A Systematic Analysis of Urticaria Disease Burden, Risk Factors in Adolescents and Middle-aged Adults (1990 - 2021) and 2050 Trend Forecast: Based on the 2021 Global Disease Study

A Systematic Analysis of Urticaria Disease Burden, Risk Factors in Adolescents and Middle-aged Adults (1990 - 2021) and 2050 Trend Forecast: Based on the 2021 Global Disease Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Systematic Analysis of Urticaria Disease Burden, Risk Factors in Adolescents and Middle-aged Adults (1990 - 2021) and 2050 Trend Forecast: Based on the 2021 Global Disease Study Jiangjiao Liu, Ying Pan, Ying Song This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6598964/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Urticaria, one of the most prevalent skin conditions worldwide, has a substantial impact on patients' quality of life The middle - aged and young population (15 - 49 years old) constitutes the backbone of society and families Analyzing their urticaria disease burden is crucial for public health policymaking. However, existing research on the global urticaria disease burden and its trends among middle - aged and young individuals is still relatively scarce. Objective: This study aims to analyze the incidence, prevalence, and disease burden (measured by disability - adjusted life - years, DALYs) of urticaria among middle - aged and young individuals globally, regionally, and nationally from 1990 to 2021, based on data from the Global Burden of Disease (GBD) database and explore its changing trends and associated factors and project the DALYs trend up to 2050 to inform healthcare policymaking. Methods: This study utilized data from the GBD database, filtering relevant data on urticaria among middle - aged and young individuals (15 - 49 years old). We calculated the incidence (ASIR), prevalence (ASPR), and DALYs rate (ASDR) using age - standardized methods and generated a world map. Using a linear regression model, we computed the annual average percentage change (EAPC) and 95% confidence interval (CI) to analyze disease burden trends across regions and countries. Additionally, we grouped patients by age (15 - 19 to 45 - 49 years old) to compare disease burden distribution across age groups and projected the DALYs trend up to 2050. All statistical analyses were performed using R software. Results: From 1990 to 2021, global urticaria cases new prevalent and DALYs in middle - aged and young individuals rose, whereas ASIR and ASPR fell. The disease burden was markedly higher in females than in males.Regionally, East Asia saw the largest drop in ASIR and ASPR, while Europe Western rose. The disease burden was higher in low - and middle - SDI countries, while high - SDI countries saw the least ASIR decline and ASPR increase. Nationally, India and China reported the highest urticaria burden. Age - specific data showed the highest incidence in the 15 - 19 age group, declining with age. By 2050, global urticaria DALYs in middle - aged and young individuals are expected to rise, but the DALYs rate may gradually decline. Conclusion: Despite declining ASIR and ASPR of urticaria among middle - aged and young individuals globally, the disease burden remains unevenly distributed. Females and younger age groups bear a heavier burden. The disease burden is especially pronounced in low - and middle - SDI countries. Future - oriented targeted interventions and policies are needed to address this emerging public health issue. urticaria burden of disease prevalence incidence disability-adjusted life years Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Urticaria, a prevalent mast cell - mediated allergic skin disease, is marked by itching and sudden - onset wheals, with or without angioedema. While not life - threatening, it can be disabling and significantly impacts quality of life( 1 ). In recent years, urticaria research has gained significant attention and achieved notable progress. Urticaria is categorized as acute or chronic based on symptom duration and can be spontaneous or induced based on triggering factors( 2 ). Most acute urticaria cases are spontaneous. Chronic spontaneous urticaria has no specific triggers and has two endotypes: IgE-mediated autoimmune/autoallergic type I and IgG - mediated type IIb. Chronic induced urticaria involves specific triggers like dermatographism, pressure, vibration, cholinergic stimuli, heat/cold, sunlight, water, and contact with certain substances. Moreover, urticaria exhibits marked epidemiological differences across regions, races, and ages.Epidemiologically, urticaria prevalence ranges from 1.5% (in the US and Europe) to 4% (in Asia and Latin America). Notably, chronic urticaria often affects middle - aged and young individuals( 3 ). Analyzing the global disease burden of urticaria in middle - aged and young individuals, its risk factors, and future trends aims to comprehensively understand its epidemiological features and disease burden across levels. This informs targeted public health policies and clinical treatment strategies. These studies help clarify urticaria incidence and prevalence trends in middle - aged and young populations across regions. This identifies high - risk areas for early intervention, informs rational medical resource allocation, prioritizes high - burden regions, assesses current treatments and public health interventions, guides future strategy adjustments, and raises public awareness to reduce patient misunderstandings and discrimination. Methods Study population All study subjects were patients diagnosed with urticaria. Although there is no international consensus on the definition of urticaria in Adolescents and Middle-Aged Adults. However, many previous studies have conventionally defined urticaria in Adolescents and Middle-Aged Adults as patients aged 15–49. This age grouping aligns with that in the GBD database facilitating data analysis and comparison. Moreover, patients in this age range have achieved stable biological and physiological maturity. Based on the above theory and prior studies, this study selected patients with urticaria aged 15–49. Data collection The Urticaria diagnosis defined in this study corresponds to the ICD-10 codes "L50". According to the International Classification of Diseases (ICD-10), urticaria is classified under code L50 and its subcodes. L50 is a general code for urticaria. Specific subcodes include :L50.0 for allergic urticaria, L50.1 for idiopathic urticaria, L50.2 for urticaria due to cold/heat, L50.3 for dermatographism urticaria,L50.4 for vibratory urticaria,L50.5 for cholinergic urticaria,L50.6 for contact urticaria, L50.8 for other urticaria types, including chronic and recurrent,L50.9 for unspecified urticaria. Solar urticaria is classified under code L56.3. The data was obtained from the Global Health data Exchange(Global Health data Exchange, GHDx) ( http://ghdx.healthdata.org/).Th e search parameters were “Urticaria” for cause; “incidence, prevalence, DALYs(Disability-Adjusted Life Years)” for measure ments; “all loctions” for location; “1990–2021” for years; “number and rate” for metrics; “male, female and both” for sex; and “Age-standardized ,15 to 49 years and corresponding 5-year bands” for age. We followed the Guidelines for Accurate and Transparent Health Estimates Reporting guidelines for cross-sectional studies. Statistical analysis Data from the GBD database describes the incidence, prevalence and DALY rates of urticaria among middle - aged and young populations globally, regionally, and nationally from 1990 to 2021 and calculated the ASIR, ASPR and ASDR for urticaria among middle - aged and young populations globally, regionally, and nationally. It generated a world map of ASIR and ASPR. The EAPC was calculated using the formula 100* (exp(β) -1), with the 95% CI derived from the linear regression model. Calculated the EAPC of urticaria among middle - aged and young populations globally, regionally, and nationally. It generated a world map of the EAPC of ASIR and EAPC of ASPR. Divided middle - aged and young urticaria patients into seven age groups: 15–19, 20–24, 25–29, 30–34, 35–39, 40–44, 45–49. Compared the age - specific burden composition of middle - aged and young urticaria patients between 1990 and 2021. The trend of DALYs counts and DALYs Rate of urticaria among middle - aged and young populations globally by 2050 was predicted. All statistics were performed using the R program (Version 4.2.1, R core team). Results Global Trends of Urticaria in Adolescents and Middle-Aged Adults from 1990 to 2021 From 1990 to 2021, the global number of incident cases of urticaria in middle - aged and young individuals showed an upward trend. It increased from 34,061,278.87 cases in 1990 (95% UI 28,510,620.09–39,445,228.14) to 48,980,455.81 cases in 2021 (41,946,875.66–56,535,268.41). From 1990 to 2021, the global number of prevalent cases of urticaria in middle - aged and young individuals also showed an upward trend. It rose from 19,560,102.20 cases in 1990 (16,203,447.31–22,872,000.70) to 28,112,995.93 cases in 2021 (23,632,580.14–33,155,870.03). The number of DALYs of urticaria in middle - aged and young individuals also showed an upward trend. From 1990 to 2021, number of DALYs increased from 1,174,072.25 cases (750,579.11–1,726,318.52) to 1,684,143.19 cases (1,079,083.42–2,451,406.98) (Fig. 1 A). From 1990 to 2021, the ASIR of urticaria in middle - aged and young individuals globally showed a downward trend. It decreased from 621.92 (520.57–720.22) per 100,000 in 1990 to 613.90 (525.75–708.59) per 100,000 in 2021. The ASPR exhibited a downward trend. It decreased from 357.15 (295.86–417.62) per 100,000 in 1990 to 352.36 (296.20–415.56) per 100,000 in 2021. The ASDR also showed a downward trend. It fell from 21.44 (13.70–31.52) per 100,000 in 1990 to 21.11 (13.52–30.73) per 100,000 in 2021(Figure 1 B). From 1990 to 2021, the number of incident cases, number of prevalent cases, and number of DALYs of urticaria in middle - aged and young females were generally higher than in males(Figure 1 A). In 2021, urticaria number of incident cases in middle - aged and young females were 1.5 times those in males༈29,005,746.15༈24,847,434.03–33,413,961.04༉vs 19,974,709.65༈16,970,723.51–23,014,288.46༉༉. Number of prevalent cases in females were 1.5 times those in males༈16,645,577.68༈13,947,013.42–19,581,464.84༉vs 11,467,418.25༈9,655,036.26–13,465,111.43༉༉. Number of DALYs in females were 1.4 times those in males༈990,335.33༈633,318.70–1,434,836.29༉vs 693,807.87༈443,201.07–1,013,034.51༉༉. From 1990 to 2021, the ASIR, ASPR, and ASDR of urticaria in both sexes showed a downward trend, similar to the general population, with female rates consistently higher than male rates༈Figure 1 B༉. In 2021, the female ASIR was 1.5 times the male ASIR༈736.59༈630.99–848.53༉per 100,000 vs 494.34༈420.00–569.57༉per 100,000༉. The female ASPR was 1.5 times the male ASPR༈422.71༈354.18–497.26༉per 100,000 vs 283.80༈238.95–333.24༉per 100,000༉. The female ASDR was 1.5 times the male ASDR༈25.15༈16.08–36.44༉per 100,000 vs 17.17༈10.97–25.07༉per 100,000༉༈appendix1 1–90). Region and sex trends of Adolescents and Middle-Aged Adults urticaria from 1990 to 2021 When calculated by SDI quintiles, the incidence and prevalence of urticaria in all global regions showed a predominantly downward trend. The most significant decline in ASIR and ASPR occurred in high - middle SDI countries: ASIR decreased from 599.7 (502.1–699)/100,000 in 1990 to 574.9 (486.9–665.6)/100,000 in 2021, while ASPR decreased from 344.6 (284.3–406.6)/100,000 in 1990 to 330.1 (275.7–390.4)/100,000 in 2021 (Table 1 ). The least decline in ASIR occurred in high - SDI and low - middle SDI countries. Conversely, ASPR increased in high - SDI countries, rising from 348.2 (302.7–397)/100,000 in 1990 to 349 (305.9–397.3)/100,000 in 2021. In 2019, regions classified as low - middle SDI had high urticaria incidence and prevalence. Table 1 region and sex trends of Adolescents and Middle-Aged Adults urticaria from 1990 to 2021 Location Location Incidence(95%UI) Incidence(95%UI) prevalence(95%UI) prevalence(95%UI) Case,1990 ASIR(per100000), Case,2021 ASIR(per100000), EAPC of ASIR(95%CI), Case,1990 ASPR(per100000), Case,2021 ASPR(per100000), EAPC of ASPR(95%CI), 1990 2021 1990–2021 1990 2021 1990–2021 Global Both 34061278.9 (28510620.1-39445228.1) 621.9 (520.6-720.2) 48980455.8 (41946875.7-56535268.4) 613.9 (525.7-708.6) -0.04 (-0.04–0.03) 19560102.2 (16203447.3-22872000.7) 357.1 (295.9-417.6) 28112995.9 (23632580.1-33155870) 352.4 (296.2-415.6) -0.04 (-0.04–0.03) Male 13535722.3 (11258629.6-15774239.4) 487.9 (405.8-568.5) 19974709.7 (16970723.5-23014288.5) 494.3 (420-569.6) 0.05 (0.04–0.05) 7779762.2 (6433929.2-9104796.1) 280.4 (231.9-328.2) 11467418.3 (9655036.3-13465111.4) 283.8 (238.9-333.2) 0.04 (0.04–0.05) Female 20525556.5 (17251516.2-23775081.1) 759.6 (638.4-879.8) 29005746.2 (24847434–33413961) 736.8 (630.3-850.6) -0.1 (-0.1–0.09) 11780340 (9778632.8-13797229.1) 435.9 (361.9-510.6) 16645577.7 (13947013.4-19581464.8) 422.7 (354.2-497.3) -0.1 (-0.1–0.09) High SDI Both 5682268 (4965149–6418357) 610.2 (533.2-689.3) 6197688.3 (5459552.7-6973355.3) 610.7 (538-687.2) -0.01 (-0.01-0) 3242631.3 (2818449-3696622.2) 348.2 (302.7–397) 3541767.3 (3104590.3-4032311.1) 349 (305.9-397.3) 0 (-0.01-0) Male 1772150.7 (1553685.3-2001626.9) 374.6 (328.4-423.1) 2018333.8 (1773069.8-2276109.9) 385.6 (338.7-434.8) 0.12 (0.11–0.13) 1016577.4 (878580.7-1156537.9) 214.9 (185.7-244.5) 1157140.2 (1008804.1-1316523.9) 221 (192.7-251.5) 0.12 (0.11–0.13) Female 3910117.3 (3417804.6-4417413.1) 853.6 (746.1-964.3) 4179354.5 (3682982.4-4696607.7) 849.8 (748.9-953.1) -0.03 (-0.04–0.03) 2226054 (1940045.5-2544626.8) 485.9 (423.5-555.5) 2384627 (2100716.6-2713359.2) 485.3 (427.6-552.3) -0.03 (-0.03–0.02) High-middle SDI Both 6838813.5 (5725892.8-7971741.4) 599.7 (502.1–699) 7313043.8 (6193755.5-8467821.2) 574.9 (486.9-665.6) -0.12 (-0.14–0.11) 3929649.2 (3241777.9-4637315.1) 344.6 (284.3-406.6) 4199127.5 (3506727.1-4966177.2) 330.1 (275.7-390.4) -0.13 (-0.14–0.12) Male 2532171.7 (2100455.4-2952794.8) 437.2 (362.6-509.8) 2824404.9 (2399717-3278206.7) 430.8 (366–500) -0.03 (-0.04–0.02) 1457682.4 (1197944.6-1721608.1) 251.7 (206.8-297.2) 1623081.3 (1366077-1914056.8) 247.6 (208.4–292) -0.04 (-0.05–0.02) Female 4306641.8 (3616353.1-5028040.4) 767.4 (644.4-895.9) 4488638.9 (3790403.2-5199044.6) 728.7 (614.6-843.3) -0.17 (-0.17–0.16) 2471966.8 (2037806.1-2919699) 440.5 (363.1-520.2) 2576046.2 (2148851.8-3051552.1) 417.8 (348.5-494.9) -0.17 (-0.17–0.16) Middle SDI Both 11410595.5 (9392789.8-13416227.6) 620.2 (510.5-729.2) 15203852.6 (12911757.7-17639771.2) 599.5 (509.1-695.6) -0.1 (-0.11–0.08) 6572892 (5368455.8-7834692.7) 357.2 (291.8-425.8) 8743677.3 (7295826.2-10362668.8) 344.8 (287.7-408.6) -0.1 (-0.11–0.09) Male 4985857.2 (4097857.1-5873898.1) 532.3 (437.5-627.1) 6719622.1 (5658904.2-7773173.8) 522.4 (439.9-604.3) -0.06 (-0.06–0.05) 2869188.1 (2350916.8-3396430) 306.3 (251-362.6) 3861505.5 (3236457.2-4557746.8) 300.2 (251.6-354.3) -0.06 (-0.07–0.05) Female 6424738.3 (5301965.5-7608139.5) 711.2 (586.9-842.2) 8484230.5 (7205084.1-9873346.5) 679.2 (576.2-792.4) -0.13 (-0.15–0.12) 3703703.9 (3017217-4439307.6) 410 (334-491.4) 4882171.7 (4051315.4-5786233.9) 390.7 (324.2–463) -0.14 (-0.15–0.13) Low-middle SDI Both 7336699.7 (6078656.1-8565023.4) 658.9 (545.9-769.2) 13492767.4 (11357468.9-15701139.4) 657.1 (553.1-764.6) -0.01 (-0.01–0.01) 4212199.8 (3459486.9-4969606.7) 378.3 (310.7-446.3) 7742404.8 (6401248-9137700.3) 377 (311.7–445) -0.01 (-0.01–0.01) Male 3106722 (2573371.5-3639155.8) 552.7 (457.8-647.4) 5655074.7 (4737530.8-6569458) 548.8 (459.7-637.5) -0.03 (-0.03–0.02) 1783169.3 (1464749.6-2106918.7) 317.2 (260.6-374.8) 3244738.2 (2685624.8-3824335.8) 314.9 (260.6-371.1) -0.03 (-0.03–0.03) Female 4229977.7 (3512654.9-4941532.3) 767.1 (637-896.1) 7837692.7 (6608009.3-9133356.5) 766.3 (644.7-894.6) 0 (0–0) 2429030.6 (2003752.1-2869259.6) 440.5 (363.4-520.3) 4497666.7 (3728104.5-5313066) 439.7 (364.4-519.4) 0 (-0.01-0) Low SDI Both 2762730.4 (2283267.9-3226564) 618.6 (511.2-722.4) 6736401.8 (5573769.5-7870297.9) 614.7 (508.6-718.1) -0.02 (-0.02–0.02) 1585396 (1315212.8-1865546.1) 355 (294.5-417.7) 3864946.5 (3205058.6-4551027.3) 352.7 (292.5-415.3) -0.02 (-0.02–0.02) Male 1127358.8 (930029.9-1330408.7) 510.2 (420.9-602.1) 2742269.4 (2260616.5-3233517.7) 506.3 (417.4–597) -0.03 (-0.03–0.02) 646539.2 (532878.7-761852) 292.6 (241.2-344.8) 1572327.3 (1294077.2-1854331.6) 290.3 (238.9-342.3) -0.03 (-0.03–0.03) Female 1635371.6 (1357689.5-1914390.9) 724.7 (601.6-848.3) 3994132.4 (3316909.7-4672746.4) 721.6 (599.2-844.1) -0.01 (-0.02–0.01) 938856.8 (780796.6-1105675.4) 416 (346-489.9) 2292619.2 (1906646.1-2701509.2) 413.6 (344-487.4) -0.02 (-0.02–0.01) Andean Latin America Both 210184.9 (173348.5-246879.6) 558.2 (460.4-655.6) 390646.9 (328724.2-457658.3) 552.7 (465.1-647.5) -0.03 (-0.03–0.03) 120507.6 (99456-141582.3) 320 (264.1–376) 223787.7 (186582.5-263268.5) 316.6 (264-372.5) -0.03 (-0.03–0.03) Male 86741.5 (71576-103138.3) 469.1 (387.1-557.8) 165072.3 (138000.4-193767.7) 466.1 (389.7-547.2) -0.02 (-0.02–0.02) 49731.7 (40582.4-58928.7) 269 (219.5-318.7) 94576.7 (78342.8-111872.9) 267.1 (221.2-315.9) -0.02 (-0.02–0.02) Female 123443.4 (102303-145899.4) 644.1 (533.8-761.3) 225574.6 (190683.1-264834.7) 640.1 (540.1-750.7) -0.02 (-0.02–0.02) 70776 (58387.4-84076.9) 369.3 (304.7-438.7) 129211 (108299.8-152438.6) 366.4 (307.1-432.3) -0.02 (-0.03–0.02) Australasia Both 158207.9 (132202.5-183441.5) 725.6 (606.3-841.3) 211755 (177949.4-247084.1) 725.7 (609.9-846.8) 0 (0–0) 90884.1 (75979-106280.2) 416.8 (348.5-487.4) 121706.9 (101936.9-142632.8) 417.1 (349.4-488.8) 0 (0–0) Male 43515.7 (36362.6-50790.5) 397.1 (331.8-463.5) 57566.1 (48309.7-67422.6) 394.5 (331.1-462.1) -0.01 (-0.02–0.01) 25150.3 (20811.2-29539.4) 229.5 (189.9-269.5) 33238.7 (27667.5-39173.5) 227.8 (189.6-268.5) -0.01 (-0.02–0.01) Female 114692.3 (95524.2-132487.8) 1057.5 (880.8-1221.6) 154188.9 (129032.8-178760.9) 1056.3 (885.8-1222.1) 0 (-0.01-0) 65733.7 (54704.2-76530.8) 606.1 (504.4-705.6) 88468.2 (73991.9-103912.9) 606.5 (507.2-712.4) 0 (-0.01-0) Caribbean Both 205722.5 (170889.2-240695.4) 557.4 (463-652.1) 267458.4 (225537.8-312839.9) 552.8 (466.2-646.6) -0.03 (-0.03–0.02) 117921.6 (97736.7-138717.7) 319.5 (264.8-375.8) 153207.2 (127806-180539.4) 316.7 (264.2-373.1) -0.03 (-0.03–0.03) Male 84644.6 (70142.6-100103.5) 468.3 (388.1-553.8) 112064.7 (93964.7-131393.7) 465.4 (390.3-545.7) -0.02 (-0.02–0.01) 48519.9 (39709.8-57507.2) 268.4 (219.7-318.2) 64200 (53416.1-75580.8) 266.6 (221.8-313.9) -0.02 (-0.02–0.02) Female 121077.9 (100781.1-142649.4) 642.8 (535.1-757.4) 155393.7 (131985-182114.3) 639.4 (543.8-750.2) -0.02 (-0.02–0.01) 69401.6 (57536.7-81953.6) 368.5 (305.5-435.1) 89007.1 (74758.5-105058.6) 366.2 (307.6-432.2) -0.02 (-0.02–0.02) Central Asia Both 403803.8 (335268.1-477038.5) 599.3 (497.6–708) 578329.1 (489411.4-677303.6) 587 (496.8-687.5) -0.06 (-0.08–0.04) 232812.9 (191627.2-277804.3) 345.5 (284.4-412.3) 332514.2 (275495.4-395082) 337.5 (279.6–401) -0.07 (-0.09–0.05) Male 129221.2 (106257.3-153571.6) 386 (317.4-458.7) 184381.1 (154584.9-217065.4) 372.6 (312.3-438.6) -0.1 (-0.12–0.08) 75271.9 (61133.3-90939.4) 224.8 (182.6-271.6) 106926.9 (88559-127184.5) 216.1 (178.9–257) -0.11 (-0.14–0.09) Female 274582.7 (225271.9-325807.3) 810 (664.5-961.1) 393948 (330355.4-462767) 804 (672.3-945.2) -0.02 (-0.03-0) 157540.9 (129310.1-189036.6) 464.7 (381.5-557.6) 225587.3 (187082.9-268586.7) 460.1 (381.6-547.8) -0.02 (-0.04–0.01) Central Europe Both 794868.3 (675607.1-908631.9) 633.5 (538.5-724.2) 653668.8 (572660.9-740532.6) 614 (537.9-695.6) -0.1 (-0.11–0.09) 456449 (384329.8-535342.5) 363.8 (306.3-426.7) 374445 (322342.2-429157.3) 351.7 (302.8-403.1) -0.11 (-0.12–0.1) Male 242836 (205604.7-281579.6) 382.9 (324.2–444) 199204.3 (174360.3-224538) 366 (320.3-412.5) -0.13 (-0.15–0.12) 140751.2 (117550.7-165694.3) 222 (185.4-261.3) 114959.4 (99011.8-131356.2) 211.2 (181.9-241.3) -0.15 (-0.16–0.14) Female 552032.3 (471110.6-632865.6) 889.6 (759.2-1019.8) 454464.5 (397089.3-519315.4) 871.4 (758.5–990) -0.05 (-0.06–0.05) 315697.8 (265589.5-370119.8) 508.7 (428-596.4) 259485.7 (223982.5-298573.4) 498.7 (430.4-573.8) -0.06 (-0.07–0.05) Central