Pattern and determinants of respiratory mortality in Kerala, South India (original) (raw)
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The Lancet Global Health, 2018
Background India has 18% of the global population and an increasing burden of chronic respiratory diseases. However, a systematic understanding of the distribution of chronic respiratory diseases and their trends over time is not readily available for all of the states of India. Our aim was to report the trends in the burden of chronic respiratory diseases and the heterogeneity in their distribution in all states of India between 1990 and 2016. Methods Using all accessible data from multiple sources, we estimated the prevalence of major chronic respiratory diseases and the deaths and disability-adjusted life-years (DALYs) caused by them for every state of India from 1990 to 2016 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016. We assessed heterogeneity in the burden of chronic obstructive pulmonary disease (COPD) and asthma across the states of India. The states were categorised into four groups based on their epidemiological transition level (ETL). ETL was defined as the ratio of DALYs from communicable diseases to those from non-communicable diseases and injuries combined, with a low ratio denoting high ETL and vice versa. We also assessed the contribution of risk factors to DALYs due to COPD. We compared the burden of chronic respiratory diseases in India against the global average in GBD 2016. We calculated 95% uncertainty intervals (UIs) for the point estimates. Findings The contribution of chronic respiratory diseases to the total DALYs in India increased from 4•5% (95% UI 4•0-4•9) in 1990 to 6•4% (5•8-7•0) in 2016. Of the total global DALYs due to chronic respiratory diseases in 2016, 32•0% occurred in India. COPD and asthma were responsible for 75•6% and 20•0% of the chronic respiratory disease DALYs, respectively, in India in 2016. The number of cases of COPD in India increased from 28•1 million (27•0-29•2) in 1990 to 55•3 million (53•1-57•6) in 2016, an increase in prevalence from 3•3% (3•1-3•4) to 4•2% (4•0-4•4). The age-standardised COPD prevalence and DALY rates in 2016 were highest in the less developed low ETL state group. There were 37•9 million (35•7-40•2) cases of asthma in India in 2016, with similar prevalence in the four ETL state groups, but the highest DALY rate was in the low ETL state group. The highest DALY rates for both COPD and asthma in 2016 were in the low ETL states of Rajasthan and Uttar Pradesh. The DALYs per case of COPD and asthma were 1•7 and 2•4 times higher in India than the global average in 2016, respectively; most states had higher rates compared with other locations worldwide at similar levels of Sociodemographic Index. Of the DALYs due to COPD in India in 2016, 53•7% (43•1-65•0) were attributable to air pollution, 25•4% (19•5-31•7) to tobacco use, and 16•5% (14•1-19•2) to occupational risks, making these the leading risk factors for COPD. Interpretation India has a disproportionately high burden of chronic respiratory diseases. The increasing contribution of these diseases to the overall disease burden across India and the high rate of health loss from them, especially in the less developed low ETL states, highlights the need for focused policy interventions to address this significant cause of disease burden in India.
International Research Journal of Pharmacy, 2020
The aim of the study was to identify the epidemiology of respiratory problems and to assess their association with various risk factors in patients of St. Joseph’s general hospital, Guntur, Andhra Pradesh. The study was conducted over a period of 8 months (July-2019 to February-2020) in 71 patients (both males and females) and the data was analyzed using EXCEL 2007 and SPSS version 6.0. The study was conducted throughout 3 seasons (Monsoon, autumn, winter) during which people are more prone to respiratory problems. Demographic information like the name, age, gender, address, and previous medical history was included. The risk factors like time of admission (month), location, age, gender, past medical history & other co-morbidities and social history were considered. The diagnosed pulmonary problems include Asthma, Bronchitis (acute, chronic & viral), COPD, Interstitial Lung Disease, LRTI, Lung Cancer, Pneumonia, Respiratory Failure, Tuberculosis, Tonsillitis and Shortness of Breath ...
Determinants of respiratory diseases in East Sikkim
BMC Research Notes, 2013
Background: Due to the difficult geographic terrain with lack of roads and transport, the Sikkim State in India finds difficulties in contending the respiratory diseases especially during the rainy seasons. Findings: A case-control study was conducted for two months at the Central Referral Hospital of East Sikkim involving 110 individuals in the age group of 10 years and above. Due to feasibility constraints, 55 cases and 55 controls were selected by applying the non-probability sampling method with age and sex matching. The collected data were tabulated and analyzed by using the SPSS (Statistical Package for Social Sciences) version 10.0 for windows. Findings were expressed in terms of proportion, Chi Square Test and Multiple Logistic Regression Analysis. Here, p-value <0.05 was considered as statistically significant. This study revealed that the presence of overcrowding, chronic exposure to allergens, smoking habits, chronic respiratory illnesses within last 5 years, family history of chronic respiratory illnesses and mental illnesses were independently associated with respiratory diseases. Conclusion: This study should be replicated in other parts of Sikkim to obtain more confirmatory evidence on determinants of respiratory diseases.
