-6736(21)01826-2 Manfredi, A., Salvarani, C., & Sebastiani, M. (2023). Rituximab for connective tissue disease-associated interstitial lung disease. The Lancet. Respiratory medicine , 11 (1), 3–4. https://doi.org/10.1016/S2213-2600(22)00356-3 Shin, K. H., & Shin, S. W. (2018). Idiopathic Pulmonary Fibrosis. The New England journal of medicine , 379 (8), 795–796. https://doi.org/10.1056/NEJMc1807508 Kim, T. J., Vonneilich, N., Lüdecke, D., & von dem Knesebeck, O. (2017). Income, financial barriers to health care and public health expenditure: A multilevel analysis of 28 countries. Social science & medicine (1982) , 176 , 158–165. https://doi.org/10.1016/j.socscimed.2017.01.044 Podolanczuk, A. J., Wong, A. W., Saito, S., Lasky, J. A., Ryerson, C. J., & Eickelberg, O. (2021). Update in Interstitial Lung Disease 2020. American journal of respiratory and critical care medicine , 203 (11), 1343–1352. https://doi.org/10.1164/rccm.202103-0559UP Table 4 to 6 Table 4 to 6 are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Table456.dotx Appendices.doc Cite Share Download PDF Status: Published Journal Publication published 26 Sep, 2025 Read the published version in European Journal of Medical Research → Version 1 posted Editorial decision: Revision requested 09 Jul, 2025 Reviews received at journal 07 Jul, 2025 Reviewers agreed at journal 01 Jul, 2025 Reviewers agreed at journal 01 Jul, 2025 Reviewers agreed at journal 31 May, 2025 Reviews received at journal 06 May, 2025 Reviewers agreed at journal 29 Apr, 2025 Reviewers invited by journal 10 Mar, 2025 Editor assigned by journal 10 Jan, 2025 Submission checks completed at journal 10 Jan, 2025 First submitted to journal 08 Jan, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5787561","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":400568706,"identity":"4fc39ff7-1c83-498f-b58b-2f4e9b8b4fb1","order_by":0,"name":"Xiaoshuang He","email":"","orcid":"","institution":"First Affiliated Hospital of Shihezi University","correspondingAuthor":false,"prefix":"","firstName":"Xiaoshuang","middleName":"","lastName":"He","suffix":""},{"id":400568707,"identity":"b95f8e55-c173-44b8-bb83-114fc8e3485f","order_by":1,"name":"Lu Wang","email":"","orcid":"","institution":"Xinjiang Medical University","correspondingAuthor":false,"prefix":"","firstName":"Lu","middleName":"","lastName":"Wang","suffix":""},{"id":400568708,"identity":"cf8be91a-5631-49da-bdc5-e7c69d7553eb","order_by":2,"name":"Yu Zhao","email":"","orcid":"","institution":"First Affiliated Hospital of Shihezi University","correspondingAuthor":false,"prefix":"","firstName":"Yu","middleName":"","lastName":"Zhao","suffix":""},{"id":400568709,"identity":"f73d47b5-2cbb-4606-bcfd-91702a1d057c","order_by":3,"name":"Yuanyuan Qu","email":"","orcid":"","institution":"First Affiliated Hospital of Shihezi University","correspondingAuthor":false,"prefix":"","firstName":"Yuanyuan","middleName":"","lastName":"Qu","suffix":""},{"id":400568710,"identity":"dd57d059-2c5f-4001-a19b-34f99b707368","order_by":4,"name":"Wenyan Xin","email":"","orcid":"","institution":"First Affiliated Hospital of Shihezi University","correspondingAuthor":false,"prefix":"","firstName":"Wenyan","middleName":"","lastName":"Xin","suffix":""},{"id":400568711,"identity":"d7b0648a-c55c-41cc-973d-7cb15406b675","order_by":5,"name":"Lina Xu","email":"","orcid":"","institution":"First Affiliated Hospital of Shihezi University","correspondingAuthor":false,"prefix":"","firstName":"Lina","middleName":"","lastName":"Xu","suffix":""},{"id":400568712,"identity":"65ca9bc3-b379-4f8b-ab86-aa201e96c977","order_by":6,"name":"Wanyu Li","email":"","orcid":"","institution":"First Affiliated Hospital of Shihezi University","correspondingAuthor":false,"prefix":"","firstName":"Wanyu","middleName":"","lastName":"Li","suffix":""},{"id":400568713,"identity":"01aea0eb-4cda-4128-8173-cf8d4405a498","order_by":7,"name":"Chao Wu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAv0lEQVRIiWNgGAWjYFACxsYDHxsYGPgYeEA8CaK0NBycCdTCxka8FgaGw7wILUQA3fbDDYdtd9jIs8n3HpNgbLPII6jF7Exiw+HcM2mGbWx8aUAtEsWEtRwAaWk7zNjGxmMmwXBGIrGBoJbzDxsOW7b9tydByw2gLYxtBxIhWiqI0vKw4WBvW3JyG1uOsUVCBTF+OZ/+8MHPNjvbfuYzhjc+GNQRDjFkwCKRwMCQQJIW5g8MpGoZBaNgFIyCEQEAoOs9Vj4sExUAAAAASUVORK5CYII=","orcid":"","institution":"First Affiliated Hospital of Shihezi University","correspondingAuthor":true,"prefix":"","firstName":"Chao","middleName":"","lastName":"Wu","suffix":""}],"badges":[],"createdAt":"2025-01-08 09:23:18","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5787561/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5787561/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s40001-025-03141-x","type":"published","date":"2025-09-26T15:57:37+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":73788747,"identity":"e0447fb9-e17b-4830-aee4-ee78865f0c2c","added_by":"auto","created_at":"2025-01-14 16:36:17","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":491056,"visible":true,"origin":"","legend":"\u003cp\u003eTemporal trend of age-standardised incidence rate, age-standardised disability-adjusted life years rate, and age-standardised mortality rate for the burden of interstitial lung disease and pulmonary sarcoidosis in adolescents and young adults, globally and by socio-demographic index (SDI). Five categories: countries with a high, high–middle, middle, low–middle, or low SDI from 1990 to 2019.\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-5787561/v1/34611be42e2f0cb19cf19d08.png"},{"id":73788741,"identity":"a6e67195-0609-4781-84e6-01bcc805f127","added_by":"auto","created_at":"2025-01-14 16:36:16","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1168381,"visible":true,"origin":"","legend":"\u003cp\u003eGlobal map of age-standardised disability-adjusted life years (DALYs) rates for both sexes combined in 2019, categorised based on age-standardised incidence, DALYs, mortality rate quintiles for interstitial and pulmonary sarcoidosis in AYAs. (A) Age-standardised incidence quintiles in 2019. (B) Age-standardised DALYs quintiles in 2019. (C) Age-standardised mortality quintiles in 2019.\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-5787561/v1/c893db21627ebc40106ceec3.png"},{"id":73788743,"identity":"5013675b-5e5a-4a50-8446-18fc11b6ad97","added_by":"auto","created_at":"2025-01-14 16:36:16","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":389186,"visible":true,"origin":"","legend":"\u003cp\u003eAge-standardised incidence rate (ASIR) of interstitial lung disease and pulmonary sarcoidosis per 100,000 individuals among regions based on socio-demographic indices of each year.\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-5787561/v1/5ad9107321580fbf0165ee47.png"},{"id":73788749,"identity":"b0658e7f-7c98-4f9b-a59f-301d5678d5f8","added_by":"auto","created_at":"2025-01-14 16:36:17","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":350549,"visible":true,"origin":"","legend":"\u003cp\u003eAge-standardised DALY rate of interstitial lung disease and pulmonary sarcoidosis per 100,000 individuals among regions based on the SDI of each year.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-5787561/v1/c4a7a0bb9985fe15167bab35.png"},{"id":73788755,"identity":"b77bedb1-569d-46b4-b283-a592f8071439","added_by":"auto","created_at":"2025-01-14 16:36:17","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":351614,"visible":true,"origin":"","legend":"\u003cp\u003eAge-standardised mortality rate (ASMR) of interstitial lung disease and pulmonary sarcoidosis per 100,000 individuals among regions based on socio-demographic indices of each year.\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-5787561/v1/a2185e7c2cc87303d5b0a587.png"},{"id":73789649,"identity":"b8f66a5d-91d7-4159-85eb-6751f3261dc0","added_by":"auto","created_at":"2025-01-14 16:44:17","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":1143832,"visible":true,"origin":"","legend":"\u003cp\u003eChanges in interstitial lung disease and pulmonary sarcoidosis in adolescent and young adults. A; incidence, B; disability-adjusted life years, and C; deaths according to population-level determinants of population growth, ageing, and epidemiological change from 1990 to 2019 across locations. Black dot represents the overall value of change contributed by all three components. For each component, the magnitude of a positive value indicates a corresponding increase attributed to the component; the magnitude of a negative value indicates a corresponding decrease attributed to the related component.\u003c/p\u003e","description":"","filename":"Figure6.png","url":"https://assets-eu.researchsquare.com/files/rs-5787561/v1/a320a1e3c2f59b8a125eb403.png"},{"id":92430479,"identity":"a537a41c-5457-44f2-82d0-e04c877234c8","added_by":"auto","created_at":"2025-09-29 16:05:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4819959,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5787561/v1/1c1822f9-feb4-45d1-935f-f29b78ce5709.pdf"},{"id":73789642,"identity":"bd59b708-a11a-463d-875b-cbfd1fb69993","added_by":"auto","created_at":"2025-01-14 16:44:17","extension":"dotx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":162533,"visible":true,"origin":"","legend":"","description":"","filename":"Table456.dotx","url":"https://assets-eu.researchsquare.com/files/rs-5787561/v1/d9ab0d2ea91e174187fd9a3c.dotx"},{"id":73789643,"identity":"663b142a-9019-4f34-9f6c-2736c306f017","added_by":"auto","created_at":"2025-01-14 16:44:17","extension":"doc","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":4822140,"visible":true,"origin":"","legend":"","description":"","filename":"Appendices.doc","url":"https://assets-eu.researchsquare.com/files/rs-5787561/v1/7a36df0e7d30ea8587fe68d9.doc"}],"financialInterests":"No competing interests reported.","formattedTitle":"Global Burden of Disease of interstitial lung disease and pulmonary sarcoidosis in adolescents and young adults (1990–2019)","fulltext":[{"header":"Introduction","content":"\u003cp\u003eInterstitial lung diseases (ILD), also known as pulmonary fibrosis, are a group of clinically recognised disorders that lead to interstitial scarring, also referred to as pulmonary fibrosis [1,2]. ILD is classified based on its aetiology and includes connective tissue disease-associated ILD (CTD-ILD), hypersensitivity pneumonitis, drug-induced ILD, post-infectious ILD, and idiopathic interstitial pneumonia. These diseases share similar clinical features but are distinguished by their unique histopathological manifestations and findings. The most common ILDs are idiopathic pulmonary fibrosis (IPF) (\u0026gt;30% of ILD cases), hypersensitivity pneumonitis (approximately 15% of ILD cases), and connective tissue disease (CTD) (approximately 25% of ILD cases). Other ILDs include pharmacological and post-infectious ILD (e.g., post-covid disease 2019) [3]. Approximately 14% of newly diagnosed patients with IPF have pulmonary hypertension [4], and this figure increases to approximately 86% in patients with pulmonary fibrosis awaiting lung transplantation [5,6]. The overall prevalence of ILD in the United States is