Latin America Both 950534.5 (778393.8-1118842) 576.3 (471.9-678.3) 1537120.4 (1295242.6-1791653.9) 571.4 (481.5-666.1) -0.03 (-0.03–0.03) 545082.7 (449016.8-644645) 330.5 (272.2-390.8) 880683.6 (735071.1-1042832.3) 327.4 (273.3-387.7) -0.03 (-0.03–0.03) Male 388397.3 (318599.3-458464.6) 484 (397-571.3) 630094.4 (529406.9-738006.6) 480.2 (403.5-562.5) -0.03 (-0.03–0.02) 222688.1 (182506.7-264454.6) 277.5 (227.4-329.5) 360984.5 (299419-426545.7) 275.1 (228.2-325.1) -0.03 (-0.03–0.03) Female 562137.2 (463577.7-663381.6) 663.8 (547.4-783.3) 907026 (768085.5-1061215) 658.5 (556.5-770.6) -0.03 (-0.03–0.03) 322394.6 (265894.2-383039.1) 380.7 (314-452.3) 519699 (433424.3-615115) 377.2 (314.5-446.4) -0.03 (-0.03–0.03) Central Sub-Saharan Africa Both 275608.1 (225935.6-324725) 558.6 (458-658.2) 733876.1 (604806.4-861621.1) 557 (459.1–654) -0.01 (-0.01–0.01) 158039.6 (130084.3-186510.9) 320.3 (263.7–378) 420801.6 (347331.9-495191.1) 319.4 (263.6-375.9) -0.01 (-0.01–0.01) Male 114525.2 (93557.5-137067.7) 470.2 (384.1-562.7) 308658.3 (254284-367264.3) 469.3 (386.6-558.4) -0.01 (-0.01-0) 65670.4 (53216.6-78235.3) 269.6 (218.5-321.2) 176977.8 (144390.2-209549.4) 269.1 (219.5-318.6) -0.01 (-0.01–0.01) Female 161082.9 (133198.6-190586.5) 644.9 (533.3–763) 425217.8 (352219.9-502467.8) 644.4 (533.9-761.7) 0 (0–0) 92369.2 (75912.2-109853.3) 369.8 (303.9-439.8) 243823.8 (201086.9-289823.2) 369.6 (304.8-439.3) 0 (0–0) East Asia Both 8542487.8 (7002750.8-10118670.8) 613.7 (503.1–727) 7839756.3 (6578171.5-9128528.2) 563.5 (472.8-656.2) -0.24 (-0.26–0.22) 4930858.9 (4009585.1-5910382.8) 354.3 (288.1-424.6) 4523381.1 (3780492.9-5350926.1) 325.1 (271.7-384.6) -0.24 (-0.26–0.22) Male 3544883.4 (2889273.3-4223778.8) 493.5 (402.3-588.1) 3328162.9 (2815412.9-3851102.8) 460.6 (389.6–533) -0.2 (-0.22–0.17) 2043772.6 (1666016.3-2421208.3) 284.5 (232-337.1) 1917416.9 (1593274.3-2270957.9) 265.4 (220.5-314.3) -0.2 (-0.22–0.18) Female 4997604.4 (4091824.2-6013043) 741.9 (607.4-892.6) 4511593.4 (3780884.6-5295529.2) 676.1 (568-794.2) -0.27 (-0.3–0.25) 2887086.3 (2338441.9-3499432.8) 428.6 (347.1-519.5) 2605964.2 (2158765.1-3081774.8) 389.7 (322.9-460.9) -0.28 (-0.3–0.25) Eastern Europe Both 1380161.5 (1160306.6-1602199.2) 619.3 (520.7–719) 1192618.8 (1008982.2-1391970.2) 613.4 (518.9-715.9) -0.05 (-0.08–0.03) 793514.2 (661567.5-938599.5) 356.1 (296.9-421.2) 684018.1 (572174.7-804663.2) 351.8 (294.3-413.8) -0.06 (-0.08–0.03) Male 437027.8 (361329-509132.8) 393.3 (325.2-458.2) 371830.8 (313206–433238) 383.5 (323-446.8) -0.11 (-0.14–0.07) 253453.3 (209110-298102.9) 228.1 (188.2-268.3) 214886.7 (178741.5-254547.8) 221.6 (184.4-262.5) -0.12 (-0.16–0.09) Female 943133.7 (792222.4-1095717.1) 844.1 (709.1-980.7) 820788.1 (695732.5-963539.5) 840.8 (713.2-982.2) -0.02 (-0.04–0.01) 540060.9 (451656.9-638601.7) 483.4 (404.2-571.6) 469131.4 (393752.4-552292.2) 481.3 (403.9-566.6) -0.03 (-0.05–0.01) Eastern Sub-Saharan Africa Both 966643.9 (789136.6-1142988.8) 573.5 (468.2-678.2) 2420255.6 (1983405.4-2855208.5) 572 (468.8-674.8) -0.01 (-0.01–0.01) 554440.4 (455801.4-655925) 329 (270.4-389.2) 1388034.5 (1142469.2-1640441.4) 328.1 (270-387.7) -0.01 (-0.01–0.01) Male 391395.7 (318295.4-465033.8) 481.1 (391.2-571.6) 994060.6 (811781.3-1176397.3) 480.9 (392.7-569.1) -0.01 (-0.01-0) 224466.8 (184088-266511.1) 275.9 (226.3-327.6) 570034.7 (467807.9-675509.5) 275.8 (226.3-326.8) -0.01 (-0.01-0) Female 575248.2 (472687.6-680339.2) 659.8 (542.1-780.3) 1426195 (1176815.8-1682221.5) 659.3 (543.2–778) -0.01 (-0.01-0) 329973.6 (270577.8-391914.1) 378.5 (310.3-449.5) 817999.8 (674272.1-973893.4) 378 (311.6–450) -0.01 (-0.01-0) High-income Asia Pacific Both 1095251.1 (927799.9-1276314.7) 583.9 (494.7-680.5) 910405.9 (774712.2-1064260.6) 576 (490.2-673.4) -0.05 (-0.05–0.04) 626596.4 (517616.9-744251.4) 334.1 (276-396.8) 520972.6 (435901.6-622291.4) 329.6 (275.8-393.7) -0.04 (-0.05–0.04) Male 319797.2 (269495.2-373471.6) 336.1 (283.3-392.6) 268393.7 (227672.4-311511) 330.6 (280.4-383.7) -0.05 (-0.06–0.05) 184074.7 (151869.2-218678.3) 193.5 (159.6-229.9) 154123 (128317.7-183337) 189.8 (158-225.8) -0.06 (-0.06–0.05) Female 775453.9 (658050.4-905882.2) 839 (712-980.2) 642012.3 (543842.9-754647.4) 835.1 (707.8-982.9) -0.02 (-0.02–0.01) 442521.6 (364714–525799) 478.8 (394.6-568.9) 366849.5 (308385.6-439927.3) 477.3 (401.2-572.4) -0.01 (-0.02–0.01) High-income North America Both 1902022.9 (1728538.8-2073821.4) 631.6 (574-688.7) 2175971.4 (1995075.3-2355675) 638.5 (585.4-691.2) 0.01 (0-0.02) 1084762.9 (992836.6-1179001.3) 360.2 (329.7-391.5) 1244555.2 (1146165.6-1340729.9) 365.2 (336.3-393.4) 0.02 (0.01–0.02) Male 582155 (527243.1-635679.6) 385.9 (349.5-421.4) 666509.2 (612345.4-723422.8) 389.7 (358–423) 0.02 (0.01–0.02) 334022.6 (305582.7-363734.5) 221.4 (202.6-241.1) 382920.1 (354270.9-413169.2) 223.9 (207.1-241.6) 0.02 (0.01–0.03) Female 1319867.9 (1195943.7-1441638) 878.4 (795.9-959.4) 1509462.2 (1381343.4-1637444.2) 888.6 (813.7-963.5) 0.01 (0-0.02) 750740.3 (685940.3-815612.8) 499.6 (456.5-542.8) 861635.1 (792929.3-926304.2) 507.5 (467-545.6) 0.01 (0-0.03) North Africa and Middle East Both 2163106.8 (1809748-2516122.7) 667.9 (558.8-776.9) 4481122.5 (3808473.7-5190595.1) 663.3 (563.8-768.4) -0.02 (-0.03–0.02) 1239072.7 (1026290-1453793.7) 382.6 (316.9-448.9) 2567017.4 (2136354.3-3039815.2) 380 (316.2–450) -0.02 (-0.03–0.02) Male 882902.2 (739630.4-1030765) 531.9 (445.6–621) 1897120.8 (1605138.9-2213724.8) 536.6 (454-626.1) 0.04 (0.03–0.04) 503610 (416671.5-595369.5) 303.4 (251-358.7) 1083684.5 (903438.1-1276324.5) 306.5 (255.5–361) 0.04 (0.04–0.04) Female 1280204.6 (1062576.6-1502094.3) 811 (673.1-951.5) 2584001.7 (2189553.4-2995270.1) 803 (679.6-930.4) -0.04 (-0.04–0.03) 735462.7 (607054.8-863029.8) 465.9 (384.6-546.7) 1483332.9 (1236601.9-1744803.7) 460.7 (384.1-541.9) -0.04 (-0.04–0.04) Oceania Both 35798.4 (29667.7-42435.3) 554.5 (459.5-657.3) 77801.9 (64849.6-91564.7) 544.2 (453.6-640.5) -0.06 (-0.06–0.05) 20665 (16921.4-24649.4) 320.1 (262.1-381.8) 44902.9 (37066.3-53154.9) 314.1 (259.3-371.8) -0.06 (-0.06–0.06) Male 16580.4 (13492–19748) 500 (406.8-595.5) 35950.4 (29669.1-42385.6) 493.7 (407.4–582) -0.04 (-0.04–0.04) 9555 (7797.3-11354.4) 288.1 (235.1-342.4) 20712.6 (16982.9-24554.7) 284.4 (233.2-337.2) -0.04 (-0.04–0.04) Female 19218 (15852.8-22911.3) 612.1 (504.9-729.7) 41851.5 (34760.1-49545.7) 598.2 (496.8-708.9) -0.08 (-0.08–0.07) 11110 (9068.3-13406.6) 353.8 (288.8–427) 24190.3 (20048.8-28951.4) 344.9 (285.9-412.8) -0.08 (-0.08–0.07) South Asia Both 7197850.3 (5965844.4-8404065.7) 673.3 (558.1-786.2) 13792603.7 (11611004.6-16019912.2) 678 (570.8-787.5) 0.02 (0.02–0.02) 4124979.9 (3397605.7-4869778.5) 385.9 (317.8-455.6) 7901711.2 (6552630.5-9355286.8) 388.5 (322.1-459.9) 0.02 (0.02–0.02) Male 3021685.6 (2507281.1-3549709.2) 545.5 (452.6-640.8) 5656109.3 (4726677.2-6607002.1) 546.1 (456.4-637.9) 0 (0–0) 1731501.6 (1438467.7-2050037) 312.6 (259.7-370.1) 3240175.1 (2714356.9-3839386.4) 312.8 (262.1-370.7) 0 (0–0) Female 4176164.7 (3469388.5-4901270.7) 810.8 (673.6-951.6) 8136494.4 (6857542.9-9499513.8) 814.7 (685.6-952.4) 0.02 (0.01–0.02) 2393478.2 (1968772.8-2829895.9) 464.7 (382.3-549.5) 4661536.1 (3850926.6-5510789.1) 466.9 (385.7-551.9) 0.01 (0.01–0.02) Southeast Asia Both 3071793.4 (2510132.6-3650118.4) 642.5 (525.1-763.5) 4554751 (3798288.1-5339374.5) 607.9 (506.9-712.6) -0.18 (-0.19–0.17) 1782108.1 (1449488.6-2148862.7) 372.8 (303.2-449.5) 2640696.2 (2166644.3-3128772.8) 352.4 (289.2-417.6) -0.18 (-0.19–0.17) Male 1619378.8 (1323833.3-1919671.8) 688.5 (562.8-816.1) 2500906.4 (2082903.1-2928429.3) 659.8 (549.5-772.5) -0.14 (-0.15–0.13) 936310 (758655.4-1118481.1) 398.1 (322.5-475.5) 1445182 (1180413.2-1705448.7) 381.2 (311.4-449.9) -0.14 (-0.15–0.13) Female 1452414.6 (1179268.8-1737840.1) 598.1 (485.6-715.6) 2053844.6 (1701231.6-2419306.6) 556.5 (460.5–656) -0.24 (-0.26–0.23) 845798.1 (683107.2-1027739.8) 348.3 (281.3-423.2) 1195514.3 (984934.7-1422695.2) 323 (266.1-384.3) -0.25 (-0.26–0.23) Southern Latin America Both 282252.5 (237296.2-331093.3) 570.4 (479.5-669.1) 397861.1 (336592.9-466695.7) 567.6 (480.2-665.9) -0.01 (-0.01–0.01) 161395.9 (132580-192281.3) 326.1 (267.9-388.6) 227540 (188699.7-272106.9) 324.6 (269.2-388.2) -0.01 (-0.01–0.01) Male 78959.7 (65535.2-93126.6) 323 (268.1–381) 111795.2 (93895.9-131083.4) 320.6 (269.3-375.9) -0.02 (-0.03–0.02) 45490.6 (37352.8-54004.4) 186.1 (152.8-220.9) 64315.4 (52894.5-76430.4) 184.4 (151.7-219.2) -0.03 (-0.03–0.02) Female 203292.9 (171226.6-239514.2) 811.8 (683.8-956.5) 286065.9 (240879.7-336987.9) 812.3 (683.9-958.3) 0 (0–0) 115905.2 (94902.3-138857.8) 462.9 (379-554.5) 163224.6 (134521.8-195488.2) 463.5 (382-555.1) 0.01 (0-0.01) Southern Sub-Saharan Africa Both 303776.6 (248141.7-357874.7) 583.7 (476.8-687.6) 503304 (421835.6-588495.7) 577 (483.6-674.6) -0.04 (-0.05–0.03) 174206.8 (143329-206587.7) 334.7 (275.4-396.9) 288375.8 (239824.7-341450.4) 330.6 (274.9-391.4) -0.04 (-0.05–0.04) Male 123456.1 (100958.7-145974.5) 490.2 (400.8-579.6) 210963.2 (176400.7-247546.7) 486.6 (406.8-570.9) -0.02 (-0.02–0.02) 70778.5 (58335.5-84458.1) 281 (231.6-335.3) 120851.5 (100164-142788.7) 278.7 (231-329.3) -0.02 (-0.03–0.02) Female 180320.5 (148458.5-212836.6) 671.4 (552.8-792.5) 292340.8 (245702.6-343856.2) 666.7 (558.1–785) -0.02 (-0.03–0.02) 103428.3 (85152.9-123013.6) 385.1 (317–458) 167524.3 (139254.7-197924.4) 381.9 (317.4-451.1) -0.03 (-0.03–0.02) Tropical Latin America Both 933922.5 (766220-1097160.4) 588.6 (482.9-691.5) 1412048.5 (1196796.7-1639520.9) 583.2 (494.3-677.1) -0.03 (-0.03–0.03) 535421.9 (441227.4-635370.6) 337.5 (278.1-400.5) 808769.7 (676766–958683) 334 (279.5-395.9) -0.03 (-0.04–0.03) Male 386778.9 (319226.3-455066) 495.5 (409–583) 587840.5 (495057.8-685650.6) 491.3 (413.7–573) -0.03 (-0.03–0.03) 221673.9 (183122.6-263321.1) 284 (234.6-337.4) 336616.7 (279613.3-395115.7) 281.3 (233.7-330.2) -0.03 (-0.03–0.03) Female 547143.5 (452727-643868.9) 678.8 (561.7-798.8) 824208 (697366.2-960205.5) 673.5 (569-785.7) -0.03 (-0.03–0.03) 313748 (258194.4-373946.4) 389.2 (320.3-463.9) 472153 (393577-559753.8) 385.5 (321.4–457) -0.03 (-0.03–0.03) Western Europe Both 2193730.4 (1881947.2-2531308.5) 561.3 (481.5-647.7) 2176809.8 (1875705.1-2527036.4) 571.5 (492.4-663.4) 0.05 (0.04–0.05) 1240592.2 (1052736-1452414.2) 317.4 (269.4-371.6) 1233239.2 (1050420.2-1449169.1) 323.8 (275.8-380.5) 0.05 (0.04–0.06) Male 631111.1 (539052.6-726579.7) 319.1 (272.6-367.4) 620796.6 (534987-713608.2) 322.3 (277.7-370.5) 0.03 (0.03–0.04) 358368.4 (301451.7-417281.9) 181.2 (152.4–211) 352643.5 (296471.1-409364.2) 183.1 (153.9-212.5) 0.03 (0.03–0.04) Female 1562619.3 (1343115-1802782.7) 809.4 (695.7-933.8) 1556013.2 (1336938.9-1815240) 825.8 (709.9-962.6) 0.05 (0.04–0.06) 882223.8 (750194.5-1036749) 457 (388.6–537) 880595.7 (751739.4-1039971) 467.7 (399.3-552.4) 0.05 (0.04–0.06) Western Sub-Saharan Africa Both 993550.5 (812442.3-1171757.1) 574.4 (469.7-677.4) 2672290.7 (2190867.7-3148909.8) 576.7 (472.8-679.6) 0.01 (0.01–0.01) 569789.3 (469794.7-673791.8) 329.4 (271.6-389.5) 1532636.1 (1262626.8-1812261.3) 330.8 (272.5-391.1) 0.01 (0.01–0.01) Male 409728.9 (337778.1-483948.6) 482.8 (398-570.2) 1067229.1 (872925.7-1262357.3) 482.7 (394.8-570.9) 0 (0–0) 234900.4 (192749.1-277820.7) 276.8 (227.1-327.4) 611991.6 (502020.1-725984.8) 276.8 (227.1-328.3) 0 (0–0) Female 583821.7 (479263.5-692262.5) 662.6 (543.9-785.7) 1605061.6 (1324708-1896095.6) 662.4 (546.7-782.2) 0 (0–0) 334888.9 (275407.2-397162.5) 380.1 (312.6-450.8) 920644.5 (759731.6-1096029.7) 380 (313.6-452.4) 0 (-0.01-0) Between 1990 and 2021, the global ASIR of urticaria showed a predominantly downward trend at the regional level. The most significant decline occurred in East Asia, with the ASIR decreasing from 613.7 (503.1–727)/100,000 in 1990 to 563.5 (472.8–656.2)/100,000 in 2021. In contrast, Western Europe exhibited an upward trend, with the ASIR increasing from 561.3 (481.5–647.7)/100,000 in 1990 to 571.5 (492.4–663.4)/100,000 in 2021. Between 1990 and 2021, the global ASPR of urticaria showed a predominantly downward trend at the regional level. The most significant decline occurred in East Asia, with the ASPR decreasing from 354.3 (288.1–424.6)/100,000 in 1990 to 325.1 (271.7–384.6)/100,000 in 2021. In contrast, Western Europe exhibited an upward trend, with the ASPR increasing from 317.4 (269.4–371.6)/100,000 in 1990 to 323.8 (275.8–380.5)/100,000 in 2021(Table 1 ). From 1990 to 2021, ASIR and ASPR of urticaria among global young and middle - aged adults demonstrated regional variations.However, females were consistently higher than males. Country trends of Adolescents and Middle-Aged Adults urticaria from 1990 to 2021 In 2021, India, China, and Pakistan reported the highest number of new urticaria cases. India: 9,928,117.02 cases (8,334,805.52–11,535,834.11); China: 7,567,721.21 cases (6,348,556.29–8,807,709.06); Pakistan: 2,078,572.26 cases (1,738,280.05–2,430,055.42) (appendix2 91–95). The highest number of prevalent cases was in India (5,682,028.91 [4,699,572.72–6,733,844.59]), China (4,366,377.26 [3,650,334.03–5,166,497.17]), and Pakistan (1,192,081.15 [983,047.02–1,411,660.23]) (appendix2 97–101). The highest ASIR were in Nepal (1,047.24 per 100,000 [910.02–1,171.81]), Pakistan (843.25 per 100,000 [705.20–985.85]), and Sweden (804.56 per 100,000 [680.38–944.33]) (appendix2 103–107). The highest ASPR were in Nepal (609.44 per 100,000 [530.13–687.58]), Pakistan (483.61 per 100,000 [398.81–572.69]), and Bangladesh (460.59 per 100,000 [382.54–546.98]) (Fig. 2 A 2 B; appendix2 109–113); Between 1990 and 2021, the ASIR of urticaria showed a downward trend in 151 of 204 countries and territories. The most significant decline was in the Maldives, where the incidence rate decreased from 643.68 (514.82–777.91) per 100,000 in 1990 to 582.72 (479.78–693.31) per 100,000 in 2021;EAPC: -0.37 (-0.73 to -0.02), Vietnam's ASIR decreased from 632.75 (506.35–756.58) per 100,000 in 1990 to 575.92 (476.67–677.93) per 100,000 in 2021; EAPC: -0.32 (-0.73 to 0.1), In Thailand, the ASIR fell from 615.43 (501.80–729.68) per 100,000 in 1990 to 560.30 (469.23–652.40) per 100,000 in 2021; EAPC: -0.30 (-0.75 to 0.14), Spain had the largest increase, with the ASIR rising from 480.49 (420.82–554.09) per 100,000 in 1990 to 502.71 (440.58–581.93) per 100,000 in 2021; EAPC: 0.14 (-2.29 to 2.64), In Cyprus, the ASIR increased from 558.46 (471.17–653.57) per 100,000 in 1990 to 582.09 (490.65–687.57) per 100,000 in 2021; EAPC: 0.09 (-2.34 to 2.58), Ireland's ASIR rose from 554.79 (468.95–647.85) per 100,000 in 1990 to 571.34 (486.19–668.89) per 100,000 in 2021; EAPC: 0.07 (-2.32 to 2.52) (Fig. 2 E; appendix3 115–130); Urticaria's ASPR declined in 152 of 204 countries and territories. The most significant decline was in the Maldives, where ASPR fell from 373.53 (298.19–458.00) per 100,000 in 1990 to 338.14 (276.05–405.53) per 100,000 in 2021; EAPC: -0.37 (-0.71 to -0.04), Vietnam's ASPR decreased from 367.44 (296.36–446.13) per 100,000 in 1990 to 334.23 (275.01–397.22) per 100,000 in 2021; EAPC: -0.32 (-0.72 to 0.08), In Thailand, the ASPR fell from 357.19 (290.60–431.74) per 100,000 in 1990 to 324.76 (267.26–384.06) per 100,000 in 2021; EAPC: -0.31 (-0.74 to 0.12), Spain had the largest increase, with ASPR rising from 268.68 (234.77–311.61) per 100,000 in 1990 to 282.24 (247.27–328.63) per 100,000 in 2021; EAPC: 0.15 (-2.28 to 2.64), In Cyprus, the ASPR increased from 315.82 (262.60–374.68) per 100,000 in 1990 to 330.32 (274.09–395.95) per 100,000 in 2021; EAPC: 0.10 (-2.32 to 2.58), Ireland's ASPR rose from 313.30 (260.13–371.20) per 100,000 in 1990 to 323.81 (270.05–384.91) per 100,000 in 2021; EAPC: 0.08 (-2.30 to 2.52) (Fig. 2 F; appendix3 131–146). The urticaria burden across different age groups from 15 to 49 years old from 1990 to 2021 Comparison of ASIR, ASPR, and DALYs of urticaria in middle-aged and young individuals between 1990 and 2021. Urticaria's ASIR, ASPR, and DALYs all decreased with age. The highest proportion of patients was in the 15–19 age group. In 2021, the number of new cases, prevalent cases, and DALYs of urticaria was higher than in 1990 (Fig. 3 ). Predictions for the counts and rates of DALYs of global Adolescents and Middle-Aged Adults with urticaria by 2050. From 2021 to 2050, the DALYs counts of urticaria in middle-aged and young individuals are projected to gradually increase, peaking in 2035, with females consistently having higher DALYs counts than males (Fig. 4 A). From 2021 to 2050, the DALYs rate is expected to gradually decline, with a more pronounced decrease in females (Fig. 4 B). Discussion Urticaria is one of the most common skin diseases globally and has a significant impact on patients' quality of life. In recent years, the global incidence of urticaria has shown a general downward trend, but its distribution varies across different regions and countries. Urticaria in adolescents and middle-aged adults constitutes a significant proportion of the overall urticaria patient population. Moreover, adolescents and middle-aged adults form the backbone of society and families urticaria can significantly impact their quality of life. Therefore, detailed analysis of the global burden of urticaria in adolescents and middle-aged adults is vital for clinical treatment, epidemiological studies, and public health policy development. Analysis of Global Trends: From 1990 to 2021, the number of new cases, prevalent cases, and DALYs of urticaria in adolescents and middle-aged adults globally showed an upward trend. In recent years, global air pollution, climate warming, and increased humidity have promoted the growth and spread of allergens such as pollen and dust mites,increasing the risk of urticaria and worsening its burden( 4 – 8 ). Additionally, adolescents and middle-aged adults often have unhealthy lifestyles, such as lack of exercise and consumption of processed foods, seafood, and nuts, which increases the risk of urticaria. In some underdeveloped areas, antibiotic abuse remains common, disrupting the body’s ecological balance and immune system, leading to peripheral tolerance loss and increased susceptibility to urticaria( 4 , 9 ). Social and economic conditions play a significant role in urticaria among middle-aged and young people. Limited medical resources, delayed diagnosis, and inability to afford effective but expensive medications can hinder proper treatment( 10 ). Changes in population structure, such as urbanization, increase stress and reduce sleep, affecting the immune system and indirectly influencing urticaria( 5 ). Between 1990 and 2021, the ASIR, ASPR, and DALY rates of urticaria globally showed a downward trend, indicating progress in prevention and treatment. For example, Germany emphasizes comprehensive patient assessment and individualized treatment, including omalizumab, cyclosporine, psychotherapy, and physical therapy for refractory urticaria( 11 ). Japan focuses on allergen identification, avoidance, and lifestyle guidance. In treatment, it combines antihistamines with traditional japanese medicine like Kampo( 12 ). Between 1990 and 2021, females had higher urticaria indicators than males, possibly due to more estrogen receptors. Estrogen activates these receptors in mast cells, increasing intracellular calcium and promoting the release of inflammatory mediators like histamine. Additionally, genetic factors may contribute, as some immune-related genes are on the X chromosome, potentially increasing women’s autoimmune disease risk ( 13 – 16 ). Globally, to reduce urticaria incidence, it is crucial to raise disease awareness in women and conduct further research to understand underlying mechanisms and develop targeted interventions to reduce the urticaria burden( 14 – 17 ). Analysis of SDI Trend Reasons: Calculated by SDI quintiles, the ASIR and ASPR of urticaria in middle - aged and young people in all global regions mainly showed a downward trend. The most significant decline in ASIR and ASPR occurred in high - middle SDI countries. This was attributed to sustained economic development, increased public health spending, and improved healthcare. For instance, novel antihistamines and biologics are extensively used in upper-middle-income countries enabling more effective control of urticaria in these countries thereby