Universidad Peruana Cayetano Heredia

Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries

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dc.contributor.author Morgan, Brooks W.
dc.contributor.author Grigsby, Matthew R.
dc.contributor.author Siddharthan, Trishul
dc.contributor.author Chowdhury, Muhammad
dc.contributor.author Rubinstein, Adolfo
dc.contributor.author Gutierrez, Laura
dc.contributor.author Irazola, Vilma
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Bernabé Ortiz, Antonio
dc.contributor.author Alam, Dewan
dc.contributor.author Wise, Robert A.
dc.contributor.author Checkley, William
dc.date.accessioned 2018-11-30T03:10:45Z
dc.date.available 2018-11-30T03:10:45Z
dc.date.issued 2018
dc.identifier.uri https://hdl.handle.net/20.500.12866/4056
dc.description.abstract BACKGROUND: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) represents the confluence of bronchial airway hyperreactivity and chronic airflow limitation and has been described as leading to worse lung function and quality of life than found with either singular disease process. OBJECTIVE: We aimed to describe the prevalence and risk factors for ACO among adults across 6 low- and middle-income countries (LMICs). METHODS: We compiled cross-sectional data for 11,923 participants aged 35 to 92 years from 4 population-based studies in 12 settings. We defined COPD as postbronchodilator FEV1/forced vital capacity ratio below the lower limit of normal, asthma as wheeze or medication use in 12 months or self-reported physician diagnosis, and ACO as having both. RESULTS: The prevalence of ACO was 3.8% (0% in rural Puno, Peru, to 7.8% in Matlab, Bangladesh). The odds of having ACO were higher with household exposure to biomass fuel smoke (odds ratio [OR], 1.48; 95% CI, 0.98-2.23), smoking tobacco (OR, 1.28 per 10 pack-years; 95% CI, 1.22-1.34), and having primary or less education (OR, 1.35; 95% CI, 1.07-1.70) as compared to nonobstructed nonasthma individuals. ACO was associated with severe obstruction (FEV1 %, <50; 31.6% of ACO vs 10.9% of COPD alone) and severe spirometric deficits compared with participants with asthma (-1.61 z scores FEV1; 95% CI, -1.48 to -1.75) or COPD alone (-0.94 z scores; 95% CI, -0.78 to -1.10). CONCLUSIONS: ACO may be as prevalent and more severe in LMICs than has been reported in high-income settings. Exposure to biomass fuel smoke may be an overlooked risk factor, and we favor diagnostic criteria for ACO that include environmental exposures common to LMICs. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Journal of Allergy and Clinical Immunology
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject ACO en_US
dc.subject adult en_US
dc.subject aged en_US
dc.subject allergic asthma en_US
dc.subject Article en_US
dc.subject asthma en_US
dc.subject Asthma en_US
dc.subject asthma-COPD overlap en_US
dc.subject Bangladesh en_US
dc.subject biomass en_US
dc.subject bronchodilating agent en_US
dc.subject chronic obstructive lung disease en_US
dc.subject chronic obstructive pulmonary disease en_US
dc.subject COPD en_US
dc.subject cross-sectional study en_US
dc.subject disease severity en_US
dc.subject epidemiology en_US
dc.subject female en_US
dc.subject forced expiratory volume en_US
dc.subject forced vital capacity en_US
dc.subject health outcomes en_US
dc.subject human en_US
dc.subject lifestyle en_US
dc.subject low income country en_US
dc.subject major clinical study en_US
dc.subject male en_US
dc.subject middle income country en_US
dc.subject overlap en_US
dc.subject population-based en_US
dc.subject prevalence en_US
dc.subject priority journal en_US
dc.subject risk factor en_US
dc.subject risk factors en_US
dc.subject self report en_US
dc.subject spirometry en_US
dc.subject wheezing en_US
dc.title Epidemiology and risk factors of asthma-chronic obstructive pulmonary disease overlap in low- and middle-income countries en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.jaci.2018.06.052
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.03
dc.relation.issn 1097-6825


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