approximately 200 per 100,000 people, and has increased by 19.1% over the past decade, coinciding with an ageing population [7,8]. Although nodular disease is classified as ILD, it exhibits various pulmonary symptoms, including airway obstruction [9,10], with an incidence of 126\u0026ndash;160 per 100,000 people [11] and as high as 519 per 100,000 people in African American women [12]. Pulmonary sarcoidosis is a disorder characterised by an unexplained inflammatory granulomatous disease that affects a large proportion of the global population, ranging from 2\u0026ndash;160 per 100,000 people, and can affect any organ in the body. While some patients with pulmonary sarcoidosis may experience spontaneous remission without significant consequences, others may experience disease progression, leading to fibrocystic structures of the lungs being distorted. This progression is associated with a 12\u0026ndash;18% mortality rate over 5 years. Overall, the mortality rate of pulmonary sarcoidosis is approximately 7% at 5 years, with over 60% of deaths attributed to lung involvement [13]. Due to the diagnostic complexity of pulmonary sarcoidosis, the financial burden and stress on patients increase the challenges faced by individuals with this disease [14,15]. The burden of ILD and pulmonary sarcoidosis is unevenly distributed across age groups, with adolescents and young adults (AYAs) categorised as individuals aged 15\u0026ndash;39 years, facing unique challenges. Although the prevalence of ILD and pulmonary sarcoidosis may be lower in adolescents than in older adults, their impact on the loss of healthy life expectancy is disproportionately high [16,17]. Using data from the Global Burden of Disease (GBD) Study 2019, this study investigated the global impact of ILD and pulmonary sarcoidosis on AYAs between 1990 and 2019. These diseases affect respiratory function, cause various symptoms, and seriously impact lung health. This study aimed to investigate the progression of these diseases in this age group, providing valuable insights into international patterns and differences in geography, age, and sex. This analysis is essential for developing focused public health interventions and improving the well-being of AYAs.\u0026nbsp;\u003c/p\u003e\n"},{"header":"Materials and methods","content":"\u003cp\u003e\u003cstrong\u003eData source\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Institute for Health Metrics and Evaluation conducted a GBD study that provides a systematic scientific assessment of the prevalence, incidence, and mortality of diseases and injuries. The GBD 2019 study offers a comprehensive epidemiological assessment of the burden of 369 diseases and injuries across 204 countries and territories. Our study focused on patients with ILD and pulmonary sarcoidosis with an age onset of 15\u0026ndash;39 years, using data from the Global Health Data Exchange (GHD) at https://ghdx.healthdata.org. Age-, sex-, and region-specific incidence, DALY, and mortality rates for ILD and pulmonary nodular disease in the 15\u0026ndash;39-year age group were obtained from the GHD. Patient informed consent was not required to access the use of GHDx data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eD\u003c/strong\u003e\u003cstrong\u003eefinition\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInterstitial lung disease (ILD) and pulmonary sarcoidosis are long-term respiratory conditions that impact lung function and oxygen absorption as a result of scarring and inflammation. The ICD-10 codes for these conditions are D86 to D86.2 and D86.9, and J84 to J84.9, respectively. In contrast, the ICD-9 codes range from 135 to 135.9 and 515 to 516.9. It is important to note that this classification specifically does not include lung disorders caused by external factors, drug-induced interstitial lung issues, systemic or rheumatic diseases, or any other conditions leading to ILD.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analyses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAge-standardised rates and their corresponding 95% confidence intervals (CIs) were calculated using the world standard population, as shown in the GBD Study 2019\u0026nbsp;[18].\u003c/p\u003e\n\u003cp\u003eAge-standardised rates for each indicator in the population aged 15\u0026ndash;39 years were calculated using direct standardisation based on the world population [19]. The rates are expressed per 100,000 people. To assess the trends in the incidence, DALYs, and mortality associated with ILD and pulmonary sarcoidosis in AYAs, we calculated the mean annual percentage changes and corresponding 95% CIs using joint-point regression [20]. Comparisons were made based on sex and socio-demographic indices (SDI) divided into five groups. Detailed information on SDI is available in the Supplementary Material. Least-squares regression and generalised additive models were used to explore potential linear or non-linear associations between SDI and age-standardised incidence rate(ASIR), age-standardised mortality rates(ASMR), and age-standardised DALY rate. Pearson\u0026apos;s correlation analyses were used to determine the strength and direction of the relationships between the covariates. Decomposition analyses were used to calculate the impact of population growth, age-structural changes, and epidemiological changes on the burden of ILD and pulmonary sarcoidosis in young sex-specific populations, with a special focus on global, SDI, and GBD regions [21]. All statistical analyses and graphical representations were generated using R version 4.2.1. The R program V.3.6.3 was used for derivative analyses and plotting, with the significance level set at P \u0026lt; 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eGlobal distribution of ILD and pulmonary sarcoidosis in\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAYAs\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;in 2019\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn 2019, there were 2.6 million (95% CI: 1.5\u0026ndash;4.4) cases of ILD and pulmonary sarcoidosis in AYAs, with 3,428 (2,759\u0026ndash;4,266) deaths from these conditions in this age group.\u003c/p\u003e\n\u003cp\u003eThe global age-standardised incidence, DALY, and mortality rates per 100,000 population were 87.58 (95% CI: 51.66\u0026ndash;140.35), 8.02 (95% CI: 6.45\u0026ndash;9.96), and 0.11 (95% CI: 0.09\u0026ndash;0.14), respectively. When grouped based on SDI, low-index countries had the highest age-standardised prevalence rates (100.28, 95% CI: 58.28\u0026ndash;162.21), while middle-index countries had the lowest age-standardised prevalence rates (72.64, 95% CI: 42.27\u0026ndash;117.46). Similarly, age-standardised DALY rates were highest in low- and middle-index countries (10.64, 95% CI: 7.84\u0026ndash;14.57) and lowest in high- and middle-index countries (6.01, 95% CI: 4.76\u0026ndash;7.46). ASMR were also highest in low- and middle-index countries (0.16, 95% CI: 0.11\u0026ndash;0.23) and lowest in high- and middle-index countries (0.08, 95% CI: 0.06\u0026ndash;0.09). Oceania and Andean Latin America showed the greatest burden of ILD and pulmonary sarcoidosis among AYAs, with Belize having the highest age-standardised incidence, DALY, and mortality rates (Tables 1\u0026ndash;6, Appendix Tables 1\u0026ndash;12).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCountries in Andean Latin America and Oceania DALYs were concentrated in the highest quintile. Eastern and Central Europe, as well as Oceania and Andean Latin America, were in the highest quintile (Fig. 2). Age-standardised incidence rates were higher for women (87.77) than for men (86.77), while age-standardised DALY and mortality rates were higher for men (8.76% and 0.13%, respectively) than for women (7.26 and 0.10, respectively).\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1.ASIR of interstitial lung disease and pulmonary sarcoidosis in adolescents and young adults in 1990 and 2019 for all locations, with AAPC from 2009 and 2019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003elocation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNumbers in 1990\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNumbers in 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAge-standardized rates in 1990\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;(95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAge standardized rates in 2019\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;(95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAAPC, %\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;(95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eGlobal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1746787.83\u003c/p\u003e\n \u003cp\u003e(1016491.09,2837214.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2636440.02\u003c/p\u003e\n \u003cp\u003e(1556551.44,4221375.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;83.56\u003c/p\u003e\n \u003cp\u003e( 48.79,135.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;87.58\u003c/p\u003e\n \u003cp\u003e( 51.66,140.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.18\u003c/p\u003e\n \u003cp\u003e( 0.07, 0.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;337700.61\u003c/p\u003e\n \u003cp\u003e( 197203.24, 549884.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;354191.55\u003c/p\u003e\n \u003cp\u003e( 214997.59, 553860.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e100.52\u003c/p\u003e\n \u003cp\u003e( 58.59,163.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;97.65\u003c/p\u003e\n \u003cp\u003e( 59.03,152.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.07\u003c/p\u003e\n \u003cp\u003e(-0.18, 0.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.153\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh-middle SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;459067.28\u003c/p\u003e\n \u003cp\u003e( 268523.26, 746674.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;488396.59\u003c/p\u003e\n \u003cp\u003e( 288670.17, 782859.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;94.80\u003c/p\u003e\n \u003cp\u003e( 55.45,154.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;84.91\u003c/p\u003e\n \u003cp\u003e( 49.93,136.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.37\u003c/p\u003e\n \u003cp\u003e(-0.45,-0.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMiddle SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;436550.35\u003c/p\u003e\n \u003cp\u003e( 249229.39, 715759.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;701436.91\u003c/p\u003e\n \u003cp\u003e( 409141.71,1132569.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;62.84\u003c/p\u003e\n \u003cp\u003e( 36.08,103.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;72.64\u003c/p\u003e\n \u003cp\u003e( 42.27,117.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.51\u003c/p\u003e\n \u003cp\u003e( 0.43, 0.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLow-middle SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;349601.77\u003c/p\u003e\n \u003cp\u003e( 203062.60, 564305.