reducing the ASIR and ASPR ( 14 , 18 ). High SDI countries saw the least decline in ASIR and an increase in ASPR for adolescents and middle-aged adults urticaria patients. This was due to advanced medical diagnosis and increased awareness, leading to more accurate diagnosis and reporting of urticaria cases. Additionally, dietary habits (high - calorie, high - fat, high - sugar) and lifestyle stress in these countries impact urticaria in adolescents and middle-aged adults, contributing to higher prevalence rates ( 19 , 20 ). Urticaria ASIR and ASPR are both high in Low-middle SDI countries. These nations, due to limited economic development, typically have less access to healthcare resources and less effective urticaria management, resulting in elevated ASIR and ASPR ( 14 , 18 ). Moreover, infectious diseases can also increase urticaria risk ( 21 ). These regions have a high burden of infectious diseases and environmental pollution. The causal relationship between urticaria and infections (especially parasitic diseases) and pollution has been well - established. Eliminating infectious diseases can reduce the likelihood of developing urticaria. At the same time, infections can trigger or exacerbate urticaria through various mechanisms, including mast - cell activation and autoimmune reactions producing antibodies against key receptors such as IgE receptors or thyroid peroxidase. Thus, a higher incidence of infectious diseases and poor air quality may increase the incidence of urticaria in low - income regions ( 22 ). In summary, the high urticaria ASIR and ASPR in low - middle SDI countries are mainly attributed to limited economic and technological development and poor infectious disease control. Based on our analysis, we propose several specific policy recommendations: 1.Construct regional medical centers and standardize primary - care facilities to ensure equitable distribution of health - care resources; 2. Utilize big - data technology for early infectious disease warning and traceability analysis; 3. Protect biodiversity to reduce exposure to environmental allergens; 4. Conduct omics research on genetic susceptibility and environmental triggers. These interventions should be tailored to local healthcare infrastructure and socioeconomic conditions while ensuring consistency with international guidelines. Analysis of Regional Trend Reasons: We found that between 1990 and 2021, the global ASIR and ASPR of urticaria showed a predominantly downward trend at the regional level. The most significant decline was in East Asia, while Western Europe showed an upward trend. Differences in ASIR and ASPR of urticaria may be attributed to environmental and social factors. Studies indicate that groups without urticaria had higher relative humidity than those with urticaria ( 23 ). Increased humidity may alter epidermal composition, damage skin integrity, and cause microbial and immune dysregulation, leading to urticaria ( 24 ). Most East Asian regions are coastal with high relative humidity, which can reduce urticaria prevalence. A time - series analysis confirmed that exposure to air pollutants such as O3, PM2.5, and PM10 increases urticaria risk with cumulative effects ( 18 , 25 ). In recent years, East Asia’s air pollution control efforts have reduced air pollution, leading to a decline in urticaria ASIR and ASPR. In contrast, urban greening in Western Europe results in more airborne pollens and dust mites. A Singapore study found that European populations are more sensitive to seasonal allergens like pollen, which may increase urticaria incidence in European countries ( 26 ). In summary, implementing energy - saving and emission - reduction strategies and reducing allergen exposure can lower urticaria incidence. Regions with less decline should also improve these factors to reduce the urticaria burden in middle - aged and young people globally ( 27 – 29 ). Analysis of National Trend Reasons: At the national level, from 1990 to 2021, the ASIR of urticaria in adolescents and middle-aged adults showed a downward trend in 151 of 204 countries and territories. The ASPR showed a downward trend in 152 countries and territories. This indicates that the disease burden of urticaria in adolescents and middle-aged adults has declined in most countries globally. This is primarily attributed to the improvement of global medical standards. Countries like Germany and the UK have well - developed universal health coverage, providing basic medical security for urticaria patients ( 30 ). Some European medical institutions create records for chronic urticaria patients, with regular follow - ups, condition monitoring, and timely treatment adjustments to improve quality of life ( 31 ). The US National Institutes of Health (NIH) funds research projects on urticaria pathogenesis and new treatments, supporting the development of more effective therapies ( 32 ). The European Medicines Agency (EMA) prioritizes the review and approval of biologics for severe or refractory urticaria, enabling patients to benefit sooner ( 33 ). However, the decline varies across countries, with a few still experiencing an increasing disease burden. Thus, countries with a heavy or less declining burden of urticaria in adolescents and middle-aged adults should enhance improvement measures. For instance, high - burden countries like India and China can reduce their burden by improving medical security, boosting drug research, establishing priority review and approval mechanisms, and launching public education campaigns ( 1 , 29 , 34 – 37 ). Countries where the burden of urticaria in adolescents and middle-aged adults is increasing are Spain, Cyprus and Ireland. Spain and Cyprus are in the Mediterranean, and Ireland has a temperate maritime climate. Recent temperature increases and changes in precipitation have extended the growing and dispersal seasons of plant pollens, raising exposure chances and urticaria incidence rates ( 38 ). The highest ASIR and ASPR are in Nepal and Pakistan. As South Asian countries, Nepal and Pakistan have seen industrial growth worsen environmental pollution, increasing urticaria incidence and prevalence. Geographically, Nepal is in a high - altitude area with strong UV radiation, which can damage the skin barrier and trigger urticaria ( 18 , 39 , 40 ). To address these factors, a range of interventions are needed. These include increasing investment in healthcare infrastructure, improving access to medical services, and implementing targeted public health initiatives to reduce exposure to environmental risk factors. Such measures could benefit countries and regions with a high burden of urticaria in adolescents and middle-aged adults ( 41 – 44 ). Analysis of Age - Grouped Trend Reasons: Urticaria ASIR, ASPR, and DALYs in adolescents and middle-aged adults decreased with age in 1990 and 2021. The highest proportion of patients was in the 15–19 age group. In 2021, the number of new cases, prevalent cases, and DALYs of urticaria was higher than in 1990. The disease burden of urticaria in adolescents and middle-aged adults is concentrated in the 15–19 age group. This may be attributed to differences in immune system function and regulation among age groups. Individuals aged 15–19 are in puberty, with changing sex hormone levels. Estrogen can bind to estrogen receptors in immune cells, affecting gene expression. This shifts the immune response from innate to adaptive, potentially influencing immune cell development and function and triggering urticaria ( 45 ). Moreover, adolescents and middle-aged adults have a complex diet, including allergenic foods and those with additives and preservatives, which can trigger urticaria. They also face work - and life - related pressures, leading to anxiety and depression. These affect neurotransmitter and hormone secretion, indirectly triggering or worsening urticaria ( 8 ). A tailored, stepwise approach is needed to manage urticaria in adolescents and middle-aged adults. For example, launch health promotion projects to encourage regular routines, moderate exercise, and a balanced diet. For chronic spontaneous urticaria patients, use biologics and tools to assess disease severity and treatment response. Psychological education and behavioral interventions can also improve their anxiety and depression. In addition, developing and implementing public health interventions to reduce exposure to environmental risk factors and enhance overall health is crucial. This can help alleviate the urticaria burden and improve treatment outcomes in affected populations ( 14 , 46 – 48 ). Analysis of the Reasons for the DALYs Trend Prediction by 2050: From 2021 to 2050, the DALYs counts of urticaria in adolescents and middle-aged adults will gradually increase globally, while the DALYs rate will gradually decline. Over the next 30 years, sustained global population growth will lead to an increase in the DALYs counts of urticaria in adolescents and middle-aged adults. Exposure to allergens and irritants, such as air pollution and chemicals, will also increase the DALYs counts of urticaria ( 4 , 48 ). Additionally, changes in lifestyle factors, including diet, stress, and sedentary behavior, may also contribute to an increase in urticaria cases ( 49 , 50 ). Finally, over time, improved diagnosis and increased awareness of urticaria will lead to higher detection rates of urticaria cases ( 51 , 52 ), which will also contribute to an increase in DALYs counts. However, concurrently, improvements in socioeconomic conditions, healthcare infrastructure, and access to treatment and care will lead to a gradual decline in the DALYs rate ( 53 , 54 ). Limitations and Outlook: Due to insufficient data in the GBD database for some countries and regions, the assessment of the urticaria burden may be inaccurate, potentially resulting in data biases in these areas. Additionally, the GBD database has limitations related to time constraints. Although the GBD database is updated annually, the timely availability of certain data may be limited, meaning the latest data may not reflect the most recent disease trends and health risk factors. Lastly, the GBD database also has deficiencies due to a lack of geographical specificity. Therefore, our study results should be interpreted with consideration of the GBD database's limitations to avoid data misunderstandings or misuse. It is also recommended to combine the analysis with data from other sources and relevant regional contexts. Conclusion Over the past 30 years, the number of new urticaria cases among adolescents and middle-aged adults globally has risen with population growth ,yet, the ASIR has declined reflecting global progress in managing the disease, driven by better diagnosis, treatment, and public education. However, significant challenges persist. The urticaria burden is especially heavy among females aged 15 - 19 and in low - middle SDI countries. Thus, it is imperative to implement targeted interventions promptly. Such as intensifying health education and awareness initiatives aimed at adolescents and middle-aged women. Boosting investment in healthcare resources for low-middle SDI countries. Fostering international collaboration. While also emphasizing the importance of adopting context - appropriate strategies. Tailoring measures to countries' diverse cultures, regions, and habits to sustainably reduce the disease burden and uneven distribution issue. In responding to this public health challenge. Declarations Data Availability The study leverages publicly available data from the Global Burden of Disease Study 2021 (GBD 2021).The data was obtained from the Global Health data Exchange(Global Health data Exchange, GHDx) (http://ghdx.healthdata.org/). Therefore, ethics approval was not required. Funding Statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Authors' Contributions: JJ L had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors contributed to concept and design; critical revision of the manuscript for important intellectual content; administrative, technical, or material support; and supervision. YP contributed to acquisition, analysis, and interpretation of data and drafting of the manuscript. JJ Land YS contributed to statistical analysis. Conflicts of Interest: None declared. Associated Data This section collects any data citations, data availability statements, or supplementary materials included in this article. References Zuberbier T, Abdul Latiff AH, Abuzakouk M, Aquilina S, Asero R, Baker D, et al. The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77(3):734-66. Kolkhir P, Giménez-Arnau AM, Kulthanan K, Peter J, Metz M, Maurer M. Urticaria. Nat Rev Dis Primers. 2022;8(1):61. Giménez-Arnau AM, Manzanares N, Podder I. Recent updates in urticaria. Med Clin (Barc). 2023;161(10):435-44. 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How geographic access to care shapes disease burden: The current impact of post-exposure prophylaxis and potential for expanded access to prevent human rabies deaths in Madagascar. PLoS Negl Trop Dis. 2021;15(4):e0008821. Hennino A, Bérard F, Guillot I, Saad N, Rozières A, Nicolas JF. Pathophysiology of urticaria. Clin Rev Allergy Immunol. 2006;30(1):3-11. Godse KV, Zawar V, Krupashankar D, Girdhar M, Kandhari S, Dhar S, et al. Consensus statement on the management of urticaria. Indian J Dermatol. 2011;56(5):485-9. Choi SH, Baek HS. Approaches to the diagnosis and management of chronic urticaria in children. Korean J Pediatr. 2015;58(5):159-64. Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, Ballmer-Weber B, et al. The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. 2018;73(7):1393-414. Weldon D. Quality of life in patients with urticaria and angioedema: assessing burden of disease. Allergy Asthma Proc. 2014;35(1):4-9. Milán T, Verkasalo PK, Kaprio J, Koskenvuo M. Lifestyle differences in twin pairs discordant for basal cell carcinoma of the skin. Br J Dermatol. 2003;149(1):115-23. Maurer M, Zuberbier T, Metz M. The Classification, Pathogenesis, Diagnostic Workup, and Management of Urticaria: An Update. Handb Exp Pharmacol. 2022;268:117-33. Frigas E, Park MA. Acute urticaria and angioedema: diagnostic and treatment considerations. Am J Clin Dermatol. 2009;10(4):239-50. Taneja N, Mewara A. Shigellosis: Epidemiology in India. Indian J Med Res. 2016;143(5):565-76. Caraballo L, Zakzuk J, Lee BW, Acevedo N, Soh JY, Sánchez-Borges M, et al. Particularities of allergy in the Tropics. World Allergy Organ J. 2016;9:20. Additional Declarations No competing interests reported. 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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-6598964","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":466601046,"identity":"d50bae85-7b7f-4b4c-afc2-395672d273f6","order_by":0,"name":"Jiangjiao Liu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAuklEQVRIiWNgGAWjYBACPmYGBgMJBgkefv7mA8RpYYNosZGRnHEsgUgtECrNxuBAjgGRWth5DAosGA7zMBw48/HGGwY7Od0Ggg7jMQA67DAPY3PvZss5DMnGZgeI1cLMcHabNNCuxG1Ea2FjyHlGkpY0Hh6GHDZitbAVgAKZR0LimLHlHAMi/MLPf3ibMTAq7e3PNz+88abCTo6gFpBFxpL/ICwJHiKjhvnhBwaYFuJ0jIJRMApGwQgDAKyPMwkEYw8CAAAAAElFTkSuQmCC","orcid":"","institution":"Heilongjiang Provincial Hospital","correspondingAuthor":true,"prefix":"","firstName":"Jiangjiao","middleName":"","lastName":"Liu","suffix":""},{"id":466601047,"identity":"7414a90d-ad86-4412-ba41-e8f42bb49e63","order_by":1,"name":"Ying Pan","email":"","orcid":"","institution":"Heilongjiang Provincial Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ying","middleName":"","lastName":"Pan","suffix":""},{"id":466601048,"identity":"fff5a959-551f-4b65-8664-772c2754ab61","order_by":2,"name":"Ying Song","email":"","orcid":"","institution":"Heilongjiang Provincial Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ying","middleName":"","lastName":"Song","suffix":""}],"badges":[],"createdAt":"2025-05-06 04:53:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6598964/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6598964/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":84276580,"identity":"146fda19-1aed-4269-bc22-4f51f10f5041","added_by":"auto","created_at":"2025-06-10 05:41:26","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":11062872,"visible":true,"origin":"","legend":"\u003cp\u003eGlobal Trends of Urticaria in Adolescents and Middle-Aged Adults from 1990 to 2021.Figure1A. Urticaria Incidence counts, Prevalence counts and DALY number among Global Population Aged 15 - 49 from 1990 to 2021. Figure1B. From 1990 to 2021, the global age - standardized incidence rate, prevalence rate and DALY rate of urticaria among people aged 15 - 49. DALY: disability-adjusted life year.\u003c/p\u003e","description":"","filename":"figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-6598964/v1/525ffc1b62b5eb491a67f90f.png"},{"id":84278153,"identity":"58ae97c8-32d4-44f5-8713-ed81815cad97","added_by":"auto","created_at":"2025-06-10 06:06:43","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":5616543,"visible":true,"origin":"","legend":"\u003cp\u003eCountry trends of Adolescents and Middle-Aged Adults urticaria from 1990 to 2021. Age-standardized incidence rate (A), age-standardized prevalence rate (B),15-49 years incidence rate (C), 15-49 years prevalence rate (D) and estimated annual percentage change (EAPC) incidence plot(E), estimated annual percentage change (EAPC) prevalence plot(F) for urticaria per 100,000 population in 2021 in 204 countries and territories.\u003c/p\u003e","description":"","filename":"figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-6598964/v1/0b2f67d193823f6b106718d3.png"},{"id":84276589,"identity":"ec0a9c6b-2b97-4edd-a0c3-e4bc117f618e","added_by":"auto","created_at":"2025-06-10 05:41:27","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":3212709,"visible":true,"origin":"","legend":"\u003cp\u003eThe urticaria burden across different age groups from 15 to 49 years old from 1990 to 2021. Global incidence cases(A)、age-standardized incidence rate(B)、prevalence cases(C)、age-standardized prevalence rate(D)、daly cases(E)、age-standardized daly rate(F) by gross domestic product (GDP) in US dollars per capita in 1990-2021, with linear trend line and R\u003csup\u003e2\u003c/sup\u003e\u003csub\u003e.\u003c/sub\u003e DALY: disability-adjusted life year.\u003c/p\u003e","description":"","filename":"figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-6598964/v1/c7d23888c2c0f88e7d2a0f62.png"},{"id":84276591,"identity":"0dad421b-f726-4637-a349-132ec8728cfb","added_by":"auto","created_at":"2025-06-10 05:41:27","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":2218840,"visible":true,"origin":"","legend":"\u003cp\u003ePredictions for the counts and rates of DALYs of global Adolescents and Middle-Aged Adults with urticaria by 2050. 15-49 years daly counts(A)、15-49 years daly rate(B). DALY: disability-adjusted life year.\u003c/p\u003e","description":"","filename":"figure4.png","url":"https://assets-eu.researchsquare.com/files/rs-6598964/v1/0e6f3a712a1c3b46960ea9e5.png"},{"id":95656491,"identity":"347d0a4c-b42a-4a12-99d2-8d443582ba7e","added_by":"auto","created_at":"2025-11-11 16:18:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":22085363,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6598964/v1/8250e78a-b2c4-4312-9529-fe85b2d2219b.pdf"},{"id":84277161,"identity":"bca0d198-5cca-4406-a1ee-61dd3ffe6651","added_by":"auto","created_at":"2025-06-10 06:01:09","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":1589565,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6598964/v1/5245e370d98fc6adbe7f93ec.