International Journal of Medical Science and Public Health, 2014
Background: The prevalence of respiratory morbidity among elderly in rural area ranges between 31-35%. Quality of life is a subjective measure of wellbeing. Multiple morbidities have effect on quality of life. Aims & Objective: (1) To study the prevalence and risk factors of respiratory morbidity among the elderly at a village in Bangalore Urban district; (2) To assess the quality of life among them. Materials and Methods: This study was a cross sectional study conducted at Tarabanahalli, Bangalore Urban District, Karnataka. Study subjects consisted of elderly population aged ≥ 60 years residing at Tarabanahalli for at least 6 months. Data collection was done using a structured interview schedule based on SGRQ-C (St George's respiratory questionnaire for COPD) and WHOQOL-BREF. Brief clinical examination of respiratory system was also done. Data analysis was done using SPSS for frequencies, measures of central tendencies, independent sample T test. Results: Total number of study subjects was 64. Males were 23(36%) and females were 41 (64%). Majority of the study subjects i.e 44 (68.75%) belonged to the age group 60-69 years. Longest held job by most of the respondents was agriculture 61(95.3%).100% reported that they had 'moderate' occupational exposure to dust. 24 (37.5%) of the study subjects had the respiratory morbidity. Inadequate ventilation in the kitchen and use of firewood as cooking fuel were significantly associated with respiratory morbidity. There was no significant association between age, gender, type of job, years of exposure to dust, level of exposure at workplace, H/o smoking tobacco ever, current smoking, passive smoking & respiratory morbidity. Conclusion: A significant negative association was found between respiratory morbidity and 'Physical health' domain of quality of life.
Socio-demographic factors of COPD mortality in India
Clinical Epidemiology and Global Health, 2020
The epidemiology of Chronic Obstructive Pulmonary Disease (COPD), one of the major killers in India, has been inadequately studied. There is dearth of national data and analysis on its associates. The present article aims to find out socio-demographic factors associated with it. Materials and methods: Data taken from National Family Health Survey (NFHS 4) (2015-16), Global Adult Tobacco Survey (GATS) 2: India 2016-17 and India: Health of the Nation's States were analyzed with scatter plot and multivariate regression. Results: COPD mortality has negative relationships with use of clean fuel and economic condition and positive relationships with smoking and Second Hand Smoking (SHS). On regression, use of clean fuel reduces and SHS at home increases COPD deaths. Conclusion: For preventing deaths from COPD, focus should be on up scaling use of clean fuel and improvement in economic condition.
Factors associated with mortality from lung cancer in India
Current Problems in Cancer, 2019
the Nation's States were analyzed, as state and/or Union Territories unit of analysis. Spearman correlation coefficient and multivariate linear regression were used for finding out association with smoking, smokeless tobacco, alcohol consumption, second hand smoking, per capita income and use of clean fuel. Results: Except Kerala, most of the states with higher death rate were confined to north India. Smoking (r = 0.575, P = 0.001), SHS at home and work (r = 0.476, P = 0.008 and r = 0.374, P = 0.042, respectively) were significantly related to deaths from ca lung. On regression, clean fuel was found significantly associated with ca lung mortality. Conclusion: There is need to put emphasis on tobacco cessation and primary prevention of smoking.
National Journal of Community Medicine, 2017
Introduction: Respiratory tract infections are perhaps the most common human ailment. It is estimated that Bangladesh, India, Indonesia and Nepal together account for 40 per cent of the global ARI mortality. The research was done to study the trend and pattern of respiratory diseases and demographic characteristics. Methodology: A hospital based retrospective study was carried out at rural health and training centre from 2006-2011. Observations: The trend of respiratory morbidity in rural health and training centre catering area was increasing from 2006-2011(2.79-14%), than little dip thereafter. Maximum percentage of respiratory patients were reported in 2012 (23.78%) followed by in 2009(19.96%). Trend of respiratory problems among 0-5 years of age from 2006-2009 in increasing trend (3.3% -13.26%) thereafter slight decrease in percentage observed. Out of all respiratory problems most common was upper respiratory tract infection (78.30%) followed by ARI/Pneumonia (15.92%). Over all contribution of respiratory morbidity among patients attending rural health and training centre was 17.09%. Conclusion: Respiratory diseases trend at rural areas were in increasing trend and most of the cases occurred of upper respiratory tract infection.
Respiratory signs and symptoms of a rural subpopulation in India: What do they tell us?
Environment Conservation Journal
The study estimated the prevalence of chronic respiratory conditions among the cooks exposed to the burning of solid biomass cooking fuel. Questionnaire-based survey and lung function tests were administered to capture the self-reported respiratory health symptoms and lung health respectively. The estimated prevalence of chronic bronchitis was 3.14%, 4.84%, 7.09%, 10.91% for 26-35, 36-45, 46-55, 56-65 years age group respectively. Obstructive lung disease was observed in 5.4%, 4.6%, 7.1%, and 13.5% of respondents for age groups 26-35, 36-45, 46-55, 56-65 year respectively and 6% over all ages (p value < 0.05 for trend). Immediate actions are needed to reduce the pollution exposure of the rural populations by providing the clean cooking energy.
Respiratory symptoms and their determinants among adult women in an urban slum area of Delhi
Indian Journal of Community Health, 2017
Background-Globally, respiratory disorders accounted for 7.4% deaths, out of total deaths during the year 2015.(1) Objective- to estimate the magnitude of respiratory symptoms and their determinants in adult women of 18-59 years. Material and Method- A cross sectional study was conducted among 500 women of 18-59 years in an urban slum of Delhi. Assessment of respiratory symptoms was done using questionnaire and observations on environmental conditions. Results- Overall prevalence of major respiratory symptoms was 24.8% in the study population. Dyspnea, chronic cough, chronic phlegm, wheeze were observed in 14.2%, 5.6%, 2.4% and 2.6% respectively. Respiratory morbidity was related to age, educational status, socio-economic status, type of house, duration of stay, biomass fuel exposure, presence of pet and tobacco smoking. Chi-square test was applied to derive association of risk factors with respiratory symptoms.