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;682706.64\u003c/p\u003e\n \u003cp\u003e( 399423.20,1099344.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;86.31\u003c/p\u003e\n \u003cp\u003e( 50.48,139.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;96.51\u003c/p\u003e\n \u003cp\u003e( 56.62,155.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.39\u003c/p\u003e\n \u003cp\u003e( 0.34, 0.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLow SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;163209.94\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;94207.09, 262156.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;408354.84\u003c/p\u003e\n \u003cp\u003e( 235546.37, 660187.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;92.52\u003c/p\u003e\n \u003cp\u003e( 53.79,148.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e100.28\u003c/p\u003e\n \u003cp\u003e( 58.28,162.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.29\u003c/p\u003e\n \u003cp\u003e( 0.25, 0.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAndean Latin America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 10429.40\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 6080.51, \u0026nbsp; \u0026nbsp; 16668.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 23243.18\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;14026.66, \u0026nbsp; \u0026nbsp; 36672.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;74.97\u003c/p\u003e\n \u003cp\u003e( 44.04,119.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;91.92\u003c/p\u003e\n \u003cp\u003e( 55.50,145.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.68\u003c/p\u003e\n \u003cp\u003e( 0.58, 0.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAustralasia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;6050.27\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 3491.86, \u0026nbsp; \u0026nbsp; \u0026nbsp;9907.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;7063.00\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 4082.02, \u0026nbsp; \u0026nbsp; 11402.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;72.53\u003c/p\u003e\n \u003cp\u003e( 41.79,118.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;68.52\u003c/p\u003e\n \u003cp\u003e( 39.46,110.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.19\u003c/p\u003e\n \u003cp\u003e(-0.21,-0.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCaribbean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;6931.01\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 3907.90, \u0026nbsp; \u0026nbsp; 11386.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 10147.41\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 5836.49, \u0026nbsp; \u0026nbsp; 16625.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;50.55\u003c/p\u003e\n \u003cp\u003e( 28.68, 83.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;56.16\u003c/p\u003e\n \u003cp\u003e( 32.30, 92.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.36\u003c/p\u003e\n \u003cp\u003e( 0.34, 0.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCentral Asia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 30285.68\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;17894.31, \u0026nbsp; \u0026nbsp; 48163.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 44829.73\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;26549.70, \u0026nbsp; \u0026nbsp; 72091.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e111.97\u003c/p\u003e\n \u003cp\u003e( 66.41,178.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e114.96\u003c/p\u003e\n \u003cp\u003e( 67.99,185.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.10\u003c/p\u003e\n \u003cp\u003e( 0.01, 0.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCentral Europe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 91333.54\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;54076.35, 147551.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 84815.45\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;51887.02, 131948.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e186.60\u003c/p\u003e\n \u003cp\u003e(110.11,301.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e206.01\u003c/p\u003e\n \u003cp\u003e(125.54,320.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.38\u003c/p\u003e\n \u003cp\u003e( 0.23, 0.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCentral Latin America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 39504.96\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;22435.50, \u0026nbsp; \u0026nbsp; 65610.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 55635.46\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;32728.57, \u0026nbsp; \u0026nbsp; 89975.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;64.27\u003c/p\u003e\n \u003cp\u003e( 36.74,106.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;55.66\u003c/p\u003e\n \u003cp\u003e( 32.76, 90.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.51\u003c/p\u003e\n \u003cp\u003e(-0.59,-0.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCentral Sub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 17470.91\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;10005.80, \u0026nbsp; \u0026nbsp; 28356.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 47150.76\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;27019.82, \u0026nbsp; \u0026nbsp; 75988.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;91.76\u003c/p\u003e\n \u003cp\u003e( 52.95,149.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;98.90\u003c/p\u003e\n \u003cp\u003e( 57.09,159.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.26\u003c/p\u003e\n \u003cp\u003e( 0.20, 0.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eEast Asia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;230600.81\u003c/p\u003e\n \u003cp\u003e( 128599.91, 390031.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;177996.75\u003c/p\u003e\n \u003cp\u003e( 102520.65, 290334.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;42.66\u003c/p\u003e\n \u003cp\u003e( 23.88, 72.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;31.06\u003c/p\u003e\n \u003cp\u003e( 17.75, 50.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.08\u003c/p\u003e\n \u003cp\u003e(-1.23,-0.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eEastern Europe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;191545.19\u003c/p\u003e\n \u003cp\u003e( 113401.51, 307410.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;172448.72\u003c/p\u003e\n \u003cp\u003e( 101544.74, 279064.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e206.31\u003c/p\u003e\n \u003cp\u003e(121.70,331.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e213.54\u003c/p\u003e\n \u003cp\u003e(124.93,345.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.14\u003c/p\u003e\n \u003cp\u003e( 0.03, 0.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eEastern Sub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 54630.25\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;31306.52, \u0026nbsp; \u0026nbsp; 88352.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;136856.04\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;78123.24, 222034.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;85.93\u003c/p\u003e\n \u003cp\u003e( 49.64,139.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;90.38\u003c/p\u003e\n \u003cp\u003e( 51.99,146.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.19\u003c/p\u003e\n \u003cp\u003e( 0.15, 0.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh-income Asia Pacific\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 64406.64\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;36702.16, 105710.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 48847.00\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;28468.58, \u0026nbsp; \u0026nbsp; 79573.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;95.05\u003c/p\u003e\n \u003cp\u003e( 54.17,155.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;87.25\u003c/p\u003e\n \u003cp\u003e( 50.67,141.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.27\u003c/p\u003e\n \u003cp\u003e(-0.36,-0.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh-income North America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;216476.57\u003c/p\u003e\n \u003cp\u003e( 127378.30, 354553.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;207387.43\u003c/p\u003e\n \u003cp\u003e( 126862.56, 320047.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e178.29\u003c/p\u003e\n \u003cp\u003e(104.63,292.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e162.04\u003c/p\u003e\n \u003cp\u003e( 99.00,249.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.28\u003c/p\u003e\n \u003cp\u003e(-0.51,-0.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eNorth Africa and Middle East\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;154924.19\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;89554.54, 250027.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;371160.19\u003c/p\u003e\n \u003cp\u003e( 216896.22, 598227.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e125.06\u003c/p\u003e\n \u003cp\u003e( 72.68,202.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e139.90\u003c/p\u003e\n \u003cp\u003e( 81.63,225.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.40\u003c/p\u003e\n \u003cp\u003e( 0.35, 0.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eOceania\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;3438.97\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 2028.18, \u0026nbsp; \u0026nbsp; \u0026nbsp;5428.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;8394.88\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 5061.16, \u0026nbsp; \u0026nbsp; 13122.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e140.70\u003c/p\u003e\n \u003cp\u003e( 83.24,221.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e159.78\u003c/p\u003e\n \u003cp\u003e( 96.45,249.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.43\u003c/p\u003e\n \u003cp\u003e( 0.37, 0.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSouth Asia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;402470.95\u003c/p\u003e\n \u003cp\u003e( 235352.92, 644912.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;875442.72\u003c/p\u003e\n \u003cp\u003e( 513231.16,1399739.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e100.73\u003c/p\u003e\n \u003cp\u003e( 59.22,161.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e117.76\u003c/p\u003e\n \u003cp\u003e( 69.18,188.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.55\u003c/p\u003e\n \u003cp\u003e( 0.52, 0.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSoutheast Asia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 46873.88\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;25798.39, \u0026nbsp; \u0026nbsp; 78268.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 74671.86\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;41503.44, 124712.