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A Systematic Analysis of Urticaria Disease Burden, Risk Factors in Adolescents and Middle-aged Adults (1990 - 2021) and 2050 Trend Forecast: Based on the 2021 Global Disease Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eUrticaria, a prevalent mast cell - mediated allergic skin disease, is marked by itching and sudden - onset wheals, with or without angioedema. While not life - threatening, it can be disabling and significantly impacts quality of life(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). In recent years, urticaria research has gained significant attention and achieved notable progress. Urticaria is categorized as acute or chronic based on symptom duration and can be spontaneous or induced based on triggering factors(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Most acute urticaria cases are spontaneous. Chronic spontaneous urticaria has no specific triggers and has two endotypes: IgE-mediated autoimmune/autoallergic type I and IgG - mediated type IIb. Chronic induced urticaria involves specific triggers like dermatographism, pressure, vibration, cholinergic stimuli, heat/cold, sunlight, water, and contact with certain substances. Moreover, urticaria exhibits marked epidemiological differences across regions, races, and ages.Epidemiologically, urticaria prevalence ranges from 1.5% (in the US and Europe) to 4% (in Asia and Latin America). Notably, chronic urticaria often affects middle - aged and young individuals(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Analyzing the global disease burden of urticaria in middle - aged and young individuals, its risk factors, and future trends aims to comprehensively understand its epidemiological features and disease burden across levels. This informs targeted public health policies and clinical treatment strategies. These studies help clarify urticaria incidence and prevalence trends in middle - aged and young populations across regions. This identifies high - risk areas for early intervention, informs rational medical resource allocation, prioritizes high - burden regions, assesses current treatments and public health interventions, guides future strategy adjustments, and raises public awareness to reduce patient misunderstandings and discrimination.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy population\u003c/h2\u003e \u003cp\u003eAll study subjects were patients diagnosed with urticaria. Although there is no international consensus on the definition of urticaria in Adolescents and Middle-Aged Adults. However, many previous studies have conventionally defined urticaria in Adolescents and Middle-Aged Adults as patients aged 15\u0026ndash;49. This age grouping aligns with that in the GBD database facilitating data analysis and comparison. Moreover, patients in this age range have achieved stable biological and physiological maturity. Based on the above theory and prior studies, this study selected patients with urticaria aged 15\u0026ndash;49.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eThe Urticaria diagnosis defined in this study corresponds to the ICD-10 codes \"L50\". According to the International Classification of Diseases (ICD-10), urticaria is classified under code L50 and its subcodes. L50 is a general code for urticaria. Specific subcodes include :L50.0 for allergic urticaria, L50.1 for idiopathic urticaria, L50.2 for urticaria due to cold/heat, L50.3 for dermatographism urticaria,L50.4 for vibratory urticaria,L50.5 for cholinergic urticaria,L50.6 for contact urticaria, L50.8 for other urticaria types, including chronic and recurrent,L50.9 for unspecified urticaria. Solar urticaria is classified under code L56.3. The data was obtained from the Global Health data Exchange(Global Health data Exchange, GHDx) (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://ghdx.healthdata.org/).Th\u003c/span\u003e\u003cspan address=\"http://ghdx.healthdata.org/).Th\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003ee search parameters were \u0026ldquo;Urticaria\u0026rdquo; for cause; \u0026ldquo;incidence, prevalence, DALYs(Disability-Adjusted Life Years)\u0026rdquo; for measure ments; \u0026ldquo;all loctions\u0026rdquo; for location; \u0026ldquo;1990\u0026ndash;2021\u0026rdquo; for years; \u0026ldquo;number and rate\u0026rdquo; for metrics; \u0026ldquo;male, female and both\u0026rdquo; for sex; and \u0026ldquo;Age-standardized ,15 to 49 years and corresponding 5-year bands\u0026rdquo; for age. We followed the Guidelines for Accurate and Transparent Health Estimates Reporting guidelines for cross-sectional studies.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eData from the GBD database describes the incidence, prevalence and DALY rates of urticaria among middle - aged and young populations globally, regionally, and nationally from 1990 to 2021 and calculated the ASIR, ASPR and ASDR for urticaria among middle - aged and young populations globally, regionally, and nationally. It generated a world map of ASIR and ASPR. The EAPC was calculated using the formula 100* (exp(β) -1), with the 95% CI derived from the linear regression model. Calculated the EAPC of urticaria among middle - aged and young populations globally, regionally, and nationally. It generated a world map of the EAPC of ASIR and EAPC of ASPR. Divided middle - aged and young urticaria patients into seven age groups: 15\u0026ndash;19, 20\u0026ndash;24, 25\u0026ndash;29, 30\u0026ndash;34, 35\u0026ndash;39, 40\u0026ndash;44, 45\u0026ndash;49. Compared the age - specific burden composition of middle - aged and young urticaria patients between 1990 and 2021. The trend of DALYs counts and DALYs Rate of urticaria among middle - aged and young populations globally by 2050 was predicted. All statistics were performed using the R program (Version 4.2.1, R core team).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eGlobal Trends of Urticaria in Adolescents and Middle-Aged Adults from 1990 to 2021\u003c/h2\u003e \u003cp\u003eFrom 1990 to 2021, the global number of incident cases of urticaria in middle - aged and young individuals showed an upward trend. It increased from 34,061,278.87 cases in 1990 (95% UI 28,510,620.09\u0026ndash;39,445,228.14) to 48,980,455.81 cases in 2021 (41,946,875.66\u0026ndash;56,535,268.41). From 1990 to 2021, the global number of prevalent cases of urticaria in middle - aged and young individuals also showed an upward trend. It rose from 19,560,102.20 cases in 1990 (16,203,447.31\u0026ndash;22,872,000.70) to 28,112,995.93 cases in 2021 (23,632,580.14\u0026ndash;33,155,870.03). The number of DALYs of urticaria in middle - aged and young individuals also showed an upward trend. From 1990 to 2021, number of DALYs increased from 1,174,072.25 cases (750,579.11\u0026ndash;1,726,318.52) to 1,684,143.19 cases (1,079,083.42\u0026ndash;2,451,406.98) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFrom 1990 to 2021, the ASIR of urticaria in middle - aged and young individuals globally showed a downward trend. It decreased from 621.92 (520.57\u0026ndash;720.22) per 100,000 in 1990 to 613.90 (525.75\u0026ndash;708.59) per 100,000 in 2021. The ASPR exhibited a downward trend. It decreased from 357.15 (295.86\u0026ndash;417.62) per 100,000 in 1990 to 352.36 (296.20\u0026ndash;415.56) per 100,000 in 2021. The ASDR also showed a downward trend. It fell from 21.44 (13.70\u0026ndash;31.52) per 100,000 in 1990 to 21.11 (13.52\u0026ndash;30.73) per 100,000 in 2021(Figure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eB).\u003c/p\u003e \u003cp\u003eFrom 1990 to 2021, the number of incident cases, number of prevalent cases, and number of DALYs of urticaria in middle - aged and young females were generally higher than in males(Figure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA). In 2021, urticaria number of incident cases in middle - aged and young females were 1.5 times those in males༈29,005,746.15༈24,847,434.03\u0026ndash;33,413,961.04༉vs 19,974,709.65༈16,970,723.51\u0026ndash;23,014,288.46༉༉. Number of prevalent cases in females were 1.5 times those in males༈16,645,577.68༈13,947,013.42\u0026ndash;19,581,464.84༉vs 11,467,418.25༈9,655,036.26\u0026ndash;13,465,111.43༉༉. Number of DALYs in females were 1.4 times those in males༈990,335.33༈633,318.70\u0026ndash;1,434,836.29༉vs 693,807.87༈443,201.07\u0026ndash;1,013,034.51༉༉. From 1990 to 2021, the ASIR, ASPR, and ASDR of urticaria in both sexes showed a downward trend, similar to the general population, with female rates consistently higher than male rates༈Figure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eB༉. In 2021, the female ASIR was 1.5 times the male ASIR༈736.59༈630.99\u0026ndash;848.53༉per 100,000 vs 494.34༈420.00\u0026ndash;569.57༉per 100,000༉. The female ASPR was 1.5 times the male ASPR༈422.71༈354.18\u0026ndash;497.26༉per 100,000 vs 283.80༈238.95\u0026ndash;333.24༉per 100,000༉. The female ASDR was 1.5 times the male ASDR༈25.15༈16.08\u0026ndash;36.44༉per 100,000 vs 17.17༈10.97\u0026ndash;25.07༉per 100,000༉༈appendix1 1\u0026ndash;90).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eRegion and sex trends of Adolescents and Middle-Aged Adults urticaria from 1990 to 2021\u003c/h2\u003e \u003cp\u003eWhen calculated by SDI quintiles, the incidence and prevalence of urticaria in all global regions showed a predominantly downward trend. The most significant decline in ASIR and ASPR occurred in high - middle SDI countries: ASIR decreased from 599.7 (502.1\u0026ndash;699)/100,000 in 1990 to 574.9 (486.9\u0026ndash;665.6)/100,000 in 2021, while ASPR decreased from 344.6 (284.3\u0026ndash;406.6)/100,000 in 1990 to 330.1 (275.7\u0026ndash;390.4)/100,000 in 2021 (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The least decline in ASIR occurred in high - SDI and low - middle SDI countries. Conversely, ASPR increased in high - SDI countries, rising from 348.2 (302.7\u0026ndash;397)/100,000 in 1990 to 349 (305.9\u0026ndash;397.3)/100,000 in 2021. In 2019, regions classified as low - middle SDI had high urticaria incidence and prevalence.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eregion and sex trends of Adolescents and Middle-Aged Adults urticaria from 1990 to 2021\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"12\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLocation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLocation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eIncidence(95%UI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eIncidence(95%UI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003eprevalence(95%UI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e \u003cp\u003eprevalence(95%UI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCase,1990\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eASIR(per100000),\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCase,2021\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eASIR(per100000),\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eEAPC of ASIR(95%CI),\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eCase,1990\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eASPR(per100000),\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eCase,2021\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eASPR(per100000),\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eEAPC of ASPR(95%CI),\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1990\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2021\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1990\u0026ndash;2021\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1990\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003e2021\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1990\u0026ndash;2021\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlobal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34061278.9 (28510620.1-39445228.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e621.9 (520.6-720.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48980455.8 (41946875.7-56535268.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e613.9 (525.7-708.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.04 (-0.04\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e19560102.2 (16203447.3-22872000.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e357.1 (295.9-417.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e28112995.9 (23632580.1-33155870)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e352.4 (296.2-415.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.04 (-0.04\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13535722.3 (11258629.6-15774239.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e487.9 (405.8-568.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19974709.7 (16970723.5-23014288.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e494.3 (420-569.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.05 (0.04\u0026ndash;0.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e7779762.2 (6433929.2-9104796.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e280.4 (231.9-328.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e11467418.3 (9655036.3-13465111.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e283.8 (238.9-333.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.04 (0.04\u0026ndash;0.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20525556.5 (17251516.2-23775081.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e759.6 (638.4-879.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29005746.2 (24847434\u0026ndash;33413961)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e736.8 (630.3-850.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.1 (-0.1\u0026ndash;0.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e11780340 (9778632.8-13797229.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e435.9 (361.9-510.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e16645577.7 (13947013.4-19581464.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e422.7 (354.2-497.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.1 (-0.1\u0026ndash;0.09)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh SDI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5682268 (4965149\u0026ndash;6418357)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e610.2 (533.2-689.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6197688.3 (5459552.7-6973355.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e610.7 (538-687.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.01 (-0.01-0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3242631.3 (2818449-3696622.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e348.2 (302.7\u0026ndash;397)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3541767.3 (3104590.3-4032311.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e349 (305.9-397.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0 (-0.01-0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1772150.7 (1553685.3-2001626.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e374.6 (328.4-423.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2018333.8 (1773069.8-2276109.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e385.6 (338.7-434.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.12 (0.11\u0026ndash;0.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1016577.4 (878580.7-1156537.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e214.9 (185.7-244.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1157140.2 (1008804.1-1316523.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e221 (192.7-251.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.12 (0.11\u0026ndash;0.13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3910117.3 (3417804.6-4417413.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e853.6 (746.1-964.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4179354.5 (3682982.4-4696607.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e849.8 (748.9-953.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.03 (-0.04\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2226054 (1940045.5-2544626.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e485.9 (423.5-555.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2384627 (2100716.6-2713359.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e485.3 (427.6-552.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh-middle SDI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6838813.5 (5725892.8-7971741.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e599.7 (502.1\u0026ndash;699)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7313043.8 (6193755.5-8467821.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e574.9 (486.9-665.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.12 (-0.14\u0026ndash;0.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3929649.2 (3241777.9-4637315.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e344.6 (284.3-406.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4199127.5 (3506727.1-4966177.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e330.1 (275.7-390.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.13 (-0.14\u0026ndash;0.12)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2532171.7 (2100455.4-2952794.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e437.2 (362.6-509.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2824404.9 (2399717-3278206.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e430.8 (366\u0026ndash;500)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.03 (-0.04\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1457682.4 (1197944.6-1721608.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e251.7 (206.8-297.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1623081.3 (1366077-1914056.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e247.6 (208.4\u0026ndash;292)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.04 (-0.05\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4306641.8 (3616353.1-5028040.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e767.4 (644.4-895.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4488638.9 (3790403.2-5199044.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e728.7 (614.6-843.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.17 (-0.17\u0026ndash;0.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2471966.8 (2037806.1-2919699)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e440.5 (363.1-520.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2576046.2 (2148851.8-3051552.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e417.8 (348.5-494.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.17 (-0.17\u0026ndash;0.16)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle SDI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11410595.5 (9392789.8-13416227.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e620.2 (510.5-729.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15203852.6 (12911757.7-17639771.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e599.5 (509.1-695.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.1 (-0.11\u0026ndash;0.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6572892 (5368455.8-7834692.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e357.2 (291.8-425.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e8743677.3 (7295826.2-10362668.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e344.8 (287.7-408.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.1 (-0.11\u0026ndash;0.09)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4985857.2 (4097857.1-5873898.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e532.3 (437.5-627.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6719622.1 (5658904.2-7773173.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e522.4 (439.9-604.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.06 (-0.06\u0026ndash;0.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2869188.1 (2350916.8-3396430)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e306.3 (251-362.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3861505.5 (3236457.2-4557746.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e300.2 (251.6-354.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.06 (-0.07\u0026ndash;0.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6424738.3 (5301965.5-7608139.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e711.2 (586.9-842.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8484230.5 (7205084.1-9873346.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e679.2 (576.2-792.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.13 (-0.15\u0026ndash;0.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3703703.9 (3017217-4439307.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e410 (334-491.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4882171.7 (4051315.4-5786233.