DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20184804

Prevalence of chronic obstructive pulmonary disease among adults in Kashmir (North India): a population based study

Asif Jeelani Hanga, Irfan Nazir Mir, Mir Mujtaba Ahmad, Waseem Raja, Seema Aleem

Abstract


Background: Chronic obstructive pulmonary disease (COPD), represents an important public health challenge that is both preventable and treatable. This study provides population based spirometry data on the burden of COPD in adult population of Kashmir Valley. Objectives of the study were to estimate the prevalence of chronic obstructive pulmonary disease and its associated risk factors in age group 40 years and above among Kashmiri population.

Methods: This study was conducted from April 2012 to December 2014. Multi stage gender stratified cluster sampling was employed to select 30 clusters from two blocks of Kashmir. A total of 504 males and 521 females performed acceptable spirometry after providing information on personal characteristics and relevant risk factors. Participants: Adults aged 40 years and above of Kashmiri ethnicity with no contraindication for spirometry. Variables: Proportion of subjects with FEV1/FVC less than 0.70, percent predicted FEV1 and FVC. Statistical methods: Descriptive statistics using frequencies, chi square test.

Results: Overall prevalence of COPD at stage I or higher was 15.90%, and was higher in males (19.05) than in females (12.08). The prevalence of Grade 1, 2, 3 and 4 COPD was 8.8%, 5.2%, 1.4% and 0.6% respectively. Chronic obstructive pulmonary disease (COPD) prevalence was associated with increased age and tobacco smoking. COPD prevalence was 2.7%, 22%, 28.2% in non-smokers, ex-smokers and current smokers respectively. 59.5% subjects had a positive history of tobacco exposure.

Conclusions: This study concludes that there is a high prevalence of COPD in Kashmir, high prevalence of COPD is attributed to high incidence of tobacco smoking in the study population.


Keywords


COPD prevalence, Smoking, Spirometry

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References


Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease revised 2011. Available at: http://www.goldcopd.com. Accessed August 8, 2012.

Bousquet J, Khaltaev N. Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach [monograph online]. Geneva, Switzerland: WHO Press; 2007. Available at: http://www.who.int/ gard/publications. Accessed on 25 February 2011.

Murray CJL, Lopez AD. Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet. 1997;349:1498–504.

Hogg JC, Chu F, Utokaparch S, Woods R, Elliott WM, Buzatu L, Cherniack RM, Rogers RM, Sciurba FC, Coxson HO, Pare PD. The Nature of Small-Airway Obstruction in Chronic Obstructive Pulmonary Disease. N Engl J Med. 2004;350:2645-53.

Snider GL. Nosology for our day: its application to chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2003;167:678–83.

Iqbal A, Schloss S, George D, Isonaka S. Worldwide guidelines for chronic obstructive pulmonary disease: a comparison of diagnosis and treatment recommendations. Respirology. 2002;7:233–9.

Celli BR, Halbert RJ, Isonaka S, Schau B. Population impact of different definitions of airway obstruction. Eur Respir J. 2003;22:268–73.

Hardie JA, Buist AS, Vollmer WM, Ellingsen I, Bakke PS, Mørkve O. Risk of over-diagnosis of COPD in asymptomatic elderly never-smokers. Eur Respir J. 2002;20:1117-22.

Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease revised 2011. Chapter 2. Available at: http://www.goldcopd.com. Accessed 8 August 2018.

Menezes AM, Perez-Padilla R, Hallal PC, Jardim JR, Muiño A, Lopez MV, et al. Worldwide burden of COPD in high- and low income countries. Part II.Burden of chronic obstructive lung disease in Latin America: the PLATINO study. Int J Tuberc Lung Dis. 2008;12(7):709-12.

Sethi D, Habibula S, Mcgee K, Peden M, Bennett S, Hyder Aa, Klevens J, Odero W, Suriyawongpaisal P. Guidelines For Conducting Community Surveys On Injuries And Violence[internet]. Switzerland: WHO Press; 2004. Chapter 4, Sampling Methodologies. Available at: http://whqlibdoc.who. int/publications/2004/9241546484.pdf. Accessed on 17 November 2018.

Bennett S, Woods L, Iiyanagec WM, Smith DB. Simplified general method for cluster sample surveys of health in developing countries. 1991. Available at: http://www.ph.ucla.edu/epi/rapid surveys/RScourse/whostatquarterly44_98_106_1991.pdf. Accessed on 16 November 2018.

Sharma R. Revision of Prasad’s social classification and provision of an online tool for real-time updating. South Asian J Cancer. 2013;2(3):157.

