Epidemiology of Copd in Urban Communities: Prevalence, Determinants, and Public Health Implications

Abstract

Objective: Bridge the gap between pulmonology and public health to measure the epidemiology and important environmental and behavioral risk factors for COPD and assess the public health implications across diverse urban populations.

Methods: A cross-sectional study was done in a large metropolitan area in three different urban districts: high density commercial, mixed residential-industrial, and peri-urban low-income settlements, all within the community. A multistage stratified cluster random sample of 4500 adults aged ≥40 years was drawn. Independent determinants of COPD were obtained using multivariable logistic regression.

Results: The overall prevalence of COPD was 8.4% (95% CI: 7.6–9.2%). Males were significantly more likely (11.2%) than females (5.8%) to be prevalent (p<0.001). Independent risk factors for COPD were current smoking (Adjusted Odds Ratio [aOR] = 4.2, p<0.001), prolonged exposure to occupational dust/fume (aOR = 2.8, p=0.002), use of indoor biomass fuels (aOR = 2.1, p=0.015) and low socioeconomic status (aOR = 1.9, p=0.021).

Conclusion: The prevalence of COPD in urban communities is still high and is a result of various traditional risk factors (tobacco) and emerging urban hazards. The results highlight the paramount need for comprehensive public health measures, such as concentrated spirometry screening in primary care and stringent urban environmental measures.