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e390.7 (324.2\u0026ndash;463)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.14 (-0.15\u0026ndash;0.13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow-middle SDI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7336699.7 (6078656.1-8565023.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e658.9 (545.9-769.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13492767.4 (11357468.9-15701139.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e657.1 (553.1-764.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.01 (-0.01\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4212199.8 (3459486.9-4969606.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e378.3 (310.7-446.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e7742404.8 (6401248-9137700.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e377 (311.7\u0026ndash;445)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.01 (-0.01\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3106722 (2573371.5-3639155.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e552.7 (457.8-647.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5655074.7 (4737530.8-6569458)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e548.8 (459.7-637.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1783169.3 (1464749.6-2106918.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e317.2 (260.6-374.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3244738.2 (2685624.8-3824335.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e314.9 (260.6-371.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4229977.7 (3512654.9-4941532.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e767.1 (637-896.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7837692.7 (6608009.3-9133356.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e766.3 (644.7-894.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0\u0026ndash;0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2429030.6 (2003752.1-2869259.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e440.5 (363.4-520.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4497666.7 (3728104.5-5313066)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e439.7 (364.4-519.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0 (-0.01-0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow SDI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2762730.4 (2283267.9-3226564)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e618.6 (511.2-722.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6736401.8 (5573769.5-7870297.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e614.7 (508.6-718.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.02 (-0.02\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1585396 (1315212.8-1865546.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e355 (294.5-417.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3864946.5 (3205058.6-4551027.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e352.7 (292.5-415.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.02 (-0.02\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1127358.8 (930029.9-1330408.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e510.2 (420.9-602.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2742269.4 (2260616.5-3233517.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e506.3 (417.4\u0026ndash;597)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e646539.2 (532878.7-761852)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e292.6 (241.2-344.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1572327.3 (1294077.2-1854331.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e290.3 (238.9-342.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1635371.6 (1357689.5-1914390.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e724.7 (601.6-848.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3994132.4 (3316909.7-4672746.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e721.6 (599.2-844.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.01 (-0.02\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e938856.8 (780796.6-1105675.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e416 (346-489.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2292619.2 (1906646.1-2701509.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e413.6 (344-487.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.02 (-0.02\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAndean Latin America\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e210184.9 (173348.5-246879.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e558.2 (460.4-655.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e390646.9 (328724.2-457658.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e552.7 (465.1-647.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e120507.6 (99456-141582.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e320 (264.1\u0026ndash;376)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e223787.7 (186582.5-263268.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e316.6 (264-372.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86741.5 (71576-103138.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e469.1 (387.1-557.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e165072.3 (138000.4-193767.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e466.1 (389.7-547.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.02 (-0.02\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e49731.7 (40582.4-58928.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e269 (219.5-318.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e94576.7 (78342.8-111872.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e267.1 (221.2-315.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.02 (-0.02\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e123443.4 (102303-145899.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e644.1 (533.8-761.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e225574.6 (190683.1-264834.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e640.1 (540.1-750.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.02 (-0.02\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e70776 (58387.4-84076.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e369.3 (304.7-438.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e129211 (108299.8-152438.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e366.4 (307.1-432.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.02 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAustralasia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e158207.9 (132202.5-183441.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e725.6 (606.3-841.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e211755 (177949.4-247084.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e725.7 (609.9-846.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0\u0026ndash;0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e90884.1 (75979-106280.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e416.8 (348.5-487.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e121706.9 (101936.9-142632.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e417.1 (349.4-488.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0 (0\u0026ndash;0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43515.7 (36362.6-50790.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e397.1 (331.8-463.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57566.1 (48309.7-67422.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e394.5 (331.1-462.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.01 (-0.02\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e25150.3 (20811.2-29539.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e229.5 (189.9-269.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e33238.7 (27667.5-39173.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e227.8 (189.6-268.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.01 (-0.02\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114692.3 (95524.2-132487.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1057.5 (880.8-1221.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e154188.9 (129032.8-178760.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1056.3 (885.8-1222.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (-0.01-0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e65733.7 (54704.2-76530.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e606.1 (504.4-705.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e88468.2 (73991.9-103912.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e606.5 (507.2-712.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0 (-0.01-0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaribbean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e205722.5 (170889.2-240695.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e557.4 (463-652.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e267458.4 (225537.8-312839.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e552.8 (466.2-646.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e117921.6 (97736.7-138717.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e319.5 (264.8-375.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e153207.2 (127806-180539.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e316.7 (264.2-373.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e84644.6 (70142.6-100103.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e468.3 (388.1-553.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e112064.7 (93964.7-131393.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e465.4 (390.3-545.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.02 (-0.02\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e48519.9 (39709.8-57507.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e268.4 (219.7-318.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e64200 (53416.1-75580.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e266.6 (221.8-313.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.02 (-0.02\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e121077.9 (100781.1-142649.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e642.8 (535.1-757.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e155393.7 (131985-182114.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e639.4 (543.8-750.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.02 (-0.02\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e69401.6 (57536.7-81953.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e368.5 (305.5-435.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e89007.1 (74758.5-105058.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e366.2 (307.6-432.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.02 (-0.02\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentral Asia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e403803.8 (335268.1-477038.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e599.3 (497.6\u0026ndash;708)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e578329.1 (489411.4-677303.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e587 (496.8-687.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.06 (-0.08\u0026ndash;0.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e232812.9 (191627.2-277804.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e345.5 (284.4-412.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e332514.2 (275495.4-395082)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e337.5 (279.6\u0026ndash;401)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.07 (-0.09\u0026ndash;0.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e129221.2 (106257.3-153571.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e386 (317.4-458.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e184381.1 (154584.9-217065.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e372.6 (312.3-438.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.1 (-0.12\u0026ndash;0.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e75271.9 (61133.3-90939.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e224.8 (182.6-271.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e106926.9 (88559-127184.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e216.1 (178.9\u0026ndash;257)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.11 (-0.14\u0026ndash;0.09)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e274582.7 (225271.9-325807.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e810 (664.5-961.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e393948 (330355.4-462767)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e804 (672.3-945.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.02 (-0.03-0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e157540.9 (129310.1-189036.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e464.7 (381.5-557.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e225587.3 (187082.9-268586.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e460.1 (381.6-547.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.02 (-0.04\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentral Europe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e794868.3 (675607.1-908631.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e633.5 (538.5-724.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e653668.8 (572660.9-740532.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e614 (537.9-695.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.1 (-0.11\u0026ndash;0.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e456449 (384329.8-535342.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e363.8 (306.3-426.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e374445 (322342.2-429157.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e351.7 (302.8-403.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.11 (-0.12\u0026ndash;0.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e242836 (205604.7-281579.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e382.9 (324.2\u0026ndash;444)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e199204.3 (174360.3-224538)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e366 (320.3-412.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.13 (-0.15\u0026ndash;0.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e140751.2 (117550.7-165694.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e222 (185.4-261.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e114959.4 (99011.8-131356.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e211.2 (181.9-241.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.15 (-0.16\u0026ndash;0.14)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e552032.3 (471110.6-632865.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e889.6 (759.2-1019.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e454464.5 (397089.3-519315.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e871.4 (758.5\u0026ndash;990)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.05 (-0.06\u0026ndash;0.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e315697.8 (265589.5-370119.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e508.7 (428-596.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e259485.7 (223982.5-298573.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e498.7 (430.4-573.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.06 (-0.07\u0026ndash;0.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentral Latin America\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e950534.5 (778393.8-1118842)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e576.3 (471.9-678.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1537120.4 (1295242.6-1791653.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e571.4 (481.5-666.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e545082.7 (449016.8-644645)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e330.5 (272.2-390.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e880683.6 (735071.1-1042832.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e327.4 (273.3-387.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e388397.3 (318599.3-458464.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e484 (397-571.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e630094.4 (529406.9-738006.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e480.2 (403.5-562.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e222688.1 (182506.7-264454.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e277.5 (227.4-329.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e360984.5 (299419-426545.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e275.1 (228.2-325.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e562137.2 (463577.7-663381.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e663.8 (547.4-783.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e907026 (768085.5-1061215)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e658.5 (556.5-770.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e322394.6 (265894.2-383039.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e380.7 (314-452.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e519699 (433424.3-615115)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e377.2 (314.5-446.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentral Sub-Saharan Africa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e275608.1 (225935.6-324725)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e558.6 (458-658.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e733876.1 (604806.4-861621.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e557 (459.1\u0026ndash;654)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.01 (-0.01\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e158039.6 (130084.3-186510.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e320.3 (263.7\u0026ndash;378)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e420801.6 (347331.9-495191.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e319.4 (263.6-375.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.01 (-0.01\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114525.2 (93557.5-137067.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e470.2 (384.1-562.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e308658.3 (254284-367264.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e469.3 (386.6-558.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.01 (-0.01-0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e65670.4 (53216.6-78235.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e269.6 (218.5-321.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e176977.8 (144390.2-209549.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e269.1 (219.5-318.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.01 (-0.01\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e161082.9 (133198.6-190586.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e644.9 (533.3\u0026ndash;763)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e425217.8 (352219.9-502467.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e644.4 (533.9-761.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0\u0026ndash;0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e92369.2 (75912.2-109853.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e369.8 (303.9-439.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e243823.8 (201086.9-289823.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e369.6 (304.8-439.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0 (0\u0026ndash;0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEast Asia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8542487.8 (7002750.8-10118670.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e613.7 (503.1\u0026ndash;727)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7839756.3 (6578171.5-9128528.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e563.5 (472.8-656.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.24 (-0.26\u0026ndash;0.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4930858.9 (4009585.1-5910382.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e354.3 (288.1-424.