COPD among 40+ people in Bangladesh

Chronic obstructive pulmonary disease (COPD) is a common, progressive, and preventable disorder that is characterized by a largely irreversible obstruction of the airways, and encompasses both emphysema and chronic bronchitis (GOLD, 2015). COPD is a prevalent condition (329 million people are affected worldwide), with an increasing incidence. Currently, the World Health Organization (WHO) ranks COPD as the 10thmost burdensome disease and fourth most important cause of death due to non-communicable disease worldwide, which is predicted to rise to third place by 2020 (World Health Organization, 2008).

COPD is a leading and still-increasing cause of chronic morbidity and mortality worldwide (GOLD, 2015; (Chapmann et al., 2006) and projected that between 1990 and 2020, COPD will become the third most common cause of death worldwide. A Dutch study predicts that an increase of 76% in the prevalence of COPD can be expected within approximately twenty years (Rutten van-Mölken MP, 2001). Most of the information available on COPD prevalence, morbidity, and mortality comes from high-income countries. Even in those countries, accurate epidemiologic data on COPD are difficult and expensive to collect. However, it is known that low- and middle-income countries already shoulder much of the burden of COPD with almost 90% of COPD deaths taking place in these countries (Lopez et al., 2006).

In Bangladesh, there are limited data regarding this potentially preventable disease. The national Sample Vital Registration System (SVRS) of the Bangladesh Bureau of Statistics (BBS), estimates that cardio- and cerebrovascular diseases combined are the major causes of death, followed by asthma and respiratory diseases. COPD data are rare. Among 30 years or older, the prevalence of COPD was 29.7 per 1000 (WHO survey). Department of Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh conducted a prospective, cross-sectional population-based survey which calculated the prevalence and risk factors of chronic obstructive pulmonary disease (COPD) among Dhaka City Population in Bangladesh. The study estimated mild, moderate, severe, and very severe COPD as 42.7%, 27.2%, 20.4%, and 9.7% respectively (Islam et al., 2013). The population studied was not representative of the entire country, and there is no clear estimate of how prevalent COPD is. There are also no substantial data from the rest of Bangladesh. Moreover, there are fewer population-based studies 6 which have investigated its incidence. Little is known about trends in COPD prevalence, incidence, and all-cause mortality in our community. To the best of our knowledge, this will be the first large-scale, population-based epidemiologic study on COPD prevalence in Bangladesh where COPD is prevalent and under-recognized in individuals 40 years of age or older.

OHDIR Foundation has performed the survey in collaboration with Chi Research & Infotec (CRIL). The time period of the survey was January to June 2018. This project was funded by DGHS, Bangladesh.