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;25.27\u003c/p\u003e\n \u003cp\u003e( 13.99, 42.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;27.09\u003c/p\u003e\n \u003cp\u003e( 15.04, 45.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.25\u003c/p\u003e\n \u003cp\u003e( 0.22, 0.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSouthern Latin America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 11826.41\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 6788.14, \u0026nbsp; \u0026nbsp; 19217.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 15944.41\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 9139.85, \u0026nbsp; \u0026nbsp; 25860.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;63.33\u003c/p\u003e\n \u003cp\u003e( 36.40,102.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;61.31\u003c/p\u003e\n \u003cp\u003e( 35.08, 99.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.06\u003c/p\u003e\n \u003cp\u003e(-0.23, 0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.496\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSouthern Sub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 30933.22\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;18043.88, \u0026nbsp; \u0026nbsp; 49307.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 52062.44\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;30335.71, \u0026nbsp; \u0026nbsp; 83701.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e153.76\u003c/p\u003e\n \u003cp\u003e( 90.25,245.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e153.61\u003c/p\u003e\n \u003cp\u003e( 89.46,247.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.03\u003c/p\u003e\n \u003cp\u003e(-0.07, 0.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.517\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eTropical Latin America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 46386.23\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;26754.12, \u0026nbsp; \u0026nbsp; 76111.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 27969.82\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;16317.03, \u0026nbsp; \u0026nbsp; 44843.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;77.25\u003c/p\u003e\n \u003cp\u003e( 44.74,127.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;30.05\u003c/p\u003e\n \u003cp\u003e( 17.46, 48.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-3.21\u003c/p\u003e\n \u003cp\u003e(-3.35,-3.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eWestern Europe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 27170.58\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;15305.03, \u0026nbsp; \u0026nbsp; 44457.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 25788.86\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;14696.73, \u0026nbsp; \u0026nbsp; 42169.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;18.44\u003c/p\u003e\n \u003cp\u003e( 10.37, 30.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;18.37\u003c/p\u003e\n \u003cp\u003e( 10.41, 30.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.04\u003c/p\u003e\n \u003cp\u003e(-0.03, 0.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.274\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eWestern Sub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 63098.18\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;36135.66, 102132.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;168583.91\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;96959.18, 271469.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;96.54\u003c/p\u003e\n \u003cp\u003e( 55.68,156.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e102.78\u003c/p\u003e\n \u003cp\u003e( 59.52,165.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.23\u003c/p\u003e\n \u003cp\u003e( 0.19, 0.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003e\n \u003cp\u003eNOTE:ASIR,age-standardised incidence rate;APPC,average annual percentage change;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Age-standardised DALY rates\u003c/strong\u003e \u003cstrong\u003eof interstitial lung disease and pulmonary sarcoidosis in adolescents and young adults in 1990 and 2019 for all locations, with AAPC from 2009 and 2019\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003elocation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNumbers in 1990\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNumbers in 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAge-standardized rates in 1990\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;(95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAge standardized rates in 2019\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;(95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAAPC, %\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;(95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eGlobal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e158654.11\u003c/p\u003e\n \u003cp\u003e(127975.23,203108.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e241150.69\u003c/p\u003e\n \u003cp\u003e(193974.44,299613.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;7.56\u003c/p\u003e\n \u003cp\u003e( 6.10, 9.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;8.02\u003c/p\u003e\n \u003cp\u003e( 6.45, 9.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.23\u003c/p\u003e\n \u003cp\u003e( 0.05, 0.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;33589.50\u003c/p\u003e\n \u003cp\u003e( 27527.65, 43736.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;34417.50\u003c/p\u003e\n \u003cp\u003e( 28584.36, 42643.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.02\u003c/p\u003e\n \u003cp\u003e( 8.21,13.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;9.60\u003c/p\u003e\n \u003cp\u003e( 7.97,11.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.15\u003c/p\u003e\n \u003cp\u003e(-0.24,-0.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh-middle SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;31653.87\u003c/p\u003e\n \u003cp\u003e( 25331.06, 39702.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;33632.19\u003c/p\u003e\n \u003cp\u003e( 26695.51, 41830.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;6.54\u003c/p\u003e\n \u003cp\u003e( 5.23, 8.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;6.01\u003c/p\u003e\n \u003cp\u003e( 4.76, 7.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.28\u003c/p\u003e\n \u003cp\u003e(-0.44,-0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMiddle SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;39931.68\u003c/p\u003e\n \u003cp\u003e( 32027.70, 53341.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;64930.84\u003c/p\u003e\n \u003cp\u003e( 52958.60, 79867.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;5.70\u003c/p\u003e\n \u003cp\u003e( 4.57, 7.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;6.75\u003c/p\u003e\n \u003cp\u003e( 5.51, 8.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.59\u003c/p\u003e\n \u003cp\u003e( 0.29, 0.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLow-middle SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;39370.82\u003c/p\u003e\n \u003cp\u003e( 27321.23, 58199.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;75052.95\u003c/p\u003e\n \u003cp\u003e( 55355.05,102675.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;9.78\u003c/p\u003e\n \u003cp\u003e( 6.78,14.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.64\u003c/p\u003e\n \u003cp\u003e( 7.84,14.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.34\u003c/p\u003e\n \u003cp\u003e( 0.07, 0.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLow SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;13992.45\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;8404.12, 21315.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;32888.13\u003c/p\u003e\n \u003cp\u003e( 23171.58, 44247.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;8.04\u003c/p\u003e\n \u003cp\u003e( 4.85,12.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;8.17\u003c/p\u003e\n \u003cp\u003e( 5.77,10.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.09\u003c/p\u003e\n \u003cp\u003e(-0.08, 0.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.312\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAndean Latin America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 3935.11\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;2474.65, \u0026nbsp; \u0026nbsp; 6070.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 6550.46\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;4451.49, \u0026nbsp; \u0026nbsp; 9114.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e26.88\u003c/p\u003e\n \u003cp\u003e(17.00,41.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e25.69\u003c/p\u003e\n \u003cp\u003e(17.46,35.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.08\u003c/p\u003e\n \u003cp\u003e(-0.36, 0.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.574\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAustralasia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;297.58\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 193.70, \u0026nbsp; \u0026nbsp; \u0026nbsp;452.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;662.88\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 372.67, \u0026nbsp; \u0026nbsp; 1033.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;3.56\u003c/p\u003e\n \u003cp\u003e( 2.32, 5.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;6.39\u003c/p\u003e\n \u003cp\u003e( 3.58,10.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;2.04\u003c/p\u003e\n \u003cp\u003e( 1.63, 2.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCaribbean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;916.31\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 705.59, \u0026nbsp; \u0026nbsp; 1220.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 1886.90\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;1304.23, \u0026nbsp; \u0026nbsp; 2663.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;6.67\u003c/p\u003e\n \u003cp\u003e( 5.14, 8.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.43\u003c/p\u003e\n \u003cp\u003e( 7.21,14.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;1.55\u003c/p\u003e\n \u003cp\u003e( 1.27, 1.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCentral Asia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 3952.13\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;2644.55, \u0026nbsp; \u0026nbsp; 5308.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 4873.89\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;3490.19, \u0026nbsp; \u0026nbsp; 6501.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e14.49\u003c/p\u003e\n \u003cp\u003e( 9.71,19.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12.51\u003c/p\u003e\n \u003cp\u003e( 8.97,16.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.47\u003c/p\u003e\n \u003cp\u003e(-0.67,-0.