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4523381.1 (3780492.9-5350926.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e325.1 (271.7-384.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.24 (-0.26\u0026ndash;0.22)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3544883.4 (2889273.3-4223778.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e493.5 (402.3-588.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3328162.9 (2815412.9-3851102.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e460.6 (389.6\u0026ndash;533)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.2 (-0.22\u0026ndash;0.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2043772.6 (1666016.3-2421208.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e284.5 (232-337.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1917416.9 (1593274.3-2270957.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e265.4 (220.5-314.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.2 (-0.22\u0026ndash;0.18)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4997604.4 (4091824.2-6013043)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e741.9 (607.4-892.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4511593.4 (3780884.6-5295529.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e676.1 (568-794.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.27 (-0.3\u0026ndash;0.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2887086.3 (2338441.9-3499432.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e428.6 (347.1-519.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2605964.2 (2158765.1-3081774.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e389.7 (322.9-460.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.28 (-0.3\u0026ndash;0.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEastern Europe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1380161.5 (1160306.6-1602199.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e619.3 (520.7\u0026ndash;719)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1192618.8 (1008982.2-1391970.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e613.4 (518.9-715.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.05 (-0.08\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e793514.2 (661567.5-938599.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e356.1 (296.9-421.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e684018.1 (572174.7-804663.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e351.8 (294.3-413.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.06 (-0.08\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e437027.8 (361329-509132.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e393.3 (325.2-458.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e371830.8 (313206\u0026ndash;433238)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e383.5 (323-446.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.11 (-0.14\u0026ndash;0.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e253453.3 (209110-298102.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e228.1 (188.2-268.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e214886.7 (178741.5-254547.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e221.6 (184.4-262.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.12 (-0.16\u0026ndash;0.09)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e943133.7 (792222.4-1095717.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e844.1 (709.1-980.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e820788.1 (695732.5-963539.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e840.8 (713.2-982.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.02 (-0.04\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e540060.9 (451656.9-638601.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e483.4 (404.2-571.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e469131.4 (393752.4-552292.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e481.3 (403.9-566.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.05\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEastern Sub-Saharan Africa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e966643.9 (789136.6-1142988.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e573.5 (468.2-678.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2420255.6 (1983405.4-2855208.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e572 (468.8-674.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.01 (-0.01\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e554440.4 (455801.4-655925)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e329 (270.4-389.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1388034.5 (1142469.2-1640441.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e328.1 (270-387.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.01 (-0.01\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e391395.7 (318295.4-465033.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e481.1 (391.2-571.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e994060.6 (811781.3-1176397.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e480.9 (392.7-569.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.01 (-0.01-0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e224466.8 (184088-266511.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e275.9 (226.3-327.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e570034.7 (467807.9-675509.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e275.8 (226.3-326.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.01 (-0.01-0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e575248.2 (472687.6-680339.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e659.8 (542.1-780.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1426195 (1176815.8-1682221.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e659.3 (543.2\u0026ndash;778)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.01 (-0.01-0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e329973.6 (270577.8-391914.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e378.5 (310.3-449.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e817999.8 (674272.1-973893.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e378 (311.6\u0026ndash;450)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.01 (-0.01-0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh-income Asia Pacific\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1095251.1 (927799.9-1276314.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e583.9 (494.7-680.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e910405.9 (774712.2-1064260.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e576 (490.2-673.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.05 (-0.05\u0026ndash;0.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e626596.4 (517616.9-744251.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e334.1 (276-396.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e520972.6 (435901.6-622291.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e329.6 (275.8-393.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.04 (-0.05\u0026ndash;0.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e319797.2 (269495.2-373471.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e336.1 (283.3-392.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e268393.7 (227672.4-311511)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e330.6 (280.4-383.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.05 (-0.06\u0026ndash;0.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e184074.7 (151869.2-218678.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e193.5 (159.6-229.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e154123 (128317.7-183337)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e189.8 (158-225.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.06 (-0.06\u0026ndash;0.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e775453.9 (658050.4-905882.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e839 (712-980.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e642012.3 (543842.9-754647.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e835.1 (707.8-982.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.02 (-0.02\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e442521.6 (364714\u0026ndash;525799)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e478.8 (394.6-568.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e366849.5 (308385.6-439927.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e477.3 (401.2-572.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.01 (-0.02\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh-income North America\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1902022.9 (1728538.8-2073821.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e631.6 (574-688.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2175971.4 (1995075.3-2355675)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e638.5 (585.4-691.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01 (0-0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1084762.9 (992836.6-1179001.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e360.2 (329.7-391.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1244555.2 (1146165.6-1340729.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e365.2 (336.3-393.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.02 (0.01\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e582155 (527243.1-635679.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e385.9 (349.5-421.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e666509.2 (612345.4-723422.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e389.7 (358\u0026ndash;423)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.02 (0.01\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e334022.6 (305582.7-363734.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e221.4 (202.6-241.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e382920.1 (354270.9-413169.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e223.9 (207.1-241.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.02 (0.01\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1319867.9 (1195943.7-1441638)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e878.4 (795.9-959.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1509462.2 (1381343.4-1637444.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e888.6 (813.7-963.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01 (0-0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e750740.3 (685940.3-815612.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e499.6 (456.5-542.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e861635.1 (792929.3-926304.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e507.5 (467-545.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.01 (0-0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNorth Africa and Middle East\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2163106.8 (1809748-2516122.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e667.9 (558.8-776.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4481122.5 (3808473.7-5190595.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e663.3 (563.8-768.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.02 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1239072.7 (1026290-1453793.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e382.6 (316.9-448.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2567017.4 (2136354.3-3039815.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e380 (316.2\u0026ndash;450)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.02 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e882902.2 (739630.4-1030765)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e531.9 (445.6\u0026ndash;621)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1897120.8 (1605138.9-2213724.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e536.6 (454-626.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.04 (0.03\u0026ndash;0.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e503610 (416671.5-595369.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e303.4 (251-358.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1083684.5 (903438.1-1276324.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e306.5 (255.5\u0026ndash;361)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.04 (0.04\u0026ndash;0.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1280204.6 (1062576.6-1502094.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e811 (673.1-951.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2584001.7 (2189553.4-2995270.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e803 (679.6-930.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.04 (-0.04\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e735462.7 (607054.8-863029.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e465.9 (384.6-546.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1483332.9 (1236601.9-1744803.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e460.7 (384.1-541.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.04 (-0.04\u0026ndash;0.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOceania\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35798.4 (29667.7-42435.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e554.5 (459.5-657.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e77801.9 (64849.6-91564.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e544.2 (453.6-640.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.06 (-0.06\u0026ndash;0.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e20665 (16921.4-24649.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e320.1 (262.1-381.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e44902.9 (37066.3-53154.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e314.1 (259.3-371.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.06 (-0.06\u0026ndash;0.06)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16580.4 (13492\u0026ndash;19748)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e500 (406.8-595.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35950.4 (29669.1-42385.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e493.7 (407.4\u0026ndash;582)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.04 (-0.04\u0026ndash;0.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9555 (7797.3-11354.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e288.1 (235.1-342.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e20712.6 (16982.9-24554.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e284.4 (233.2-337.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.04 (-0.04\u0026ndash;0.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19218 (15852.8-22911.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e612.1 (504.9-729.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41851.5 (34760.1-49545.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e598.2 (496.8-708.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.08 (-0.08\u0026ndash;0.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e11110 (9068.3-13406.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e353.8 (288.8\u0026ndash;427)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e24190.3 (20048.8-28951.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e344.9 (285.9-412.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.08 (-0.08\u0026ndash;0.07)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth Asia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7197850.3 (5965844.4-8404065.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e673.3 (558.1-786.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13792603.7 (11611004.6-16019912.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e678 (570.8-787.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.02 (0.02\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4124979.9 (3397605.7-4869778.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e385.9 (317.8-455.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e7901711.2 (6552630.5-9355286.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e388.5 (322.1-459.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.02 (0.02\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3021685.6 (2507281.1-3549709.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e545.5 (452.6-640.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5656109.3 (4726677.2-6607002.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e546.1 (456.4-637.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0\u0026ndash;0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1731501.6 (1438467.7-2050037)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e312.6 (259.7-370.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3240175.1 (2714356.9-3839386.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e312.8 (262.1-370.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0 (0\u0026ndash;0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4176164.7 (3469388.5-4901270.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e810.8 (673.6-951.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8136494.4 (6857542.9-9499513.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e814.7 (685.6-952.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.02 (0.01\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2393478.2 (1968772.8-2829895.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e464.7 (382.3-549.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4661536.1 (3850926.6-5510789.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e466.9 (385.7-551.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.01 (0.01\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSoutheast Asia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3071793.4 (2510132.6-3650118.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e642.5 (525.1-763.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4554751 (3798288.1-5339374.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e607.9 (506.9-712.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.18 (-0.19\u0026ndash;0.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1782108.1 (1449488.6-2148862.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e372.8 (303.2-449.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2640696.2 (2166644.3-3128772.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e352.4 (289.2-417.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.18 (-0.19\u0026ndash;0.17)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1619378.8 (1323833.3-1919671.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e688.5 (562.8-816.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2500906.4 (2082903.1-2928429.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e659.8 (549.5-772.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.14 (-0.15\u0026ndash;0.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e936310 (758655.4-1118481.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e398.1 (322.5-475.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1445182 (1180413.2-1705448.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e381.2 (311.4-449.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.14 (-0.15\u0026ndash;0.13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1452414.6 (1179268.8-1737840.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e598.1 (485.6-715.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2053844.6 (1701231.6-2419306.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e556.5 (460.5\u0026ndash;656)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.24 (-0.26\u0026ndash;0.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e845798.1 (683107.2-1027739.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e348.3 (281.3-423.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1195514.3 (984934.7-1422695.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e323 (266.1-384.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.25 (-0.26\u0026ndash;0.23)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouthern Latin America\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e282252.5 (237296.2-331093.