Magnitude and burden of COPD
Global and Indian Scene
Dr S.K. Jindal, MD
FAMS, FCCP, FNCCP
Professor & Head, Department of Pulmonary Medicine,
Postgraduate Institute of Medical Education & Research, Chandigarh.
Chronic obstructive pulmonary disease, popularly called COPD is a common and chronic respiratory disease. COPD commonly starts in the middle age men and most frequently occurs in smokers. Indoor air pollution from solid-fuel combustion and air pollution are other important risk factors. COPD is a major cause of morbidity and mortality the world over. This is one out of several major non-communicable diseases whose morbidity and mortality have not decreased and continue to rise, in spite of the numerous advances which have taken place.
Prevalence of COPD: The general prevalence of COPD in different countries varies between 3 to 10 percent in different adult populations. In India, the prevalence of chronic bronchitis, the prototype of COPD was seen in about 3.5 percent on an average in the Indian study on Epidemiology of Asthma, Respiratory symptoms and Chronic bronchitis (INSEARCH). The total number of patients as per 2011 census figures was estimated at 14.84 million among adults.
COPD morbidity and mortality: COPD is an important cause of respiratory disability and loss of work-days. COPD is the 2nd most common cause of loss of the disability-index DALYs in America and 9th on the global scale. In India, COPD was estimated to account for 3% of DALYs is more than one and a half time the global estimates of 1.9 percent DALYs. The economic costs of COPD pertain to not only the disease diagnosis and management but also to indirect losses from disability causing work loss, premature mortality and loss of family income (etc.). Estimates from India in the ICMR studies pointed to over Rs. 42,000 per capita expenditure due to COPD in 2006. With rising inflation rate and health-care costs, the per capita expenditure on COPD is bound to be huge.
It is a slowly progressive leading to respiratory crippling in about 2-3 decades. COPD mortality is almost the double of mortality from coronary heart disease. Globally, COPD is predicted to become the 3rd most common cause of death by the year 2030.
It is important to tackle the disease on a high priority in the national health-care agenda.
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