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Prevalence of chronic obstructive pulmonary disease and variation in risk factors across four geographically diverse resource-limited settings in Peru

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dc.contributor.author Jaganath, Devan
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Gilman, Robert H.
dc.contributor.author Wise, Robert A.
dc.contributor.author Diette, Gregory B.
dc.contributor.author Miele, Catherine H.
dc.contributor.author Bernabe-Ortiz, Antonio
dc.contributor.author Checkley, William
dc.date.accessioned 2019-02-06T14:53:35Z
dc.date.available 2019-02-06T14:53:35Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5411
dc.description.abstract BACKGROUND: It is unclear how geographic and social diversity affects the prevalence of chronic obstructive pulmonary disease (COPD). We sought to characterize the prevalence of COPD and identify risk factors across four settings in Peru with varying degrees of urbanization, altitude, and biomass fuel use. METHODS: We collected sociodemographics, clinical history, and post-bronchodilator spirometry in a randomly selected, age-, sex- and site-stratified, population-based sample of 2,957 adults aged >/=35 years (median age was 54.8 years and 49.3% were men) from four resource-poor settings: Lima, Tumbes, urban and rural Puno. We defined COPD as a post-bronchodilator FEV1/FVC < 70%. RESULTS: Overall prevalence of COPD was 6.0% (95% CI 5.1%-6.8%) but with marked variation across sites: 3.6% in semi-urban Tumbes, 6.1% in urban Puno, 6.2% in Lima, and 9.9% in rural Puno (p < 0.001). Population attributable risks (PARs) of COPD due to smoking >/=10 pack-years were less than 10% for all sites, consistent with a low prevalence of daily smoking (3.3%). Rather, we found that PARs of COPD varied by setting. In Lima, for example, the highest PARs were attributed to post-treatment tuberculosis (16% and 22% for men and women, respectively). In rural Puno, daily biomass fuel for cooking among women was associated with COPD (prevalence ratio 2.22, 95% CI 1.02-4.81) and the PAR of COPD due to daily exposure to biomass fuel smoke was 55%. CONCLUSIONS: The burden of COPD in Peru was not uniform and, unlike other settings, was not predominantly explained by tobacco smoking. This study emphasizes the role of biomass fuel use, and highlights pulmonary tuberculosis as an often neglected risk factor in endemic areas. en_US
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartof urn:issn:1465-993X
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Urbanization en_US
dc.subject Aged en_US
dc.subject Middle Aged en_US
dc.subject Peru/epidemiology en_US
dc.subject Altitude en_US
dc.subject Prevalence en_US
dc.subject Risk Factors en_US
dc.subject Longitudinal Studies en_US
dc.subject Risk Assessment en_US
dc.subject Urban Health en_US
dc.subject Rural Health en_US
dc.subject Biomass en_US
dc.subject Residence Characteristics en_US
dc.subject Predictive Value of Tests en_US
dc.subject Smoking/adverse effects/epidemiology en_US
dc.subject Spirometry en_US
dc.subject Forced Expiratory Volume en_US
dc.subject Fossil Fuels en_US
dc.subject Lung/physiopathology en_US
dc.subject Pulmonary Disease, Chronic Obstructive/diagnosis/epidemiology/physiopathology en_US
dc.subject Tuberculosis, Pulmonary/diagnosis/epidemiology en_US
dc.subject Vital Capacity en_US
dc.title Prevalence of chronic obstructive pulmonary disease and variation in risk factors across four geographically diverse resource-limited settings in Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s12931-015-0198-2
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE


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