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e570.4 (479.5-669.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e397861.1 (336592.9-466695.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e567.6 (480.2-665.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.01 (-0.01\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e161395.9 (132580-192281.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e326.1 (267.9-388.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e227540 (188699.7-272106.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e324.6 (269.2-388.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.01 (-0.01\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78959.7 (65535.2-93126.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e323 (268.1\u0026ndash;381)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e111795.2 (93895.9-131083.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e320.6 (269.3-375.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.02 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e45490.6 (37352.8-54004.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e186.1 (152.8-220.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e64315.4 (52894.5-76430.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e184.4 (151.7-219.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e203292.9 (171226.6-239514.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e811.8 (683.8-956.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e286065.9 (240879.7-336987.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e812.3 (683.9-958.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0\u0026ndash;0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e115905.2 (94902.3-138857.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e462.9 (379-554.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e163224.6 (134521.8-195488.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e463.5 (382-555.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.01 (0-0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouthern Sub-Saharan Africa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e303776.6 (248141.7-357874.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e583.7 (476.8-687.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e503304 (421835.6-588495.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e577 (483.6-674.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.04 (-0.05\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e174206.8 (143329-206587.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e334.7 (275.4-396.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e288375.8 (239824.7-341450.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e330.6 (274.9-391.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.04 (-0.05\u0026ndash;0.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e123456.1 (100958.7-145974.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e490.2 (400.8-579.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e210963.2 (176400.7-247546.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e486.6 (406.8-570.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.02 (-0.02\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e70778.5 (58335.5-84458.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e281 (231.6-335.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e120851.5 (100164-142788.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e278.7 (231-329.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.02 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e180320.5 (148458.5-212836.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e671.4 (552.8-792.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e292340.8 (245702.6-343856.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e666.7 (558.1\u0026ndash;785)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.02 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e103428.3 (85152.9-123013.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e385.1 (317\u0026ndash;458)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e167524.3 (139254.7-197924.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e381.9 (317.4-451.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTropical Latin America\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e933922.5 (766220-1097160.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e588.6 (482.9-691.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1412048.5 (1196796.7-1639520.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e583.2 (494.3-677.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e535421.9 (441227.4-635370.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e337.5 (278.1-400.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e808769.7 (676766\u0026ndash;958683)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e334 (279.5-395.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.04\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e386778.9 (319226.3-455066)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e495.5 (409\u0026ndash;583)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e587840.5 (495057.8-685650.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e491.3 (413.7\u0026ndash;573)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e221673.9 (183122.6-263321.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e284 (234.6-337.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e336616.7 (279613.3-395115.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e281.3 (233.7-330.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e547143.5 (452727-643868.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e678.8 (561.7-798.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e824208 (697366.2-960205.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e673.5 (569-785.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e313748 (258194.4-373946.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e389.2 (320.3-463.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e472153 (393577-559753.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e385.5 (321.4\u0026ndash;457)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.03 (-0.03\u0026ndash;0.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWestern Europe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2193730.4 (1881947.2-2531308.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e561.3 (481.5-647.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2176809.8 (1875705.1-2527036.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e571.5 (492.4-663.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.05 (0.04\u0026ndash;0.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1240592.2 (1052736-1452414.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e317.4 (269.4-371.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1233239.2 (1050420.2-1449169.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e323.8 (275.8-380.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.05 (0.04\u0026ndash;0.06)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e631111.1 (539052.6-726579.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e319.1 (272.6-367.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e620796.6 (534987-713608.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e322.3 (277.7-370.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.03 (0.03\u0026ndash;0.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e358368.4 (301451.7-417281.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e181.2 (152.4\u0026ndash;211)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e352643.5 (296471.1-409364.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e183.1 (153.9-212.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.03 (0.03\u0026ndash;0.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1562619.3 (1343115-1802782.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e809.4 (695.7-933.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1556013.2 (1336938.9-1815240)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e825.8 (709.9-962.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.05 (0.04\u0026ndash;0.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e882223.8 (750194.5-1036749)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e457 (388.6\u0026ndash;537)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e880595.7 (751739.4-1039971)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e467.7 (399.3-552.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.05 (0.04\u0026ndash;0.06)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWestern Sub-Saharan Africa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e993550.5 (812442.3-1171757.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e574.4 (469.7-677.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2672290.7 (2190867.7-3148909.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e576.7 (472.8-679.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01 (0.01\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e569789.3 (469794.7-673791.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e329.4 (271.6-389.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1532636.1 (1262626.8-1812261.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e330.8 (272.5-391.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.01 (0.01\u0026ndash;0.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e409728.9 (337778.1-483948.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e482.8 (398-570.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1067229.1 (872925.7-1262357.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e482.7 (394.8-570.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0\u0026ndash;0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e234900.4 (192749.1-277820.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e276.8 (227.1-327.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e611991.6 (502020.1-725984.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e276.8 (227.1-328.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0 (0\u0026ndash;0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e583821.7 (479263.5-692262.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e662.6 (543.9-785.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1605061.6 (1324708-1896095.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e662.4 (546.7-782.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0\u0026ndash;0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e334888.9 (275407.2-397162.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e380.1 (312.6-450.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e920644.5 (759731.6-1096029.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e380 (313.6-452.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0 (-0.01-0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eBetween 1990 and 2021, the global ASIR of urticaria showed a predominantly downward trend at the regional level. The most significant decline occurred in East Asia, with the ASIR decreasing from 613.7 (503.1\u0026ndash;727)/100,000 in 1990 to 563.5 (472.8\u0026ndash;656.2)/100,000 in 2021. In contrast, Western Europe exhibited an upward trend, with the ASIR increasing from 561.3 (481.5\u0026ndash;647.7)/100,000 in 1990 to 571.5 (492.4\u0026ndash;663.4)/100,000 in 2021.\u003c/p\u003e \u003cp\u003eBetween 1990 and 2021, the global ASPR of urticaria showed a predominantly downward trend at the regional level. The most significant decline occurred in East Asia, with the ASPR decreasing from 354.3 (288.1\u0026ndash;424.6)/100,000 in 1990 to 325.1 (271.7\u0026ndash;384.6)/100,000 in 2021. In contrast, Western Europe exhibited an upward trend, with the ASPR increasing from 317.4 (269.4\u0026ndash;371.6)/100,000 in 1990 to 323.8 (275.8\u0026ndash;380.5)/100,000 in 2021(Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFrom 1990 to 2021, ASIR and ASPR of urticaria among global young and middle - aged adults demonstrated regional variations.However, females were consistently higher than males.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eCountry trends of Adolescents and Middle-Aged Adults urticaria from 1990 to 2021\u003c/h3\u003e\n\u003cp\u003eIn 2021, India, China, and Pakistan reported the highest number of new urticaria cases. India: 9,928,117.02 cases (8,334,805.52\u0026ndash;11,535,834.11); China: 7,567,721.21 cases (6,348,556.29\u0026ndash;8,807,709.06); Pakistan: 2,078,572.26 cases (1,738,280.05\u0026ndash;2,430,055.42) (appendix2 91\u0026ndash;95). The highest number of prevalent cases was in India (5,682,028.91 [4,699,572.72\u0026ndash;6,733,844.59]), China (4,366,377.26 [3,650,334.03\u0026ndash;5,166,497.17]), and Pakistan (1,192,081.15 [983,047.02\u0026ndash;1,411,660.23]) (appendix2 97\u0026ndash;101). The highest ASIR were in Nepal (1,047.24 per 100,000 [910.02\u0026ndash;1,171.81]), Pakistan (843.25 per 100,000 [705.20\u0026ndash;985.85]), and Sweden (804.56 per 100,000 [680.38\u0026ndash;944.33]) (appendix2 103\u0026ndash;107). The highest ASPR were in Nepal (609.44 per 100,000 [530.13\u0026ndash;687.58]), Pakistan (483.61 per 100,000 [398.81\u0026ndash;572.69]), and Bangladesh (460.59 per 100,000 [382.54\u0026ndash;546.98]) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eA \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eB; appendix2 109\u0026ndash;113);\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eBetween 1990 and 2021, the ASIR of urticaria showed a downward trend in 151 of 204 countries and territories. The most significant decline was in the Maldives, where the incidence rate decreased from 643.68 (514.82\u0026ndash;777.91) per 100,000 in 1990 to 582.72 (479.78\u0026ndash;693.31) per 100,000 in 2021;EAPC: -0.37 (-0.73 to -0.02), Vietnam's ASIR decreased from 632.75 (506.35\u0026ndash;756.58) per 100,000 in 1990 to 575.92 (476.67\u0026ndash;677.93) per 100,000 in 2021; EAPC: -0.32 (-0.73 to 0.1), In Thailand, the ASIR fell from 615.43 (501.80\u0026ndash;729.68) per 100,000 in 1990 to 560.30 (469.23\u0026ndash;652.40) per 100,000 in 2021; EAPC: -0.30 (-0.75 to 0.14), Spain had the largest increase, with the ASIR rising from 480.49 (420.82\u0026ndash;554.09) per 100,000 in 1990 to 502.71 (440.58\u0026ndash;581.93) per 100,000 in 2021; EAPC: 0.14 (-2.29 to 2.64), In Cyprus, the ASIR increased from 558.46 (471.17\u0026ndash;653.57) per 100,000 in 1990 to 582.09 (490.65\u0026ndash;687.57) per 100,000 in 2021; EAPC: 0.09 (-2.34 to 2.58), Ireland's ASIR rose from 554.79 (468.95\u0026ndash;647.85) per 100,000 in 1990 to 571.34 (486.19\u0026ndash;668.89) per 100,000 in 2021; EAPC: 0.07 (-2.32 to 2.52) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eE; appendix3 115\u0026ndash;130);\u003c/p\u003e \u003cp\u003eUrticaria's ASPR declined in 152 of 204 countries and territories. The most significant decline was in the Maldives, where ASPR fell from 373.53 (298.19\u0026ndash;458.00) per 100,000 in 1990 to 338.14 (276.05\u0026ndash;405.53) per 100,000 in 2021; EAPC: -0.37 (-0.71 to -0.04), Vietnam's ASPR decreased from 367.44 (296.36\u0026ndash;446.13) per 100,000 in 1990 to 334.23 (275.01\u0026ndash;397.22) per 100,000 in 2021; EAPC: -0.32 (-0.72 to 0.08), In Thailand, the ASPR fell from 357.19 (290.60\u0026ndash;431.74) per 100,000 in 1990 to 324.76 (267.26\u0026ndash;384.06) per 100,000 in 2021; EAPC: -0.31 (-0.74 to 0.12), Spain had the largest increase, with ASPR rising from 268.68 (234.77\u0026ndash;311.61) per 100,000 in 1990 to 282.24 (247.27\u0026ndash;328.63) per 100,000 in 2021; EAPC: 0.15 (-2.28 to 2.64), In Cyprus, the ASPR increased from 315.82 (262.60\u0026ndash;374.68) per 100,000 in 1990 to 330.32 (274.09\u0026ndash;395.95) per 100,000 in 2021; EAPC: 0.10 (-2.32 to 2.58), Ireland's ASPR rose from 313.30 (260.13\u0026ndash;371.20) per 100,000 in 1990 to 323.81 (270.05\u0026ndash;384.91) per 100,000 in 2021; EAPC: 0.08 (-2.30 to 2.52) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eF; appendix3 131\u0026ndash;146).\u003c/p\u003e \u003cp\u003e \u003cb\u003eThe urticaria burden across different age groups from 15 to 49 years old from 1990 to 2021\u003c/b\u003e \u003c/p\u003e \u003cp\u003eComparison of ASIR, ASPR, and DALYs of urticaria in middle-aged and young individuals between 1990 and 2021. Urticaria's ASIR, ASPR, and DALYs all decreased with age. The highest proportion of patients was in the 15\u0026ndash;19 age group. In 2021, the number of new cases, prevalent cases, and DALYs of urticaria was higher than in 1990 (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003ePredictions for the counts and rates of DALYs of global Adolescents and Middle-Aged Adults with urticaria by 2050.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFrom 2021 to 2050, the DALYs counts of urticaria in middle-aged and young individuals are projected to gradually increase, peaking in 2035, with females consistently having higher DALYs counts than males (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003eA). From 2021 to 2050, the DALYs rate is expected to gradually decline, with a more pronounced decrease in females (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003eB).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eUrticaria is one of the most common skin diseases globally and has a significant impact on patients' quality of life. In recent years, the global incidence of urticaria has shown a general downward trend, but its distribution varies across different regions and countries. Urticaria in adolescents and middle-aged adults constitutes a significant proportion of the overall urticaria patient population. Moreover, adolescents and middle-aged adults form the backbone of society and families urticaria can significantly impact their quality of life. Therefore, detailed analysis of the global burden of urticaria in adolescents and middle-aged adults is vital for clinical treatment, epidemiological studies, and public health policy development.