Prevalence and risk factors of chronic obstructive pulmonary disease (COPD) in Dhaka city population.

This prospective, cross-sectional population based survey was carried out in the Respiratory wing, Department of Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh to see the prevalence and risk factors of chronic obstructive pulmonary disease (COPD) among Dhaka City Population in Bangladesh. The total sample size was 900 at the age of 35 years or above. Spirometry was performed according to ATS criteria. Data related to smoking history, respiratory symptoms, co-morbidities, physical examination findings, spirometry values and other investigation reports were noted in the questionnaire. The mean age was 45.26±10.08 (Mean±SD); of them, male 76.9% and female 23.1%. Among them, smoker was 481 with a smoking duration of 10 pack year 27.8% and non smoker were 419. Spirometric screening yielded diagnosis of COPD in 11.4% (103/900). Using operational severity criteria adopted from Global Initiative for Obstructive Lung Disease (GOLD) mild, moderate, severe and very severe COPD were found in 42.7%, 27.2%, 20.4% and 9.7% respectively. The hall mark symptom of COPD exertional dyspnea was seen in 10.4%, non-specific symptoms like cough and sputum were found in 40% and 19% respectively. Physical sign like vesicular breath sound with prolonged expiration and ronchi were found in 6.1% and 4.1% respectively. In this study, age (Mean±SD in years) (57.34±11.74), Sex (Male: Female = 4:1), low BMI (Mean±SD) (21.56±3.83), Smoker 56(20.2%) and low Socio-economic condition 54(13.6%) found to be risk factor of COPD. Regression analysis revealed that age (p<0.001), sex (p<0.001), smoking duration (p<0.001) and low socioeconomic condition (p<0.05) as independent risk factors for COPD.

Detection of chronic obstructive pulmonary disease using spirometric screening.

This study was carried out in the Respiratory wing, department of Medicine, Bangabandhu Sheikh Mujib Medical University to evaluate the efficacy of spirometric screening for the detection of chronic obstructive pulmonary disease (COPD) in Bangladeshi population. A total number of 400 participants were included in the study [60.50% male and 39.50% female, aged (M+/-SD) 48+/-7.54 years]. Free spirometry was offered to them. Among them 200 were smokers with a smoking duration of 17.07+/-7.50 pack-years and 200 non-smokers. Spirometric screening yielded diagnosis of COPD in 12.50% (50/400); of them 2.75% (11/400) was non-smoker compared to 9.75% (39/400) smoker (x2=17.92, p=<0.001) as diagnosed by spirometry following Global Initiative for Chronic Obstructive Lung diseases (GOLD) criteria. Using operational severity criteria adopted from GOLD, mild obstruction was found in 36% (18/50), moderate obstruction in 50% (25/50) and severe obstruction was found in 14% (7/50) of all subjects. The hall mark symptom of COPD, exertional dyspnoea was seen in only 4.3% (17/400) of subjects, nonspecific symptoms like cough and sputum were found in 10% (40/400) and 9.3% (37/400) respectively. Physical signs like abnormal breath sound and rhonchi were found in 3.3% (13/400) and 2.3% (9/400) respectively. Our study observed that spirometry was an effective and easy method for detection of COPD in risk group population like smokers and thus promotes smoking cessation efforts to reduce the burden of COPD in the community.