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCentral Europe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 4984.32\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;3553.67, \u0026nbsp; \u0026nbsp; 6585.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 3272.38\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;2446.87, \u0026nbsp; \u0026nbsp; 4361.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.29\u003c/p\u003e\n \u003cp\u003e( 7.31,13.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;8.18\u003c/p\u003e\n \u003cp\u003e( 6.11,10.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.79\u003c/p\u003e\n \u003cp\u003e(-0.90,-0.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCentral Latin America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 6158.96\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;5011.27, \u0026nbsp; \u0026nbsp; 8408.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;13701.68\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;8793.11, 18241.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;9.74\u003c/p\u003e\n \u003cp\u003e( 7.95,13.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e13.64\u003c/p\u003e\n \u003cp\u003e( 8.75,18.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;1.25\u003c/p\u003e\n \u003cp\u003e( 1.12, 1.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCentral Sub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 1194.45\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 446.77, \u0026nbsp; \u0026nbsp; 2284.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 2900.34\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;1442.05, \u0026nbsp; \u0026nbsp; 5198.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;6.35\u003c/p\u003e\n \u003cp\u003e( 2.36,12.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;6.12\u003c/p\u003e\n \u003cp\u003e( 3.03,10.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.14\u003c/p\u003e\n \u003cp\u003e(-0.21,-0.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eEast Asia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;16366.55\u003c/p\u003e\n \u003cp\u003e( 11910.93, 24114.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;13455.89\u003c/p\u003e\n \u003cp\u003e( 10297.28, 17678.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;2.99\u003c/p\u003e\n \u003cp\u003e( 2.18, 4.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;2.39\u003c/p\u003e\n \u003cp\u003e( 1.83, 3.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.71\u003c/p\u003e\n \u003cp\u003e(-0.87,-0.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eEastern Europe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 7209.33\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;5108.30, 10091.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 5221.64\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;3493.96, \u0026nbsp; \u0026nbsp; 7881.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;7.84\u003c/p\u003e\n \u003cp\u003e( 5.56,10.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;6.58\u003c/p\u003e\n \u003cp\u003e( 4.40, 9.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.47\u003c/p\u003e\n \u003cp\u003e(-0.70,-0.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eEastern Sub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 3781.84\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;1480.81, \u0026nbsp; \u0026nbsp; 6177.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 9069.32\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;4674.88, 13808.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;5.93\u003c/p\u003e\n \u003cp\u003e( 2.32, 9.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;5.97\u003c/p\u003e\n \u003cp\u003e( 3.07, 9.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.03\u003c/p\u003e\n \u003cp\u003e(-0.17, 0.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.739\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh-income Asia Pacific\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 5802.66\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;3793.34, \u0026nbsp; \u0026nbsp; 8878.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 4388.64\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;3133.25, \u0026nbsp; \u0026nbsp; 6217.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;8.55\u003c/p\u003e\n \u003cp\u003e( 5.58,13.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;7.78\u003c/p\u003e\n \u003cp\u003e( 5.56,11.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.27\u003c/p\u003e\n \u003cp\u003e(-0.42,-0.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh-income North America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;19646.72\u003c/p\u003e\n \u003cp\u003e( 15795.54, 24344.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;16597.08\u003c/p\u003e\n \u003cp\u003e( 13662.01, 21339.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e16.21\u003c/p\u003e\n \u003cp\u003e(13.03,20.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e13.05\u003c/p\u003e\n \u003cp\u003e(10.73,16.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.75\u003c/p\u003e\n \u003cp\u003e(-0.88,-0.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eNorth Africa and Middle East\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 8784.19\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;6028.41, 13306.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;20859.22\u003c/p\u003e\n \u003cp\u003e( 15448.59, 29636.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;6.92\u003c/p\u003e\n \u003cp\u003e( 4.76,10.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;7.90\u003c/p\u003e\n \u003cp\u003e( 5.85,11.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.45\u003c/p\u003e\n \u003cp\u003e( 0.37, 0.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eOceania\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 1136.35\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 700.86, \u0026nbsp; \u0026nbsp; 1886.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 2480.44\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;1480.43, \u0026nbsp; \u0026nbsp; 4146.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e44.72\u003c/p\u003e\n \u003cp\u003e(27.76,73.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e46.43\u003c/p\u003e\n \u003cp\u003e(27.82,77.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.11\u003c/p\u003e\n \u003cp\u003e( 0.02, 0.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSouth Asia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;48118.28\u003c/p\u003e\n \u003cp\u003e( 31496.76, 72747.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;96270.30\u003c/p\u003e\n \u003cp\u003e( 68721.06,134250.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12.14\u003c/p\u003e\n \u003cp\u003e( 7.94,18.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12.98\u003c/p\u003e\n \u003cp\u003e( 9.26,18.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.26\u003c/p\u003e\n \u003cp\u003e(-0.07, 0.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSoutheast Asia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 4896.87\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;3323.52, \u0026nbsp; \u0026nbsp; 8515.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 8196.02\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;5907.85, 12585.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;2.60\u003c/p\u003e\n \u003cp\u003e( 1.77, 4.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;2.98\u003c/p\u003e\n \u003cp\u003e( 2.15, 4.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.47\u003c/p\u003e\n \u003cp\u003e( 0.34, 0.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSouthern Latin America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 2196.23\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;1580.35, \u0026nbsp; \u0026nbsp; 3004.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 3182.43\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;2159.12, \u0026nbsp; \u0026nbsp; 4359.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11.72\u003c/p\u003e\n \u003cp\u003e( 8.44,16.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12.29\u003c/p\u003e\n \u003cp\u003e( 8.32,16.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.18\u003c/p\u003e\n \u003cp\u003e(-0.18, 0.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.315\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSouthern Sub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 2768.84\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;1659.95, \u0026nbsp; \u0026nbsp; 3810.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 3333.17\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;2192.57, \u0026nbsp; \u0026nbsp; 5277.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e14.17\u003c/p\u003e\n \u003cp\u003e( 8.49,19.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;9.76\u003c/p\u003e\n \u003cp\u003e( 6.43,15.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.30\u003c/p\u003e\n \u003cp\u003e(-1.86,-0.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eTropical Latin America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 6308.99\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;4850.56, \u0026nbsp; \u0026nbsp; 7965.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 9010.50\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;6544.58, 11158.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.34\u003c/p\u003e\n \u003cp\u003e( 7.94,13.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;9.78\u003c/p\u003e\n \u003cp\u003e( 7.09,12.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.20\u003c/p\u003e\n \u003cp\u003e(-0.50, 0.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.177\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eWestern Europe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 7921.11\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;6135.35, 11330.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 9544.40\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;6528.51, 11869.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;5.38\u003c/p\u003e\n \u003cp\u003e( 4.17, 7.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;6.84\u003c/p\u003e\n \u003cp\u003e( 4.65, 8.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.82\u003c/p\u003e\n \u003cp\u003e( 0.70, 0.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eWestern Sub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 2277.31\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;1336.40, \u0026nbsp; \u0026nbsp; 3373.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 5693.10\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;3779.46, \u0026nbsp; \u0026nbsp; 8199.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;3.51\u003c/p\u003e\n \u003cp\u003e( 2.06, 5.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;3.49\u003c/p\u003e\n \u003cp\u003e( 2.32, 5.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.03\u003c/p\u003e\n \u003cp\u003e(-0.15, 0.