\u003c/p\u003e \u003cp\u003eAnalysis of Global Trends:\u003c/p\u003e \u003cp\u003eFrom 1990 to 2021, the number of new cases, prevalent cases, and DALYs of urticaria in adolescents and middle-aged adults globally showed an upward trend. In recent years, global air pollution, climate warming, and increased humidity have promoted the growth and spread of allergens such as pollen and dust mites,increasing the risk of urticaria and worsening its burden(\u003cspan additionalcitationids=\"CR5 CR6 CR7\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Additionally, adolescents and middle-aged adults often have unhealthy lifestyles, such as lack of exercise and consumption of processed foods, seafood, and nuts, which increases the risk of urticaria. In some underdeveloped areas, antibiotic abuse remains common, disrupting the body\u0026rsquo;s ecological balance and immune system, leading to peripheral tolerance loss and increased susceptibility to urticaria(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Social and economic conditions play a significant role in urticaria among middle-aged and young people. Limited medical resources, delayed diagnosis, and inability to afford effective but expensive medications can hinder proper treatment(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Changes in population structure, such as urbanization, increase stress and reduce sleep, affecting the immune system and indirectly influencing urticaria(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Between 1990 and 2021, the ASIR, ASPR, and DALY rates of urticaria globally showed a downward trend, indicating progress in prevention and treatment. For example, Germany emphasizes comprehensive patient assessment and individualized treatment, including omalizumab, cyclosporine, psychotherapy, and physical therapy for refractory urticaria(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Japan focuses on allergen identification, avoidance, and lifestyle guidance. In treatment, it combines antihistamines with traditional japanese medicine like Kampo(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Between 1990 and 2021, females had higher urticaria indicators than males, possibly due to more estrogen receptors. Estrogen activates these receptors in mast cells, increasing intracellular calcium and promoting the release of inflammatory mediators like histamine. Additionally, genetic factors may contribute, as some immune-related genes are on the X chromosome, potentially increasing women\u0026rsquo;s autoimmune disease risk (\u003cspan additionalcitationids=\"CR14 CR15\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Globally, to reduce urticaria incidence, it is crucial to raise disease awareness in women and conduct further research to understand underlying mechanisms and develop targeted interventions to reduce the urticaria burden(\u003cspan additionalcitationids=\"CR15 CR16\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAnalysis of SDI Trend Reasons:\u003c/p\u003e \u003cp\u003eCalculated by SDI quintiles, the ASIR and ASPR of urticaria in middle - aged and young people in all global regions mainly showed a downward trend. The most significant decline in ASIR and ASPR occurred in high - middle SDI countries. This was attributed to sustained economic development, increased public health spending, and improved healthcare. For instance, novel antihistamines and biologics are extensively used in upper-middle-income countries enabling more effective control of urticaria in these countries thereby reducing the ASIR and ASPR (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). High SDI countries saw the least decline in ASIR and an increase in ASPR for adolescents and middle-aged adults urticaria patients. This was due to advanced medical diagnosis and increased awareness, leading to more accurate diagnosis and reporting of urticaria cases. Additionally, dietary habits (high - calorie, high - fat, high - sugar) and lifestyle stress in these countries impact urticaria in adolescents and middle-aged adults, contributing to higher prevalence rates (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Urticaria ASIR and ASPR are both high in Low-middle SDI countries. These nations, due to limited economic development, typically have less access to healthcare resources and less effective urticaria management, resulting in elevated ASIR and ASPR (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Moreover, infectious diseases can also increase urticaria risk (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). These regions have a high burden of infectious diseases and environmental pollution. The causal relationship between urticaria and infections (especially parasitic diseases) and pollution has been well - established. Eliminating infectious diseases can reduce the likelihood of developing urticaria. At the same time, infections can trigger or exacerbate urticaria through various mechanisms, including mast - cell activation and autoimmune reactions producing antibodies against key receptors such as IgE receptors or thyroid peroxidase. Thus, a higher incidence of infectious diseases and poor air quality may increase the incidence of urticaria in low - income regions (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). In summary, the high urticaria ASIR and ASPR in low - middle SDI countries are mainly attributed to limited economic and technological development and poor infectious disease control. Based on our analysis, we propose several specific policy recommendations: 1.Construct regional medical centers and standardize primary - care facilities to ensure equitable distribution of health - care resources; 2. Utilize big - data technology for early infectious disease warning and traceability analysis; 3. Protect biodiversity to reduce exposure to environmental allergens; 4. Conduct omics research on genetic susceptibility and environmental triggers. These interventions should be tailored to local healthcare infrastructure and socioeconomic conditions while ensuring consistency with international guidelines.\u003c/p\u003e \u003cp\u003eAnalysis of Regional Trend Reasons:\u003c/p\u003e \u003cp\u003eWe found that between 1990 and 2021, the global ASIR and ASPR of urticaria showed a predominantly downward trend at the regional level. The most significant decline was in East Asia, while Western Europe showed an upward trend. Differences in ASIR and ASPR of urticaria may be attributed to environmental and social factors. Studies indicate that groups without urticaria had higher relative humidity than those with urticaria (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Increased humidity may alter epidermal composition, damage skin integrity, and cause microbial and immune dysregulation, leading to urticaria (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Most East Asian regions are coastal with high relative humidity, which can reduce urticaria prevalence. A time - series analysis confirmed that exposure to air pollutants such as O3, PM2.5, and PM10 increases urticaria risk with cumulative effects (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). In recent years, East Asia\u0026rsquo;s air pollution control efforts have reduced air pollution, leading to a decline in urticaria ASIR and ASPR. In contrast, urban greening in Western Europe results in more airborne pollens and dust mites. A Singapore study found that European populations are more sensitive to seasonal allergens like pollen, which may increase urticaria incidence in European countries (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). In summary, implementing energy - saving and emission - reduction strategies and reducing allergen exposure can lower urticaria incidence. Regions with less decline should also improve these factors to reduce the urticaria burden in middle - aged and young people globally (\u003cspan additionalcitationids=\"CR28\" citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAnalysis of National Trend Reasons:\u003c/p\u003e \u003cp\u003eAt the national level, from 1990 to 2021, the ASIR of urticaria in adolescents and middle-aged adults showed a downward trend in 151 of 204 countries and territories. The ASPR showed a downward trend in 152 countries and territories. This indicates that the disease burden of urticaria in adolescents and middle-aged adults has declined in most countries globally. This is primarily attributed to the improvement of global medical standards. Countries like Germany and the UK have well - developed universal health coverage, providing basic medical security for urticaria patients (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). Some European medical institutions create records for chronic urticaria patients, with regular follow - ups, condition monitoring, and timely treatment adjustments to improve quality of life (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). The US National Institutes of Health (NIH) funds research projects on urticaria pathogenesis and new treatments, supporting the development of more effective therapies (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). The European Medicines Agency (EMA) prioritizes the review and approval of biologics for severe or refractory urticaria, enabling patients to benefit sooner (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). However, the decline varies across countries, with a few still experiencing an increasing disease burden. Thus, countries with a heavy or less declining burden of urticaria in adolescents and middle-aged adults should enhance improvement measures. For instance, high - burden countries like India and China can reduce their burden by improving medical security, boosting drug research, establishing priority review and approval mechanisms, and launching public education campaigns (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan additionalcitationids=\"CR35 CR36\" citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). Countries where the burden of urticaria in adolescents and middle-aged adults is increasing are Spain, Cyprus and Ireland. Spain and Cyprus are in the Mediterranean, and Ireland has a temperate maritime climate. Recent temperature increases and changes in precipitation have extended the growing and dispersal seasons of plant pollens, raising exposure chances and urticaria incidence rates (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). The highest ASIR and ASPR are in Nepal and Pakistan. As South Asian countries, Nepal and Pakistan have seen industrial growth worsen environmental pollution, increasing urticaria incidence and prevalence. Geographically, Nepal is in a high - altitude area with strong UV radiation, which can damage the skin barrier and trigger urticaria (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e). To address these factors, a range of interventions are needed. These include increasing investment in healthcare infrastructure, improving access to medical services, and implementing targeted public health initiatives to reduce exposure to environmental risk factors. Such measures could benefit countries and regions with a high burden of urticaria in adolescents and middle-aged adults (\u003cspan additionalcitationids=\"CR42 CR43\" citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAnalysis of Age - Grouped Trend Reasons:\u003c/p\u003e \u003cp\u003eUrticaria ASIR, ASPR, and DALYs in adolescents and middle-aged adults decreased with age in 1990 and 2021. The highest proportion of patients was in the 15\u0026ndash;19 age group. In 2021, the number of new cases, prevalent cases, and DALYs of urticaria was higher than in 1990. The disease burden of urticaria in adolescents and middle-aged adults is concentrated in the 15\u0026ndash;19 age group. This may be attributed to differences in immune system function and regulation among age groups. Individuals aged 15\u0026ndash;19 are in puberty, with changing sex hormone levels. Estrogen can bind to estrogen receptors in immune cells, affecting gene expression. This shifts the immune response from innate to adaptive, potentially influencing immune cell development and function and triggering urticaria (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). Moreover, adolescents and middle-aged adults have a complex diet, including allergenic foods and those with additives and preservatives, which can trigger urticaria. They also face work - and life - related pressures, leading to anxiety and depression. These affect neurotransmitter and hormone secretion, indirectly triggering or worsening urticaria (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). A tailored, stepwise approach is needed to manage urticaria in adolescents and middle-aged adults. For example, launch health promotion projects to encourage regular routines, moderate exercise, and a balanced diet. For chronic spontaneous urticaria patients, use biologics and tools to assess disease severity and treatment response. Psychological education and behavioral interventions can also improve their anxiety and depression. In addition, developing and implementing public health interventions to reduce exposure to environmental risk factors and enhance overall health is crucial. This can help alleviate the urticaria burden and improve treatment outcomes in affected populations (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan additionalcitationids=\"CR47\" citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAnalysis of the Reasons for the DALYs Trend Prediction by 2050:\u003c/p\u003e \u003cp\u003eFrom 2021 to 2050, the DALYs counts of urticaria in adolescents and middle-aged adults will gradually increase globally, while the DALYs rate will gradually decline. Over the next 30 years, sustained global population growth will lead to an increase in the DALYs counts of urticaria in adolescents and middle-aged adults. Exposure to allergens and irritants, such as air pollution and chemicals, will also increase the DALYs counts of urticaria (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e). Additionally, changes in lifestyle factors, including diet, stress, and sedentary behavior, may also contribute to an increase in urticaria cases (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e). Finally, over time, improved diagnosis and increased awareness of urticaria will lead to higher detection rates of urticaria cases (\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e), which will also contribute to an increase in DALYs counts. However, concurrently, improvements in socioeconomic conditions, healthcare infrastructure, and access to treatment and care will lead to a gradual decline in the DALYs rate (\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eLimitations and Outlook:\u003c/p\u003e \u003cp\u003eDue to insufficient data in the GBD database for some countries and regions, the assessment of the urticaria burden may be inaccurate, potentially resulting in data biases in these areas. Additionally, the GBD database has limitations related to time constraints. Although the GBD database is updated annually, the timely availability of certain data may be limited, meaning the latest data may not reflect the most recent disease trends and health risk factors. Lastly, the GBD database also has deficiencies due to a lack of geographical specificity. Therefore, our study results should be interpreted with consideration of the GBD database's limitations to avoid data misunderstandings or misuse. It is also recommended to combine the analysis with data from other sources and relevant regional contexts.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOver the past 30 years, the number of new urticaria cases among adolescents and middle-aged adults globally has risen with population growth ,yet, the ASIR has declined reflecting global progress in managing the disease, driven by better diagnosis, treatment, and public education. However, significant challenges persist. The urticaria burden is especially heavy among females aged 15 - 19 and in low - middle SDI countries. Thus, it is imperative to implement targeted interventions promptly. Such as intensifying health education and awareness initiatives aimed at adolescents and middle-aged women. Boosting investment in healthcare resources for low-middle SDI countries. Fostering international collaboration. While also emphasizing the importance of adopting context - appropriate strategies. Tailoring measures to countries\u0026apos; diverse cultures, regions, and habits to sustainably reduce the disease burden and uneven distribution issue. In responding to this public health challenge.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study leverages publicly available data from the Global Burden of Disease Study 2021 (GBD 2021).The data was obtained from the Global Health data Exchange(Global Health data Exchange, GHDx) (http://ghdx.healthdata.org/). Therefore, ethics approval was not required.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Statement:\u003c/strong\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\u003eAuthors\u0026apos; Contributions:\u003c/strong\u003e JJ L had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors contributed to concept and design; critical revision of the manuscript for important intellectual content; administrative, technical, or material support; and supervision. YP contributed to acquisition, analysis, and interpretation of data and drafting of the manuscript. JJ Land YS contributed to statistical analysis.\u003c/p\u003e\n\u003cp\u003eConflicts of Interest: None declared.\u003c/p\u003e\u003ch2\u003e\u003cstrong\u003eAssociated Data\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThis section collects any data citations, data availability statements, or supplementary materials included in this article.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eZuberbier T, Abdul Latiff AH, Abuzakouk M, Aquilina S, Asero R, Baker D, et al. The international EAACI/GA\u0026sup2;LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77(3):734-66.\u003c/li\u003e\n\u003cli\u003eKolkhir P, Gim\u0026eacute;nez-Arnau AM, Kulthanan K, Peter J, Metz M, Maurer M. Urticaria. Nat Rev Dis Primers. 2022;8(1):61.\u003c/li\u003e\n\u003cli\u003eGim\u0026eacute;nez-Arnau AM, Manzanares N, Podder I. Recent updates in urticaria. 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World Allergy Organ J. 2016;9:20.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"urticaria, burden of disease, prevalence, incidence, disability-adjusted life years","lastPublishedDoi":"10.21203/rs.3.rs-6598964/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6598964/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Urticaria, one of the most prevalent skin conditions worldwide, has a substantial impact on patients' quality of life The middle - aged and young population (15 - 49 years old) constitutes the backbone of society and families Analyzing their urticaria disease burden is crucial for public health policymaking. However, existing research on the global urticaria disease burden and its trends among middle - aged and young individuals is still relatively scarce.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003eThis study aims to analyze the incidence, prevalence, and disease burden (measured by disability - adjusted life - years, DALYs) of urticaria among middle - aged and young individuals globally, regionally, and nationally from 1990 to 2021, based on data from the Global Burden of Disease (GBD) database and explore its changing trends and associated factors and project the DALYs trend up to 2050 to inform healthcare policymaking.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003eThis study utilized data from the GBD database, filtering relevant data on urticaria among middle - aged and young individuals (15 - 49 years old). We calculated the incidence (ASIR), prevalence (ASPR), and DALYs rate (ASDR) using age - standardized methods and generated a world map. Using a linear regression model, we computed the annual average percentage change (EAPC) and 95% confidence interval (CI) to analyze disease burden trends across regions and countries. Additionally, we grouped patients by age (15 - 19 to 45 - 49 years old) to compare disease burden distribution across age groups and projected the DALYs trend up to 2050. All statistical analyses were performed using R software.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003eFrom 1990 to 2021, global urticaria cases new prevalent and DALYs in middle - aged and young individuals rose, whereas ASIR and ASPR fell. The disease burden was markedly higher in females than in males.Regionally, East Asia saw the largest drop in ASIR and ASPR, while Europe Western rose. The disease burden was higher in low - and middle - SDI countries, while high - SDI countries saw the least ASIR decline and ASPR increase. Nationally, India and China reported the highest urticaria burden. Age - specific data showed the highest incidence in the 15 - 19 age group, declining with age. By 2050, global urticaria DALYs in middle - aged and young individuals are expected to rise, but the DALYs rate may gradually decline.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003eDespite declining ASIR and ASPR of urticaria among middle - aged and young individuals globally, the disease burden remains unevenly distributed. Females and younger age groups bear a heavier burden. The disease burden is especially pronounced in low - and middle - SDI countries. Future - oriented targeted interventions and policies are needed to address this emerging public health issue.\u003c/p\u003e","manuscriptTitle":"A Systematic Analysis of Urticaria Disease Burden, Risk Factors in Adolescents and Middle-aged Adults (1990 - 2021) and 2050 Trend Forecast: Based on the 2021 Global Disease Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-10 05:41:21","doi":"10.21203/rs.3.rs-6598964/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"821d22f7-8899-4f1e-831d-117e2fd3b6f7","owner":[],"postedDate":"June 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-11T09:24:34+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-10 05:41:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6598964","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6598964","identity":"rs-6598964","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}