|Year : 2006 | Volume
| Issue : 2 | Page : 93-94
Respiratory disease epidemiology in India
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh., India
S K Jindal
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh.
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Jindal S K. Respiratory disease epidemiology in India. Lung India 2006;23:93-4
India is a vast country with an enormously variable population. There are large differences in geographical, environmental, ethnic, religious, cultural and socioeconomic parameters in different population groups in India which affect the human health and disease occurrence. Therefore, the study of disease epidemiology in India is singularly difficult. Nonetheless, it is of paramount importance to know of their prevalences and risk factors. Factually speaking, the great variability makes it even more crucial to do an epidemiological mapping of diseases in the country.
Information on epidemiology of chronic respiratory problems in India is available through several small and sporadic studies conducted by individual investigators from time to time. The two most common respiratory disorders which have been studied included asthma and chronic obstructive pulmonary disease (COPD). But the studies have often lacked in uniformity of definitions, designs, methodologies and reporting techniques. Moreover, the samples sizes were generally small but for an occasional report.
In the last decade, we have had studies on prevalence of asthma in adults from Mumbai and Chandigarh , . There are also a few reports on asthma in children including the results of the International Study of Asthma and Allergies in Childhood (ISAAC) ,,, . Information on COPD is rather limited but for a few surveys , . It had been therefore difficult to assess the magnitude of the problem based on reasonable assumptions and estimates.
Fortunately, the Indian Council of Medical Research constituted a National Asthma Task Force with whose sponsorship a multicentric study on respiratory disease epidemiology was undertaken at four centres in India i.e. Chandigarh (the coordinating Centre), Delhi, Bangalore and Kanpur. This study lays the foundation not only for assessment and estimation of the disease burden and management strategies but also for future research in chronic airway obstruction.
The mean asthma prevalence in this study is reported in 2.38% of 73605 individuals of over 15 years of age  . One or more respiratory symptoms were present in 4.3-10.5% subjects. Female sex, advancing age, usual residence in urban areas, lower socioeconomic status, history suggestive of atopy, history of asthma in a first degree relative and all forms of tobacco smoking were associated with significantly higher odds of having asthma  . There were a few centre to centre differences underlining the importance of assessment in different regions. In a report published in this issue of the journal, utilizing the same study design and methodology, the overall prevalence of asthma in Jaipur, Rajasthan has been reported as 0.96% with almost similar risk factors  Analysis of the 62109 nonsmoking subjects in the ICMR study revealed that the environmental tobacco (ETS) exposure was an important risk factor for asthma and respiratory symptoms  . The mean prevalence of COPD defined by the criteria of chronic bronchitis, was 4.1% in 35295 adults of over 35 years of age in whom tobacco smoking and ETS exposure among nonsmoker individuals were found as important risk factors  . In a separate analysis for the population prevalence of tobacco smoking, 15.6% were detected as ever-smokers  . Bidi was reported as the commonest form of smoking, especially in the rural areas.
The results of this study have helped to answer some of the questions and fill some of the lacunae in the knowledge of epidemiology of asthma, tobacco smoking and COPD. An important observation made for the first time in the study is the clear demonstration of a statistically significant association between ETS exposure and COPD in nonsmoking patients  .
A lot more needs to be studied on these two common disorders responsible for a huge health care burden. This is the time to assess the problem of chronic airways obstruction beyond its routine recognition by cough, wheezing and breathlessness responding variably to bronchodilators and/ or other inhaled drugs.
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