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.632\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNOTE:APPC,average annual percentage change;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3. ASMR of interstitial lung disease and pulmonary sarcoidosis in adolescents and young adults in 1990 and 2019 for all locations, with AAPC from 2009 and 2019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003elocation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNumbers in 1990\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNumbers in 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAge-standardized rates in 1990\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;(95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAge standardized rates in 2019\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;(95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAAPC, %\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;(95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eGlobal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2200.13\u003c/p\u003e\n \u003cp\u003e(1774.10,2824.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3428.03\u003c/p\u003e\n \u003cp\u003e(2759.44,4266.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003cp\u003e(0.09,0.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003cp\u003e(0.09,0.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.30\u003c/p\u003e\n \u003cp\u003e( 0.08, 0.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;451.03\u003c/p\u003e\n \u003cp\u003e( 379.29, 598.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;467.36\u003c/p\u003e\n \u003cp\u003e( 387.81, 578.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003cp\u003e(0.11,0.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003cp\u003e(0.11,0.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.14\u003c/p\u003e\n \u003cp\u003e(-0.32, 0.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.129\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh-middle SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;406.92\u003c/p\u003e\n \u003cp\u003e( 328.42, 493.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;443.35\u003c/p\u003e\n \u003cp\u003e( 348.14, 521.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003cp\u003e(0.07,0.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003cp\u003e(0.06,0.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.23\u003c/p\u003e\n \u003cp\u003e(-0.44,-0.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.035\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMiddle SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;557.21\u003c/p\u003e\n \u003cp\u003e( 451.95, 757.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;932.24\u003c/p\u003e\n \u003cp\u003e( 754.67,1149.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003cp\u003e(0.07,0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003cp\u003e(0.08,0.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.64\u003c/p\u003e\n \u003cp\u003e( 0.28, 1.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLow-middle SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;586.10\u003c/p\u003e\n \u003cp\u003e( 386.42, 907.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1126.03\u003c/p\u003e\n \u003cp\u003e( 804.44,1606.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003cp\u003e(0.10,0.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003cp\u003e(0.11,0.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.31\u003c/p\u003e\n \u003cp\u003e(-0.01, 0.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.061\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLow SDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;197.16\u003c/p\u003e\n \u003cp\u003e( 106.71, 315.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;455.67\u003c/p\u003e\n \u003cp\u003e( 302.09, 634.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003cp\u003e(0.06,0.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003cp\u003e(0.08,0.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.03\u003c/p\u003e\n \u003cp\u003e(-0.18, 0.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAndean Latin America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 62.71\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;38.66, \u0026nbsp; \u0026nbsp; 98.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;104.82\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;69.72, 147.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.44\u003c/p\u003e\n \u003cp\u003e(0.27,0.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003cp\u003e(0.27,0.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.11\u003c/p\u003e\n \u003cp\u003e(-0.40, 0.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.453\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAustralasia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;3.58\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 2.16, \u0026nbsp; \u0026nbsp; \u0026nbsp;6.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;9.75\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 4.97, \u0026nbsp; \u0026nbsp; 15.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003cp\u003e(0.03,0.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003cp\u003e(0.05,0.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;2.77\u003c/p\u003e\n \u003cp\u003e( 2.42, 3.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCaribbean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 13.82\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;10.46, \u0026nbsp; \u0026nbsp; 18.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 29.86\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;19.98, \u0026nbsp; \u0026nbsp; 43.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003cp\u003e(0.08,0.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003cp\u003e(0.11,0.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;1.68\u003c/p\u003e\n \u003cp\u003e( 1.36, 1.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCentral Asia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 59.32\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;37.62, \u0026nbsp; \u0026nbsp; 81.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 72.92\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;50.06, \u0026nbsp; \u0026nbsp; 99.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003cp\u003e(0.14,0.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003cp\u003e(0.13,0.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.51\u003c/p\u003e\n \u003cp\u003e(-0.74,-0.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCentral Europe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 61.72\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;42.54, \u0026nbsp; \u0026nbsp; 80.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 33.94\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;25.36, \u0026nbsp; \u0026nbsp; 42.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003cp\u003e(0.09,0.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003cp\u003e(0.06,0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.36\u003c/p\u003e\n \u003cp\u003e(-1.53,-1.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCentral Latin America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 93.17\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;74.95, 130.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;219.49\u003c/p\u003e\n \u003cp\u003e( 135.75, 296.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003cp\u003e(0.12,0.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003cp\u003e(0.14,0.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;1.40\u003c/p\u003e\n \u003cp\u003e( 1.26, 1.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCentral Sub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 15.75\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp; 4.05, \u0026nbsp; \u0026nbsp; 33.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 37.00\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;14.20, \u0026nbsp; \u0026nbsp; 74.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003cp\u003e(0.02,0.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003cp\u003e(0.03,0.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.31\u003c/p\u003e\n \u003cp\u003e(-0.40,-0.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eEast Asia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;203.77\u003c/p\u003e\n \u003cp\u003e( 147.41, 324.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;182.34\u003c/p\u003e\n \u003cp\u003e( 135.70, 246.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003cp\u003e(0.03,0.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003cp\u003e(0.02,0.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.43\u003c/p\u003e\n \u003cp\u003e(-0.67,-0.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eEastern Europe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 73.80\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;51.31, 103.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 44.72\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;31.73, \u0026nbsp; \u0026nbsp; 74.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003cp\u003e(0.06,0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003cp\u003e(0.04,0.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.08\u003c/p\u003e\n \u003cp\u003e(-1.62,-0.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eEastern Sub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 49.42\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;13.86, \u0026nbsp; \u0026nbsp; 86.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;117.56\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;49.64, 189.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003cp\u003e(0.02,0.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003cp\u003e(0.03,0.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.04\u003c/p\u003e\n \u003cp\u003e(-0.29, 0.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.724\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh-income Asia Pacific\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 62.08\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;42.34, 102.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 45.30\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;35.43, \u0026nbsp; \u0026nbsp; 68.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003cp\u003e(0.06,0.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003cp\u003e(0.06,0.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.41\u003c/p\u003e\n \u003cp\u003e(-0.57,-0.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh-income North America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;276.07\u003c/p\u003e\n \u003cp\u003e( 217.08, 341.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;226.53\u003c/p\u003e\n \u003cp\u003e( 186.67, 305.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003cp\u003e(0.18,0.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003cp\u003e(0.15,0.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.84\u003c/p\u003e\n \u003cp\u003e(-1.02,-0.