Park K. Park’s textbook of preventive and social medicine. 21st edition. Chapter 13. India: Banarsidasbhanot publishers; 2011: 694.

Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function Testing. Eur Respir J. 2005;26:153–61.

Aggarwal AN, Gupta D, Jindal SK. Comparison of Indian reference equations for spirometry interpretation. Respirology. 2007;12(5):763–8.

Menezes AM, Victora CG, Perez-Padilla R. The Platino project: methodology of a multicenter prevalence survey of chronic obstructive pulmonary disease in major Latin American cities. BMC Med Res Methodol. 2004;17:4-15.

Manning DM, Bramante S. The epidemiology and economics of chronic obstructive pulmonary disease. Proc Am Thorax Soc. 2007;4(7):502-6.

Menezes AM, Perez-Padilla R, Jardim JR, Muino A, Lopez MV, Valdivia G, et al. Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study. Lancet. 2005;366:1875–81.

Danielsson P, Ólafsdóttir IS, Benediktsdóttir B, Gíslason T, Janson C. The prevalence of chronic obstructive pulmonary disease in Uppsala, Sweden--the Burden of Obstructive Lung Disease (BOLD) study: cross-sectional population-based study. Clin Respir J. 2012;6(2):120-7.

Fukuchi Y, Nishimura M, Ichinose M, Adachi M, Nagai A, Kuriyama T, Takahashi K, et al. COPD in Japan: the Nippon COPD epidemiology study. Respirology. 2004;9:458–65.

Plywaczewski R, Bednarek M, Jonczak L, Zielinski J. Prevalence of COPD in Warsaw population. Pneumonol Alergol Pol. 2003;71:329–35.

Zhong N, Wang C, Yao W. Prevalence of Chronic obstructive pulmonary disease in China A large, population based survey. Am J Respir Crit Care Med. 2007;176:753–60.

Lea Schirnhofer, Bernd Lamprecht, William M, Vollmer, Michael J, Allison, Michael Studnicka, Robert L, Jensen, A. Sonia Buist. COPD Prevalence in Salzburg, Austria. CHEST. 2007;131:29–36.

Buist AS, McBurnie MA, Vollmer WM, Gillespie S, Burney P, Mannino DM, et al. BOLD Collaborative Research Group. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet. 2007;370:741-50.

Foreman MG, Zhang L, Murphy J, Hansel NN, Make B, Hokanson JE, et al, the COPDGene Investigators. Early-onset COPD is associated with female gender, maternal factors, and African American Race in the COPDGene study. Am J Respir Crit Care Med. 2011;184:414-20.

Minasa M, Hatzogloua C, Karetsia E, Papaioannoua A, Tanoua K, Tsarouchaa R, et al. COPD prevalence and the differences between newly and previously diagnosed COPD patients in a spirometry program. Prim Care Resp J. 2010;19(4):363-70.

Jindal SK, Aggarwal AN, Chaudhry K, Chhabra SK, D’Souza GA, Gupta SK, et al. Tobacco smoking in India: prevalence, quit-rates and respiratory morbidity. Indian J Chest Dis Allied Sci. 2006;48(1):37-42.

Lindberg A, Eriksson B, Larsson LG, Ronmark E, Sandstrom T, Lundback B. Seven-year cumulative incidence of COPD in an age-stratified general population sample. Chest. 2006;129(4):879-85.

Bousquet J, Khaltaev N. Global surveillance, prevention and control of chronic respiratory diseases A comprehensive approach. Switzerland: WHO press; 2007. Chapter 10, Tobacco Smoking: The Major Threat in High Income Countries, As Well As in Low And Middle Income Countries. Available at: http://www.who.int/gard/publications/ Risk%20factors.pdf. Accessed on 11 September 2012.

Tan WC, Bourbeau J, FitzGerald JM, Cowie R, Chapman K, Hernandez P, Buist SA, Sin DD. Can age and sex explain the variation in COPD rates across large urban cities? A population study in Canada. Int J Tuberc Lung Dis. 2011;15(12):1691–6.

Kanervisto M, Vasankari T, Laitinen T, Heliövaara M, Jousilahti P, Saarelainen S. Low socioeconomic status is associated with chronic obstructive airway diseases.Respir Med. 2011;105(8):1140-6.

Smith M, Augustyn M, Kurmi O. Prevalence and correlates of airflow obstruction in ∼317,000 never-smokers in China. Eur Respir J. 2014l;44(1):66-77.

Kurmi OP, Semple S, Simkhada P, Smith WC, Ayres JG. COPD and chronic bronchitis risk of indoor air pollution from solid fuel: a systematic review and meta-analysis. Thorax. 2010;65(3):221-8.