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eNorth Africa and Middle East\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;106.40\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;68.98, 179.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;260.09\u003c/p\u003e\n \u003cp\u003e( 189.03, 394.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003cp\u003e(0.06,0.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003cp\u003e(0.07,0.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.49\u003c/p\u003e\n \u003cp\u003e( 0.29, 0.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eOceania\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 17.02\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;10.09, \u0026nbsp; \u0026nbsp; 28.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 36.52\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;20.54, \u0026nbsp; \u0026nbsp; 64.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003cp\u003e(0.41,1.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003cp\u003e(0.39,1.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.01\u003c/p\u003e\n \u003cp\u003e(-0.08, 0.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.796\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSouth Asia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;732.31\u003c/p\u003e\n \u003cp\u003e( 453.86,1157.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1454.17\u003c/p\u003e\n \u003cp\u003e(1012.07,2114.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003cp\u003e(0.12,0.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003cp\u003e(0.14,0.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.19\u003c/p\u003e\n \u003cp\u003e(-0.21, 0.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.345\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSoutheast Asia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 69.50\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;45.48, 126.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;119.59\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;83.92, 193.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003cp\u003e(0.02,0.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003cp\u003e(0.03,0.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.51\u003c/p\u003e\n \u003cp\u003e( 0.36, 0.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSouthern Latin America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 33.82\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;23.65, \u0026nbsp; \u0026nbsp; 47.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 49.27\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;32.29, \u0026nbsp; \u0026nbsp; 68.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003cp\u003e(0.13,0.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003cp\u003e(0.12,0.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.19\u003c/p\u003e\n \u003cp\u003e(-0.21, 0.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSouthern Sub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 39.78\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;21.85, \u0026nbsp; \u0026nbsp; 56.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 44.43\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;27.00, \u0026nbsp; \u0026nbsp; 77.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003cp\u003e(0.11,0.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003cp\u003e(0.08,0.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.62\u003c/p\u003e\n \u003cp\u003e(-2.31,-0.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eTropical Latin America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 94.28\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;70.10, 119.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;147.96\u003c/p\u003e\n \u003cp\u003e( 106.00, 184.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003cp\u003e(0.12,0.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003cp\u003e(0.11,0.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.07\u003c/p\u003e\n \u003cp\u003e(-0.24, 0.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eWestern Europe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;109.75\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;85.30, 163.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;139.51\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;89.08, 168.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003cp\u003e(0.06,0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003cp\u003e(0.06,0.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;0.95\u003c/p\u003e\n \u003cp\u003e( 0.76, 1.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eWestern Sub-Saharan Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 22.07\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;10.58, \u0026nbsp; \u0026nbsp; 33.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp; 52.24\u003c/p\u003e\n \u003cp\u003e( \u0026nbsp;32.51, \u0026nbsp; \u0026nbsp; 73.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003cp\u003e(0.02,0.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003cp\u003e(0.02,0.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.23\u003c/p\u003e\n \u003cp\u003e(-0.43,-0.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNOTE:;ASMR,age-standardised mortality rates ;APPC,average annual percentage change;\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, we collected data on the incidence, mortality, and DALYs in AYAs from 204 countries and territories between 1990 and 2019, focusing on ILD and publicly available information on pulmonary sarcoidosis. The findings of this study contribute to our understanding of ILD and pulmonary sarcoidosis patterns in AYAs. Consistent with a previous study\u0026nbsp;[22], an increasing trend in\u0026nbsp;the global age-standardised incidence and DALY rates was observed in AYAs. Additionally, age-standardised incidence rates were highest in countries with low SDIs. This trend is associated with factors such as increased industrial activity, air pollution, tobacco smoke, automobile traffic, and higher levels of occupational exposure in these\u0026nbsp;densely populated areas\u0026nbsp;[23,24]. Furthermore, age-standardised DALY and mortality rates among AYAs were highest in\u0026nbsp;low\u0026nbsp;SDI countries. Several factors contribute to this: 1) The diagnosis of ILD or pulmonary sarcoidosis imposes a significant financial burden on individuals, particularly affecting low-income populations\u0026nbsp;[25]. 2) Rising treatment costs over time exacerbate financial pressures. Individuals with low incomes or living in low-income areas frequently face challenges accessing necessary medications and medical services\u0026nbsp;[26]. Owing to advances in healthcare and public health, the global DALYs\u0026nbsp;is expected to decrease. However, our findings show that standardised DALY rates decreased in high and middle\u0026ndash;high SDI countries but increased in low, middle\u0026ndash;low, and low-SDI countries.\u0026nbsp;These inter-regional differences\u0026nbsp;were evident. Low-SDI countries could benefit from observing and adopting best practices by high-SDI countries to advocate for\u0026nbsp;a more efficient allocation of healthcare resources. Our analyses showed that age-standardised morbidity in AYAs was higher in women,\u0026nbsp;whereas age-standardised DALY and mortality were higher in men. Despite the higher incidence in women, men tended to have a poorer prognosis. Additionally, CTD-ILD is more common in women but tends to progress more rapidly in men, with a higher prevalence of common interstitial pneumonia\u0026nbsp;[27,28].\u003c/p\u003e\n\u003cp\u003eBetween 1990 and 2019, age-standardised DALY and mortality rates were negatively correlated with SDI in AYAs. Conversely, age-standardised morbidity was positively correlated with the SDI. This can be attributed to the increased accessibility of healthcare in more developed regions, leading to early detection and timely treatment [29]. Our study showed a significant increase in global morbidity among AYAs, especially in low-SDI areas, mainly due to population growth and epidemiological changes. Analyses of global mortality and DALYs among AYAs showed that epidemiological changes and population growth led to increases in mortality and DALYs. Our study was limited by a lack of primary sources, and the GBD 2019 data may have underestimated the total burden of ILD. The GBD 2019 data excluded external causes of ILD, pharmacological ILD, ILD due to systemic rheumatic diseases, and other specific types of ILD under the categories of ILD and pulmonary sarcoidosis [30]. Therefore, future GBD reports should include these subtypes to provide a more comprehensive overview of the burden of ILD. The complexity and country-specific nature of the classification of ILD and pulmonary nodular disease present challenges in identifying cases and determining data sources. Including a broader and more detailed classification of ILD in the GBD study will improve our understanding of the disease burden.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAYAs with ILD and pulmonary sarcoidosis are at a greater risk of long-term effects that may impact productivity growth and social structure than older patients. Therefore, recognising and addressing the global burden of ILD and pulmonary sarcoidosis in AYAs is critical for developing effective healthcare policies and improving the outcomes associated with these diseases.\u003c/p\u003e\n"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding sources\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData statement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe original contributions presented in the study are included in the\u003c/p\u003e\n\u003cp\u003earticle/supplementary material; further inquiries can be directed to the\u003c/p\u003e\n\u003cp\u003ecorresponding authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eXiaoshuang He\u003c/strong\u003e: Data curation, Methodology, Formal analysis, Writing \u0026ndash;\u003c/p\u003e\n\u003cp\u003eoriginal draft, Writing \u0026ndash; review \u0026amp; editing. \u003cstrong\u003eLu Wang\u003c/strong\u003e: Data curation,\u003c/p\u003e\n\u003cp\u003eFormal analysis. \u003cstrong\u003eYu Zhao\u003c/strong\u003e: Data curation, Writing \u0026ndash; original draft. \u003cstrong\u003eYuanyuan Qu:\u0026nbsp;\u003c/strong\u003eMethodology. \u003cstrong\u003eWenyan Xin:\u0026nbsp;\u003c/strong\u003eResources. \u003cstrong\u003eLina Xu:\u0026nbsp;\u003c/strong\u003eResources. \u003cstrong\u003eWanyu Li:\u0026nbsp;\u003c/strong\u003eResources. \u003cstrong\u003eChao Wu\u003c/strong\u003e: Conceptualization, Writing \u0026ndash; original draft, Project administration.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo parts of this manuscript are being considered for publication\u003c/p\u003e\n\u003cp\u003eelsewhere. All authors have read and approved this manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSharp, M., Mustafa, A. M., Farah, N., \u0026amp; Bonham, C. A. (2023). Interstitial Lung Disease and Sarcoidosis. \u003cem\u003eClinics in chest medicine\u003c/em\u003e, \u003cem\u003e44\u003c/em\u003e(3), 575\u0026ndash;584. https://doi.org/10.1016/j.ccm.2023.06.003\u003c/li\u003e\n\u003cli\u003eHuang H. (2024). \u003cem\u003eZhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases\u003c/em\u003e, \u003cem\u003e47\u003c/em\u003e(1), 44\u0026ndash;49. https://doi.org/10.3760/cma.j.cn112147-20231021-00252\u003c/li\u003e\n\u003cli\u003eMaher T. M. (2024). Interstitial Lung Disease: A Review. \u003cem\u003eJAMA\u003c/em\u003e, \u003cem\u003e331\u003c/em\u003e(19), 1655\u0026ndash;1665. https://doi.org/10.1001/jama.2024.3669\u003c/li\u003e\n\u003cli\u003eRaghu, G., Behr, J., Brown, K. 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Diagnosis and Treatment of Pulmonary Sarcoidosis: A Review. \u003cem\u003eJAMA\u003c/em\u003e, \u003cem\u003e327\u003c/em\u003e(9), 856\u0026ndash;867. https://doi.org/10.1001/jama.2022.1570\u003c/li\u003e\n\u003cli\u003eWong, A. W., Koo, J., Ryerson, C. J., Sadatsafavi, M., \u0026amp; Chen, W. (2022). A systematic review on the economic burden of interstitial lung disease and the cost-effectiveness of current therapies. \u003cem\u003eBMC pulmonary medicine\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(1), 148. https://doi.org/10.1186/s12890-022-01922-2\u003c/li\u003e\n\u003cli\u003eHarper, L. J., Love, G., Singh, R., Smith, A., Culver, D. A., \u0026amp; Thornton, J. D. (2021). 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Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. \u003cem\u003eLancet (London, England)\u003c/em\u003e, \u003cem\u003e396\u003c/em\u003e(10258), 1204\u0026ndash;1222. https://doi.org/10.1016/S0140-6736(20)30925-9\u003c/li\u003e\n\u003cli\u003eGBD 2019 Diseases and Injuries Collaborators (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. \u003cem\u003eLancet (London, England)\u003c/em\u003e, \u003cem\u003e396\u003c/em\u003e(10258), 1204\u0026ndash;1222. https://doi.org/10.1016/S0140-6736(20)30925-9\u003c/li\u003e\n\u003cli\u003eGBD 2019 Demographics Collaborators (2020). Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. \u003cem\u003eLancet (London, England)\u003c/em\u003e, \u003cem\u003e396\u003c/em\u003e(10258), 1160\u0026ndash;1203. https://doi.org/10.1016/S0140-6736(20)30977-6\u003c/li\u003e\n\u003cli\u003eKim, H. J., Fay, M. P., Feuer, E. J., \u0026amp; Midthune, D. N. (2000). Permutation tests for joinpoint regression with applications to cancer rates. \u003cem\u003eStatistics in medicine\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e(3), 335\u0026ndash;351. https://doi.org/10.1002/(sici)1097-0258(20000215)19:3\u0026lt;335::aid-sim336\u0026gt;3.0.co;2-z\u003c/li\u003e\n\u003cli\u003eCheng, X., Yang, Y., Schwebel, D. C., Liu, Z., Li, L., Cheng, P., Ning, P., \u0026amp; Hu, G. (2020). Population ageing and mortality during 1990-2017: A global decomposition analysis. \u003cem\u003ePLoS medicine\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e(6), e1003138. https://doi.org/10.1371/journal.pmed.1003138\u003c/li\u003e\n\u003cli\u003eMa, X., Zhu, L., Kurche, J. S., Xiao, H., Dai, H., \u0026amp; Wang, C. (2022). Global and regional burden of interstitial lung disease and pulmonary sarcoidosis from 1990 to 2019: results from the Global Burden of Disease study 2019. \u003cem\u003eThorax\u003c/em\u003e, \u003cem\u003e77\u003c/em\u003e(6), 596\u0026ndash;605. https://doi.org/10.1136/thoraxjnl-2020-216732\u003c/li\u003e\n\u003cli\u003eSes\u0026eacute;, L., Caliez, J., Annesi-Maesano, I., Cottin, V., Pesce, G., Didier, M., Carton, Z., Israel-Biet, D., Crestani, B., Dudoret, S. G., Cadranel, J., Wallaert, B., Tazi, A., Ma\u0026icirc;tre, B., Pr\u0026eacute;vot, G., Marchand-Adam, S., Hirschi, S., Dury, S., Giraud, V., Gondouin, A., \u0026hellip; COFI collaborators (2021). 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Income and Other Contributors to Poor Outcomes in U.S. Patients with Sarcoidosis. \u003cem\u003eAmerican journal of respiratory and critical care medicine\u003c/em\u003e, \u003cem\u003e201\u003c/em\u003e(8), 955\u0026ndash;964. https://doi.org/10.1164/rccm.201906-1250OC\u003c/li\u003e\n\u003cli\u003eJohannson, K. A., Chaudhuri, N., Adegunsoye, A., \u0026amp; Wolters, P. J. (2021). Treatment of fibrotic interstitial lung disease: current approaches and future directions. \u003cem\u003eLancet (London, England)\u003c/em\u003e, \u003cem\u003e398\u003c/em\u003e(10309), 1450\u0026ndash;1460. https://doi.org/10.1016/S0140-6736(21)01826-2\u003c/li\u003e\n\u003cli\u003eManfredi, A., Salvarani, C., \u0026amp; Sebastiani, M. (2023). Rituximab for connective tissue disease-associated interstitial lung disease. \u003cem\u003eThe Lancet. Respiratory medicine\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e(1), 3\u0026ndash;4. https://doi.org/10.1016/S2213-2600(22)00356-3\u003c/li\u003e\n\u003cli\u003eShin, K. H., \u0026amp; Shin, S. W. (2018). Idiopathic Pulmonary Fibrosis. \u003cem\u003eThe New England journal of medicine\u003c/em\u003e, \u003cem\u003e379\u003c/em\u003e(8), 795\u0026ndash;796. https://doi.org/10.1056/NEJMc1807508\u003c/li\u003e\n\u003cli\u003eKim, T. J., Vonneilich, N., L\u0026uuml;decke, D., \u0026amp; von dem Knesebeck, O. (2017). Income, financial barriers to health care and public health expenditure: A multilevel analysis of 28 countries. \u003cem\u003eSocial science \u0026amp; medicine (1982)\u003c/em\u003e, \u003cem\u003e176\u003c/em\u003e, 158\u0026ndash;165. https://doi.org/10.1016/j.socscimed.2017.01.044\u003c/li\u003e\n\u003cli\u003ePodolanczuk, A. J., Wong, A. W., Saito, S., Lasky, J. A., Ryerson, C. J., \u0026amp; Eickelberg, O. (2021). Update in Interstitial Lung Disease 2020. \u003cem\u003eAmerican journal of respiratory and critical care medicine\u003c/em\u003e, \u003cem\u003e203\u003c/em\u003e(11), 1343\u0026ndash;1352. https://doi.org/10.1164/rccm.202103-0559UP\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Table 4 to 6","content":"\u003cp\u003eTable 4 to 6 are available in the Supplementary Files section.\u003c/p\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-medical-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejmr","sideBox":"Learn more about [European Journal of Medical Research](http://eurjmedres.biomedcentral.com)","snPcode":"40001","submissionUrl":"https://submission.nature.com/new-submission/40001/3","title":"European Journal of Medical Research","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"burden, adolescents and young adults, incidence, DALYs, death, trend","lastPublishedDoi":"10.21203/rs.3.rs-5787561/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5787561/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Interstitial lung disease (ILD) and pulmonary sarcoidosis are common respiratory diseases that are difficult to diagnose and costly to treat. Adolescents and young adults (AYAs) aged 15–39 years are frequently overlooked in global burden estimates despite their unique epidemiological and societal implications. Comprehensive global burden estimates are lacking. To address this gap, we analysed the results of the Global Burden of Disease Study (GBD) 2019, focusing on Disability-Adjusted Life Years (DALYs).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e Using the GBD 2019 dataset, we calculated age-standardised rate of incidence, mortality, and DALYs and their average annual percentage change from 1990–2019 across various factors, including sex, socio-demographic index (SDI), and geographic region. Decomposition analyses explored the impacts of population growth, changing age structures, and epidemiological changes on ILD incidence, DALYs, and mortality in AYAs globally and across different SDI and GBD regions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eIn 2019, there were 2.6 million cases of ILD and pulmonary sarcoidosis in AYAs, and 3,428 deaths were attributed to these diseases. Age-standardised incidence and DALY rates significantly increased between 1990 and 2019. Females experienced higher rates than males. Standardised DALY rates decreased in high and middle–high SDI countries but increased in low, middle–low, and low-SDI countries. The primary reason was population growth, significantly impacting areas in the lower SDI quintiles.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eThis study provides recent epidemiological data on the burden of ILD and pulmonary sarcoidosis in AYAs. These findings highlight the importance of targeted control measures to reduce the burden in this age group.\u003c/p\u003e","manuscriptTitle":"Global Burden of Disease of interstitial lung disease and pulmonary sarcoidosis in adolescents and young adults (1990–2019)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-14 16:36:12","doi":"10.21203/rs.3.rs-5787561/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-07-09T07:11:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-07T21:31:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"212868575078676335054779756508936731830","date":"2025-07-01T21:07:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"162810902804383249874149192287883596605","date":"2025-07-01T13:03:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"173290547795246262973376500763832590765","date":"2025-05-31T06:15:44+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-06T07:23:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"293886243743999732816168202866055908626","date":"2025-04-29T13:31:21+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-03-10T21:55:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-01-10T15:40:29+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-01-10T13:36:16+00:00","index":"","fulltext":""},{"type":"submitted","content":"European Journal of Medical Research","date":"2025-01-08T09:14:45+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-medical-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ejmr","sideBox":"Learn more about [European Journal of Medical Research](http://eurjmedres.biomedcentral.com)","snPcode":"40001","submissionUrl":"https://submission.nature.com/new-submission/40001/3","title":"European Journal of Medical Research","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6246c33e-66d0-4153-b385-3fbf70f1029d","owner":[],"postedDate":"January 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-09-29T16:00:45+00:00","versionOfRecord":{"articleIdentity":"rs-5787561","link":"https://doi.org/10.1186/s40001-025-03141-x","journal":{"identity":"european-journal-of-medical-research","isVorOnly":false,"title":"European Journal of Medical Research"},"publishedOn":"2025-09-26 15:57:37","publishedOnDateReadable":"September 26th, 2025"},"versionCreatedAt":"2025-01-14 16:36:12","video":"","vorDoi":"10.1186/s40001-025-03141-x","vorDoiUrl":"https://doi.org/10.1186/s40001-025-03141-x","workflowStages":[]},"version":"v1","identity":"rs-5787561","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5787561","identity":"rs-5787561","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}